Two hands being held

Having an open dialogue with your aging loved ones about cognitive decline means you'll be better prepared if it occurs.

As our relatives age, their cognitive abilities may decline, including their memory and thinking skills. The stark reality is that cognitive decline is not limited to just a few — statistics show that it is becoming increasingly common. This means proactive planning is more important than ever. Having the conversation with your elderly family members is the first step to managing the physical, emotional and financial challenges when cognitive decline strikes.

Dr. David Brown, CIBC’s Corporate Medical Director, provided us with insights into cognitive decline as well as some personal anecdotes. David and his wife had first-hand experience with an elderly relative who experienced cognitive decline. They were also part of her support circle.

We often paint an idyllic picture and tend to tune out the negative. However, if we are being truly objective, we might recognize that something is not quite right.

The most obvious things to look for are emotions bubbling to the surface or denial that something bad, like a fall, has occurred. You might notice that the individual repeats themselves or loses words when speaking. They may also come up with strange explanations for things. David recounts an episode that occurred with his loved one. “She was stopped by the police because she was travelling at high speed, and explained she wanted to travel from Toronto to Ottawa and back in a day. This was very strange because she would normally never consider this a viable, or even wise, option.”

Human beings have the ability to hide things well. Watch for behavioural patterns and ask probing questions to your relative’s acquaintances, then connect the information. David explains, “You can also gently rattle the cage. For instance, you can address the fact that their home might not be safe any longer. You’re touching a nerve, because you’re saying that the status quo isn’t acceptable any longer. This will get them thinking.”

With the prevalence of dementia increasing at an alarming rate1, it is important to have an open and honest discussion as early as possible, and gently persist until your loved one is a willing participant. “We asked our relative quite bluntly, ‘What’s your plan B?’ Despite offering her a number of options, she decided that it was too early to worry about plan B. She preferred to ‘cross that bridge’ when she got there. Actually, she would cross that bridge when we got there.”

The conversations should never stop, but may be difficult and even painful. With time and patience you can help create a plan. Once in place, you will all have peace of mind knowing that you can face the issues should they arise. Here are some key things to consider:

Identify a trusted network. Work through questions, such as who will manage my money on a day-to-day basis? Who should have access to my accounts, assets, will? Who should I appoint as my power of attorney?   

Choose a trusted medical expert. A gerontologist is a key specialist for the elderly. They closely follow a patient’s physical health and are specifically trained to manage the psychosocial component of cognitive decline.

Understand potential threats. Everyone should be aware that elder abuse is a concern that comes with cognitive decline. It is important to understand the warning signs, which might include donations to unverified charities or unexplained cheques to strangers.

As part of the planning process, it is also important to understand the economic impact of cognitive-related issues. Consider that the annual cost to Canadians to care for those living with dementia is $10.4 billion.2

“An aging population combined with longer life spans and strained social services has in recent years seen more and more Canadians taking on the role of caregiver for their aging parents. And, in the coming years that tendency is only likely to intensify.”—CIBC economics experts Benjamin Tal and Royce Mendes.

This is David’s message for all of us. Walk, walk, walk! Exercise is so important to your overall well-being. Also, watch your blood pressure and sugar levels and keep your mind sharp! Reading, crossword puzzles or any activity that requires brain power is great. Most importantly, do not isolate yourself because that can lead to depression.

Facing cognitive decline is challenging, but preparing for it gives peace of mind. As a caregiver, it gives you a sense of comfort knowing that plans are in place that take into account your loved one’s wishes.

David’s last words on the topic are eye-opening. “This is not just about the elderly and supporting them. In reality, we should all start preparing for cognitive-related impairments in our 50s. Remember, by the time you find out that something’s wrong, it’s probably too late.”