Q: My mother who has dementia talks to relatives who have died. What should I do?

A: There are wake up calls in the world of caregiving. Too often the world "normal" becomes an accepted condition and the world of "clinical red flags" get overlooked.

Your Mom is doing her best to articulate to you that it is time to bring in the experts, in the medical community around you, and make them part of your team of resources. Clinical symptoms such as these highlight the importance of getting a geriatrician involved who can see and experience the entire clinical picture. Geriatricians will defer to gero-psychiatry if they see depression or behavior that needs to be assessed and addressed.

Dementia is a progressive condition. However, in the world of disease management, it does not mean that we need to accept it without intervention. Sometimes, we have to live in the moments with our loved ones and understand their reality; sometimes, we have to understand if there is an underlying condition.

Of course, we should talk to our loved ones when they are reminiscing and sometimes not as lucid as we have come to expect. The human touch is a vital connection for an "in the moment" intervention. Although touch connection and attention might be needed in the moment, it does not replace the need for assessment and evaluation on an ongoing basis.

I am a firm believer that self esteem is vital for the caregiver and caree, no matter what. The environment, medication, or some other factor may need to be looked at when questions arise that caregivers cannot answer.

That means that we need to attend to our own minds, bodies, and souls. Self-esteem also means that our loved one needs to feel safe and competent in the environment they are in, as well.

Medicare is quite open to making sure your Mom is seen by a medical doctor to assess what is the best environment for her and if medications, whether too much or too little, play a factor.

Caregivers need not be martyrs. The medical and mental health world is waiting. Speak to her primary doctor, neurologist, psychiatrist or licensed allied health professional trained in geriatric care to assess and evaluate what is the best next move.