How to Tell if Your Parent Has Dementia

If you are reading this, someone you love — probably a parent — is doing things that worry you. Maybe it's small. The same question twice in a holiday dinner. A bill you found unopened. A familiar route they got lost on. Maybe it's bigger than small, and you've been quietly carrying it for months.

This is a guide for adult children who aren't sure whether what they're seeing is dementia, normal aging, or something else. It is written for the midnight Google search — the one you do when you don't want to bring it up to a sibling yet because you're not sure if you're overreacting.

You are probably not overreacting.

The question to start with

Before listing signs, there is one question that moves the needle more than any other: "Is this person meaningfully different from how they were two years ago?"

Not "are they getting older" — everyone is. Not "do they forget things sometimes" — everyone does. The question is whether, compared to who they were on average over a recent baseline, something in how they think, decide, or function has shifted.

If the answer is yes, there is something worth paying attention to, even if the explanation turns out to be benign.

Concrete signs, in daily-life terms

Below are the things that come up most often in clinical interviews when a family member's first report is "I just feel like something's off." If several of these are present in someone you know, sustained over weeks to months, it is worth a medical conversation.

Memory

• Asks the same question multiple times in the same visit, and doesn't seem to remember the first answer.
• Forgets important recent events — a doctor's appointment last week, your birthday, a phone call two days ago.
• Relies heavily on you, or on sticky notes, in a way they didn't before.
• Loses track of objects and cannot reconstruct where they were last seen.
• Increasingly asks others to confirm basic recent facts.

Language and conversation

• Pauses in the middle of sentences to search for a word, often substituting "that thing" or "the one."
• Loses the thread of a conversation at a dinner table and stops participating.
• Calls familiar things by unusual names ("the round thing on the wall" for a clock).
• Writing becomes harder — shorter replies to letters, less structured thought in emails.

Judgment and decisions

• Makes uncharacteristic financial decisions. Falls for scam calls. Gives out information on the phone.
• Wears clothes inappropriate for the weather. Hygiene or appearance slips.
• Drives less safely — getting lost in familiar areas, failing to notice a traffic signal, small fender-benders.

Mood and personality

• Becomes more anxious in unfamiliar settings or with larger groups.
• Becomes more irritable, suspicious, or withdrawn.
• Stops activities they used to love — a regular book club, a weekly call with a friend.
• Friends or siblings describe them as "not quite themselves."

Daily function

• Missed bills, unpaid parking tickets, expired registrations.
• Kitchen accidents — the stove left on, food left out.
• Difficulty with multi-step tasks that were once automatic (a familiar recipe, the monthly reconciliation).
• Avoidance of tasks that used to be ordinary.

Physical

• Shuffling gait, balance problems, falls that weren't typical.
• Visual hallucinations, especially benign ones ("there were children playing in the living room").
• Acting out dreams during sleep, shouting or moving violently while asleep.
• Sudden changes — these often indicate delirium from an acute illness rather than dementia.

If you're seeing several of these

Start a short behavior diary. Over the next two to four weeks, jot down:

• Specific incidents and dates
• What your parent said, or what happened
• Anyone else present who noticed
• Whether a new medication, illness, or life event might be involved

Two weeks of specific examples is worth more than six months of vague impressions. Bring the diary to the eventual appointment.

Questions to ask yourself

These are the questions a clinician will end up asking you or your parent. Sitting with them before the visit helps:

1. When did this start? Best guess in months or seasons.
2. Is it gradual, or did it come on suddenly? Sudden usually means delirium or stroke, not slow-developing dementia.
3. Is it getting worse, staying the same, or better?
4. What can they still do independently? Cooking, cleaning, driving, shopping, medication, finances, dressing, bathing, toileting.
5. What can they no longer do independently?
6. Have other family members noticed?
7. Have there been recent changes — a new medication, a fall, a surgery, a loss, a move?
8. Is there family history of dementia?
9. Any safety concerns yet — driving, stove, wandering, financial exploitation?

How to start the conversation

This is often the hardest part. The person you're worried about often does not want to have this conversation, and may minimize, deflect, or get angry. A few approaches that tend to work better than the alternatives:

• Lead with observation, not diagnosis. "I noticed you had a harder time at dinner remembering what we'd been talking about. I wanted to check in." Not "I think you might be getting dementia."
• Frame the visit as routine. "It's been a while since your last physical. I'd like to go with you, and we'll just ask about a few things."
• Offer to go together. Partnership, not inspection.
• Pick a low-pressure moment. Not Thanksgiving dinner, not when they're already tired, not in front of grandchildren.
• Expect more than one conversation. The first usually ends inconclusively. The second, a few weeks later, often lands differently.

If you're not sure how to start, our caregiver how-to guide for home clock drawing tests has specific script examples that work in the same register.

If they refuse to go to a doctor

This happens often. A few options:

• Call their primary care physician privately. Explain what you've observed. Many offices will note it and bring the concern into the patient's next routine visit themselves.
• Wait a few weeks and try again with slightly different framing.
• Ask another trusted family member to be part of the conversation — a grandchild, a longtime friend, a sibling.
• Do nothing for a month and observe. If things are stable, your worry may have been acute rather than sustained. If things are getting worse, the conversation gets easier the next time.
• Consider a home-based cognitive screen like a clock drawing test. A low score sometimes reframes the question for a reluctant parent.

When not to wait

A small set of situations are medical urgencies, not "let's schedule a visit next month":

• Sudden confusion over hours to days — usually delirium, stroke, or severe infection.
• Sudden weakness, numbness, or trouble speaking — possible stroke.
• A recent head injury followed by new confusion.
• A sudden severe headache.
• Confusion with fever or other signs of acute illness, especially in a parent over 70. Urinary tract infections in older adults are famous for causing sudden confusion that reverses with antibiotics.

Any of these belong in an emergency department, not in a "schedule a visit" conversation.

What to expect at the first visit

A typical first primary care visit for cognitive concerns includes:

• A detailed history from both your parent and you, ideally together.
• A cognitive screen — likely a Mini-Cog or clock drawing test, possibly a MoCA.
• A medication review — some common medications cause cognitive changes.
• Blood work to rule out reversible causes (thyroid, B12, folate, metabolic panel).
• Possibly a referral to a neurologist, geriatrician, or memory clinic for a fuller workup.
• A plan — what we're going to watch, what we're going to treat, what to do next.

The goal of this visit is not diagnosis. The goal is to start the process.

One last note

Watching a parent change is hard in ways nothing else prepares you for. It is also a shared experience. The Alzheimer's Association runs a free 24-hour helpline (1-800-272-3900) with clinicians and social workers who do nothing but talk to people in your exact situation. If you need someone to talk to before your parent's next doctor visit, that is what they are there for.

A good first step for you is the doctor's office. The best second step is not trying to carry this alone.

Related reading

• Early Signs of Dementia vs Normal Aging
• 10 Warning Signs of Alzheimer's Disease
• Clock Drawing Test for Caregivers: How to Administer at Home
• What to Do After a Low Clock Drawing Test Score

References

• Alzheimer's Association. 10 Early Signs and Symptoms of Alzheimer's. alz.org.
• Alzheimer's Association Helpline: 1-800-272-3900.
• National Institute on Aging. Talking with Your Doctor About Memory Problems. nia.nih.gov.

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Disclosure: Dr. Shimada is the founder of Tokei Health. This article is informational and is not a substitute for individual medical advice from your own clinician.