The family usually notices before the person does. And then the family starts checking — gently, lovingly, constantly — and within a month every meal has an exam in it.
This is about the conversation itself: what to say, what to stop saying, and how to raise it without the raising becoming the problem. Whether it is worth looking at in the first place is a different question, and so is what to do when the answer keeps coming back as there’s nothing wrong with me.
What it looks like when it has gone wrong
Questions over lunch that are really tests. Lists that get hidden. One sibling giving way and the other losing patience. A fear of leaving them on their own, sitting next to a fear of taking the car keys, with nobody saying either out loud.
The volume goes up because nobody knows what they are supposed to do. And the person in the middle of it defends themselves, which is the only sensible response to being examined at your own table.
Four habits worth dropping
All four are done out of love. All four make the next conversation harder.
“Do you remember…?” as a check. If the answer is no, they have not been helped, they have been caught. And the cost is not one awkward moment — it is that they start avoiding conversations where it might happen again, which takes away exactly the practice that was doing them good.
Talking about them in front of them. She’s been doing this for months, haven’t you, Mum. People notice this even when their memory does not hold the details, and being discussed in the third person in your own kitchen is a very specific humiliation.
Removing tasks all at once. You shouldn’t be cooking. You shouldn’t be driving. Sometimes one of those is genuinely necessary. Announcing it without having talked about it first is worse than the change itself: what stings is not losing the task, it is finding out that other people have started deciding for you.
Comparing them to how they were, in every other sentence. You’d never have forgotten that before. It does nothing for the present and it lands as a running commentary on decline.
Changing how you speak does not fix anything on its own. It does lower the temperature enough that a decision can get made.
What tends to work instead
Presence without a prognosis. I’m here; you don’t have to prove to me that you’re fine. It is a short sentence and it does more than any of the careful ones.
One example, recent and specific. Not a list of everything that has gone wrong since March. A dossier starts an argument, and then the argument becomes the subject instead of the memory.
Leave the label out of it. Let’s get it looked at; nobody has to decide today what it is. Most refusals are refusals of the word, not of the appointment.
Make it ordinary rather than an event. Attaching it to a check-up that is already happening, or to something their own doctor has suggested, works far better than a family summit. If the suggestion comes from their doctor, it usually travels further than it does from a son or daughter.
Send the right person. In most families that is not whoever has been arguing with them about it. It might be the other sibling, an old friend, or a grandchild.
Doing this from another country
If you live in England and they live in Granada, the conversation has two extra difficulties, and both are worth naming.
It gets compressed into a visit. You have a fortnight, you can see the difference clearly because you last came at Christmas, and so the whole thing gets raised on day two of a holiday — with a house full of people, everyone out of routine, and a flight home on the horizon. That is close to the worst set of conditions available. If you can, raise it early and small, and let it sit for a few days rather than trying to reach a decision before you leave.
It gets decided in a group chat. Three siblings in two countries reach an agreement about what should happen, and only then does anyone speak to the person it is about. They can tell. Being presented with a family consensus is the fastest way to produce a refusal, and the refusal will be about the process, not the appointment.
Worth agreeing in advance who is the one point of contact — not so that the others are excluded, but so that your mother is not having the same difficult conversation four separate times in a week.
Getting ready for the appointment
The most useful thing you can bring is not a worry. It is a question.
Write down three things: what has changed in the last year, what has stopped holding up, and what you actually want to know. Is her memory worse than it should be at seventy-eight? Can he still manage his own money safely? The neurologist has asked for a cognitive profile. Those lead to different pieces of work, and saying which one you want changes what happens.
Concrete examples with rough dates are worth more in a first session than any amount of she’s been getting worse lately, which says neither how much nor since when.
Two things about how the work is arranged, because they decide what can be organised from where.
The assessment itself is always done in person, at home in Granada — never by video call. The tasks need physical material, timed conditions and someone in the room watching how they are approached, and no arrangement gets around that. Home has a second advantage here: there is no clinic to persuade anyone into a car for, which removes one whole argument from the list.
The first conversation is a different thing entirely. That one is free, and it can be by phone or video call — so it can be you having it from the UK, before anything has been said at home, purely to work out whether it is worth arranging at all.
And the boundary that saves families a great deal of confusion later: a medical diagnosis is made by a doctor, with their own examination and investigations. What a neuropsychologist can do is describe how the person is functioning day to day and advise the people living with them.
When to arrange it
When the conversations at home have started to revolve around the forgetting. When you no longer know which tasks they can safely do alone. When you need something concrete to take to a doctor rather than a collection of anecdotes. Or when every visit now contains the same argument.
You do not have to be certain first. Not being certain is the reason to ask.
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 parent’s home in Granada.
The first conversation is free, by phone or video call, and you are welcome to have it from the UK. Bringing a description of what has changed, rather than a conclusion, is the most useful way to start it.