Dementia
When the person you know is slowly becoming someone different
Watching a parent or partner lose their memory, their independence, or their sense of who they are is one of the most painful experiences a family can go through. A clear assessment changes what is possible — for the person living with dementia, and for everyone who cares for them.
Recognition
Does This Feel Like You?
If any of the following sound familiar, you are not alone — and you have come to the right place.
Your family member is forgetting things they should know — recent conversations, appointments, names of people close to them
They repeat the same question or story several times within a single conversation
They get confused about the date, the time, or where they are — especially in unfamiliar settings
Their personality has changed — they are more irritable, suspicious, withdrawn, or disinhibited than before
They are struggling with tasks they used to manage easily — bills, cooking, driving, using appliances
They are getting lost in familiar places, or losing track of what they were doing mid-task
You have noticed a decline but other family members are dismissing it as normal ageing
As a caregiver, you are exhausted, worried, and unsure how to manage what is ahead
Understanding
What Dementia Actually Is
Dementia is an umbrella term for a group of progressive brain conditions that cause a decline in memory, thinking, behaviour, and the ability to perform everyday activities — severe enough to interfere with daily life. It is not a normal part of ageing, though it becomes more common with age.
The most common type is Alzheimer's disease, which accounts for 60–70% of cases and is characterised by progressive memory loss, language difficulties, disorientation, and gradual loss of functional independence. Vascular dementia — caused by reduced blood supply to the brain — is the second most common type. Lewy body dementia and frontotemporal dementia present differently: the former with visual hallucinations, fluctuating cognition, and Parkinsonism; the latter with pronounced personality and behaviour changes often before significant memory loss.
Dementia is progressive and currently irreversible. However, accurate diagnosis matters enormously — because some presentations that mimic dementia are treatable, because different types of dementia require different management, because medications can slow progression and manage symptoms in some forms, and because families who understand what they are dealing with are far better equipped to provide care and plan ahead.
Clearing the air
What People Often Get Wrong
Misconceptions about Dementia cause real harm — they delay help and increase shame. Here is what is actually true.
Common belief
"Memory loss is just a normal part of getting old"
What's actually true
Some slowing of memory and processing speed is normal with ageing. Dementia is not. Forgetting where you put your keys is normal; forgetting what keys are for is not. Significant, progressive memory impairment that affects daily functioning warrants assessment, not acceptance.
Common belief
"There is no point in getting a diagnosis because nothing can be done"
What's actually true
A diagnosis opens access to medications that can slow progression in Alzheimer's disease, allow for treatment of reversible causes, enable better management of behavioural symptoms, and — critically — allow the person and family to plan, make important decisions while capacity is preserved, and access support services.
Common belief
"Dementia only affects memory"
What's actually true
Dementia affects a wide range of cognitive and behavioural functions — language, spatial awareness, judgment, personality, emotional regulation, and the ability to perform daily tasks. In frontotemporal dementia, behaviour and personality changes may precede memory loss entirely.
Common belief
"The person knows they have dementia and is hiding it"
What's actually true
Lack of insight — anosognosia — is a neurological feature of many dementias, not deliberate concealment. The person may genuinely not register or perceive their own deficits. This is not denial; it is a symptom.
Common belief
"Dementia is only a concern for very elderly people"
What's actually true
While dementia is more common with advancing age, early-onset dementia (before age 65) does occur. Any significant progressive decline in cognitive function deserves assessment regardless of age.
The science
Why This Happens
The causes of dementia vary by type. Alzheimer's disease involves the accumulation of abnormal protein deposits — amyloid plaques and tau tangles — that disrupt neural communication and cause progressive neuronal death. Vascular dementia results from cumulative damage to the brain's blood vessels, often through strokes or chronic small vessel disease. Lewy body and frontotemporal dementias involve other patterns of abnormal protein accumulation in specific brain regions.
Risk factors include advancing age, cardiovascular risk factors (hypertension, diabetes, high cholesterol, smoking), physical inactivity, social isolation, hearing loss, and depression. Some of these are modifiable — managing cardiovascular risk and remaining mentally and socially active in midlife and beyond are associated with reduced risk. Genetic factors play a role in some forms, particularly early-onset Alzheimer's and frontotemporal dementia.
Real impact
How Dementia Affects Daily Life
The effects go well beyond the symptoms themselves.
Independence
Dementia progressively erodes the ability to manage finances, drive, cook, and eventually personal care. Planning for this loss of independence — while the person still has capacity to participate in those decisions — is one of the most important practical tasks following diagnosis.
Safety
Wandering, leaving appliances on, vulnerability to exploitation, and driving risk are all significant safety concerns. Anticipating and planning for these risks is an essential part of dementia management.
Behavioural and psychological symptoms
Agitation, aggression, depression, anxiety, psychosis, sleep disruption, and disinhibition are common at various stages of dementia. These behavioural and psychological symptoms of dementia (BPSD) cause significant distress to both the person and their caregivers — and are treatable.
Family and caregivers
Dementia is a family diagnosis. The demands on caregivers — practical, emotional, financial, and relational — are enormous. Caregiver burnout is common and serious. Families need support in their own right, not just the person with dementia.
Legal and financial planning
Powers of attorney, advance care directives, and financial planning need to be established while the person still has capacity to participate. Delay makes this significantly more complicated.
Before seeking help
What Most Families Try First
Most people who come to us have already tried a lot of other things. If any of these sound familiar, you are not alone — and you have not failed.
