The hard part is not usually getting an answer. It is the week afterwards, when there is a report on the table, possibly a diagnosis from a doctor, and no clear idea of what anybody is supposed to do on Monday.
Families describe this remarkably consistently. A document nobody can read without a dictionary. A fear of the label, sitting alongside a fear of doing nothing. And underneath, a practical question that the diagnosis did not answer: what changes at home, and who does what.
Two different jobs
It is worth separating them, because they get confused constantly.
The medical diagnosis belongs to the doctor. Whether there is a disease, which one, and what treatment follows is theirs, established with their own examination and investigations.
Neuropsychological work is the other side: looking at how the person functions — what is intact, what has gone, what that means for daily life — and proposing something to do about it. Cognitive stimulation, follow-up to see whether things are holding, and work with whoever lives with them. Those are complementary, not competing. Fernando has worked alongside neurologists — assessment and follow-up in the Movement Disorders Unit at Hospital de Sant Pau, and at Ace Alzheimer Center in Barcelona — and the boundary is not a formality: it is knowing which questions belong to whom.
If your parent has come through the Spanish system or their doctor in the UK has been involved, the report is written to be useful to them. If nobody medical has looked at this yet, the plan may well start by saying so.
What a plan looks like
Not an open-ended commitment. A usable plan has three parts, and the third is the one families rarely get offered.
A block of work. Specific, with a stated purpose: stimulation aimed at particular functions, or follow-up, or both, plus practical adjustments in the house.
A point where it gets reviewed. Agreed in advance, with a date on it. Not “we’ll see how it goes.”
A decision at that point. Carry on, change the approach, or stop because it has gone as far as it usefully can. Stopping is a legitimate outcome and should be said out loud at the start, so nobody feels they have failed when it arrives.
Nobody should be signing anyone up to something indefinite on day one. If what you are being offered has no review point and no exit, ask why.
What the plan does not promise
It does not stop a disease. Nothing in this field does, and anyone telling you otherwise is selling something.
What good work can do is different, and worth having: make the day easier to run, reduce the friction that turns a difficult afternoon into an argument, keep the person doing what they can still do for as long as they can do it, and give the family a way of behaving that isn’t guesswork. That is a real change in how a household feels. It is just not a cure, and the difference should never be blurred.
Nor is stimulation a package bought off a shelf. Worksheets applied to everybody regardless of profile are an activity, not an intervention. What is worked on should follow from what the assessment found; if it doesn’t, it is an expensive way to fill an hour.
Where you can be, if you live abroad
The testing has to happen in person, at home in Granada. That is fixed, and no arrangement gets around it.
Almost everything else is more flexible than families expect. The feedback session, where the results are explained and the plan is agreed, can be done by video call, with you and your sister on the line from England while your father is at his kitchen table. So can the review conversations later on. So can the sessions that are about coaching whoever is doing the day-to-day — which, if you are the one ringing every night to check whether the tablets were taken, includes you.
Being present for the explanation matters more than it sounds. When one relative hears it and passes it on, the plan degrades in transmission: by the third retelling, “attention is the weak point, so keep conversations short” has become “he can’t concentrate”, and nobody remembers what they were supposed to do differently.
Agree who is the point of contact, and make sure that person is not the only one who has heard the reasoning.
What the family gets asked to do
Usually less than they fear, and different from what they expect.
Most of it is about consistency: everybody using the same wording for the same things, the same routine, the same level of help for the same task — because the most tiring thing for someone with a cognitive change is not the difficulty, it is four people helping in four different ways.
Some of it is about restraint. Not correcting every error. Not stepping in at the first hesitation. Not quizzing. Letting something be done slowly rather than done for them.
And some of it is about the carer, which nobody puts in the plan and everybody should. Whoever is doing this every day is also part of what has to hold up over the coming months. If the plan has nothing in it for them, it isn’t finished.
When to arrange it
When you have a question and no idea what would answer it. When there is already a medical report and what is missing is what to do at home. When the family needs concrete instructions rather than a diagnosis. Or when the last few months have been spent reacting, and you would like to be a step ahead of it instead.
Talking it through in English
Fernando Ruiz Martínez is a psychologist and neuropsychologist in Granada (Col. M-39091), working in English or Spanish, at your home in Granada or by video call for the parts that allow it.
The first conversation is free, by phone or video call, and can be had from the UK before anything is arranged. Bringing the report you already have to it is often the fastest way to find out what is worth doing next.