Q: My elderly mother is showing signs of dementia. She is often confused and forgetful, but she doesn't recognize it. Do I tell her?

A: There is an old adage in psychological theory. Filtering out all the "psychobabble," the saying is: "when caregiving, the 'messenger often gets killed'"metaphorically of course.

No doubt when a loved one is becoming confused and forgetful, the person is probably aware of it already. They may suspect they have dementia or Alzheimer's. Shame, stigma and fear may prevent them from acknowledging that reality. Hence, my suggestion is that the caregivers let the elderly person's physician deliver the diagnosis and be the messenger; not you.

Sometimes, an elderly person will listen to a trusted, objective third party more so than a well-intentioned family member.

Prepare the doctor with some background about the symptoms your elderly mother is exhibiting. Then suggest a routine visit so the doctor can recommend and conduct an evaluation. This may be where the doctor refers your parent to a neurologist.

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Preparing the doctor ahead of time enables the "messenger" to be clear, direct, and available for questions that educate, empower, and allow the caregiver to support a loved one diagnosed with Alzheimer's or dementia.