Attributing changes to normal ageing — or to stress, grief, or other life events — and not seeking assessment
The family noticing the changes but the person themselves dismissing concerns and refusing assessment
A GP consultation that provides limited investigation and no specialist referral
Managing increasing difficulties at home alone — taking on more and more caregiving without support — until a crisis forces a change
Conflict within the family about how serious the problem is, or about decisions regarding care
Waiting for the problem to become undeniable before seeking help — by which point the window for capacity-based planning has often passed
The process
How Dementia Is Diagnosed
Dementia assessment requires a structured evaluation of cognitive function, a medical assessment to exclude reversible causes, and a careful history that includes the perspective of a family member who knows the person well.
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A detailed clinical history from both the person and an informant who knows them well — covering the timeline of changes, which functions are affected, and the impact on daily life
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Cognitive assessment using standardised tools to evaluate memory, attention, language, visuospatial function, and executive function
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Physical examination and investigation — blood tests, thyroid function, B12, and brain imaging to exclude reversible causes of cognitive decline and to support diagnosis of dementia subtype
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Assessment of behavioural and psychological symptoms — depression, anxiety, psychosis, sleep disruption, and agitation — which require their own management
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Assessment of the caregiving situation and family support system
An accurate diagnosis — including the type of dementia — is the foundation of appropriate management. Not all cognitive decline is dementia, and not all dementia is Alzheimer's.
Ready to get clarity?
An accurate assessment is the starting point for everything. Dr. Divya takes the time to get it right — and to explain her findings clearly, without pressure.
Treatment
How We Help
Management of dementia encompasses medical treatment, behavioural intervention, caregiver support, and careful long-term planning.
Comprehensive geriatric psychiatric assessment — establishing diagnosis, type, stage, and a clear management plan
Medication where appropriate — acetylcholinesterase inhibitors for Alzheimer's disease and Lewy body dementia can slow progression; memantine for moderate to severe stages; medications for BPSD where behavioural approaches are insufficient
Management of behavioural and psychological symptoms — structured non-pharmacological approaches are first-line for BPSD; medication is used judiciously when needed
Caregiver education and support — helping families understand the condition, what to expect, and how to respond to challenging behaviours in ways that reduce distress for everyone
Guidance on legal, financial, and care planning — supporting families in taking the practical steps that preserve options and reduce future crisis
Coordination with community services, social support, and specialist services as needs evolve
This is part of our Geriatric Psychiatry service — where you can learn more about Dr. Divya's full approach.
Outcomes
What Improves with the Right Support
We are always honest about what is realistic. With appropriate support and time, these are the changes families and individuals most often notice.
A clear diagnosis that replaces uncertainty and allows the person and family to understand what they are dealing with
Better management of behavioural symptoms — reduced agitation, improved sleep, less distress for the person and their carers
A family that is informed, supported, and not navigating alone
Legal and financial plans in place while the person still has capacity to participate in making them
Slowing of cognitive decline in some types of dementia with appropriate medication
A caregiver who has their own support and is not at breaking point
Timing
When to Seek Help
If you have noticed progressive changes in memory, thinking, or behaviour in an older family member — do not wait for the problem to become severe. Earlier assessment produces better outcomes.
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Progressive memory loss that affects daily functioning — not just occasional forgetfulness
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Personality or behaviour changes that are out of character and persistent
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Getting lost in familiar places, or significant difficulty with previously routine tasks
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Increasing confusion about time, place, or the identity of people they know
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Any concern from the person themselves, however briefly expressed, about their own memory
An earlier assessment preserves more options — for treatment, for planning, and for the person to remain involved in decisions about their own care.
Not sure if you need help?
It is completely okay to reach out just to ask. Dr. Divya is happy to help you work out whether an assessment is the right next step — with no pressure.
Common questions
Frequently Asked Questions
Is dementia hereditary?
The genetic risk varies by type. Most dementia is not directly inherited — having a parent with Alzheimer's increases risk but does not make it certain. A small proportion of early-onset Alzheimer's and most frontotemporal dementia cases have a stronger genetic component. Concerns about family history are worth discussing in the context of a proper assessment.
Can dementia be cured?
There is currently no cure for the common forms of dementia. Some medications can slow progression and manage symptoms. Some causes of cognitive decline — thyroid disorders, B12 deficiency, depression, normal pressure hydrocephalus — are reversible, which is why assessment matters. Research into disease-modifying treatments is active.
Should the person be told their diagnosis?
Yes, in almost all cases — with appropriate sensitivity and support. People with dementia have the right to know their diagnosis, to make plans while they retain capacity, and to access support. Concealing the diagnosis from the person while telling the family is rarely justified and often counterproductive.
How do I manage when they refuse to accept there is a problem?
Lack of insight is a common feature of dementia, not deliberate obstruction. Engaging through the person's own concerns and priorities — rather than confronting their denial directly — is usually more productive. Psychiatric assessment can often be introduced as a general health check rather than a specific memory concern.
When should we think about care home placement?
This is a deeply personal decision that depends on the level of care needed, the family's capacity to provide it, and the safety of the person at home. There is no universal answer. What matters is that the decision is made with good information, appropriate support, and without guilt — care home placement is not a failure of family duty.
Also worth reading
Related Conditions
Early assessment changes what is possible — for your family member and for you.
Book a consultation with Dr. Divya C.R. at Intune Mind, Coimbatore. In-person and telepsychiatry appointments available.