How do I evaluate my sister for possible dementia?

Since your sister has stated in the past that she would like to know if she had dementia, I think you can open a conversation with her about this. "Sis, I know you don't sleep well. You seem to be more and more forgetful. Do you think it would be a good idea to take this up with your doctor, and see if there is another cause besides sleep issues, and if there is anything to do about it?" You don't have to mention the word "dementia" if you feel that would upset her.

What kinds of things is she forgetting? Might she leave the burners on or take her once a day medicine three times? Is her memory problem putting her at risk for dangerous behaviors?

I know that we associate dementia with memory loss, and that is correct. But it is almost always associated with other lapses as well. For example, poor judgment or belligerence or inability to handle the check book or credit cards could all be linked to dementia. Is Sis showing any other signs of new and unusual behavior?

Does Sis live alone? Does she have moldy food in her fridge? Worse, does she eat it? Is she behind on some bills and paying others twice?

Depending on the severity and risk level of her forgetfulness, and especially if there are other symptoms present, I think you should encourage her to discuss her health with her doctor. You could offer to accompany her if she's afraid she might forget all her symptoms or what the doctor tells her.

I'm curious, if the family suspects dementia, why wouldn't they want her evaluated?

My guess is denial.

No one wants a dementia diagnosis and no family member wants to have to deal with what comes with the caregiving and decision making.

Jeanne has the right approach to handling the situation. I would try to go along with her so you can hear it from the doctor's mouth.

Dear happyjack,

I know its tough in families but I hope your sister will go to the doctor an evaluation. We all have to start somewhere. I think the lack of sleep and age is probably a factor. But she could also have diabetes, high cholesterol, high blood pressure, side effects of medication, vascular dementia, general related age decline.

It's hard in families to see our loved ones age and then struggle to get the help they need. No one wants to admit to needing help but hopefully with you as her advocate she will.

Thank you for your responses. She does have hypertension and elevated cholesterol. I will be seeing her in late July and will bring the subject up then. I live 3 hours away from her and think this should be an "in person" conversation. Yes, she has left the burners on, fallen, and my niece is now paying the bills. My sis is also severely depressed which I'm sure is a contributing factor. Just so sad to see the sister I knew changing so much. If there's something that can be done that would be wonderful. Her hubby is a doc and doesn't think the meds for dementia work so she's not taking any of them.

There are no drugs that reverse dementia.

There are meds that can ameliorate the symptoms. So, think depression, anxiety, agitation, insomnia, paranoia, delusions, hallucinations. All of these are symptoms that are sometimes seen in various types of dementia.

Meds, judiciously used, can help.