Names keep going on me. It is one of the most common things anyone says about their own memory, and one of the least useful on its own, because it happens to everybody and it also happens at the start of something.
Worrying about it does not sort it out. What does help is knowing which detail actually separates the two, and it is not how often it happens.
The tip of the tongue is not the thing
An ordinary lapse has a shape. You know the word. You can feel its size, sometimes its first letter, often what it is next to. It will not come, and then it turns up — twenty minutes later, in the car, once you have stopped chasing it. Or you change the subject and it arrives on its own.
That is retrieval being slow. It is normal, it gets worse with tiredness and stress at any age, and it is not what anyone is worried about.
The pattern worth attention looks different in a few particular ways.
The word does not come back at all. Not later, not in the car, not when someone else says something adjacent. It simply is not there, and the gap does not fill in.
Something else takes its place. That thing in the kitchen, the one for heating things up — and microwave never arrives, not with time and not with a prompt. Description standing in for the word, repeatedly, is more informative than the number of times it happens.
It reaches names that are close in. Losing the name of someone you met twice in 2019 is not the same event as losing your grandson’s. Frequency of use matters far more than how many words go missing.
It is starting to shape conversations. Sentences get shorter. Certain topics get avoided. Someone who used to tell long stories has stopped, and everyone has assumed they are just tired.
None of those, alone and once, means anything. Together, and held over months, they are a good enough reason to have it looked at properly instead of argued about.
If you live in two languages, read this bit first
This is where families here get it wrong in both directions, and it is worth being precise.
If English is your first language and you have lived in Spain for twenty years, you lose Spanish words constantly. Everybody does. Words in a language learned as an adult are more fragile under tiredness, stress or illness than words in your first, and losing them is not a sign of anything on its own. Neither is mixing the two mid-sentence — that is ordinary in bilingual households and always has been.
So the thing to watch is not the Spanish. It is the first language, in well-practised situations: the words for things in your own kitchen, the names of the people you speak to weekly, the vocabulary of the work you did for thirty years.
The mirror-image error is just as common. A family who only ever hears their mother in English, on the phone, may miss that her Spanish has become much harder work than it was — or may over-read that same fact, when the honest explanation might be that she has simply stopped using it since her husband died and her neighbours moved away.
Either way: say clearly, at the first conversation, what languages the person actually uses, for what, and how well they used them before. It genuinely changes what can be tested and how the results should be read. Assuming it, in either direction, is where the errors come from.
Before you conclude it is memory
Two things get mistaken for word-finding trouble often enough to be worth ruling out first.
Hearing. A name that was never clearly heard cannot be remembered, and from the outside the two look identical. Somebody who is losing hearing gradually will not necessarily know it, and will look vague in exactly the situations — several people talking, a noisy bar — where names come up most.
Everything else that degrades memory. Sleep, low mood, grief, medication, general health. Low mood in an older person often shows up as forgetting and slowness rather than as sadness, and it is missed constantly. If someone has been widowed in the last year, that year is not a fair sample of anybody’s memory.
That list is the reason the first move is not to search for a disease name at three in the morning, and not to start a puzzle regime either. Exercises cannot tell you why a word went missing — that is what they are worst at.
What to write down before an appointment
This is the single most useful preparation, and it takes about ten minutes.
Two or three concrete examples from this month, not from the last five years. For each one: what word went, in what situation, whether it came back on its own, and whether somebody had to supply it. An approximate date is enough.
That is worth considerably more in a first session than she’s been struggling more lately, which says neither how much nor since when. It also protects you against the two ways memory of memory goes wrong: forgetting that this was already happening at Christmas, or reading every ordinary lapse of the last decade as an early sign now that you are looking for one.
Add anything that changed at the same time — a new tablet, a bereavement, a hospital stay, a move, sleep that broke.
What to do in the house meanwhile
Stop testing. Who came round on Tuesday? What’s my sister’s name? Spot checks feel like taking an interest and land as an exam. They raise the tension, and tension makes retrieval worse, which makes the next check worse still.
Do not supply the word instantly. Give it a few seconds. Being finished for you, all day, is what stops people trying.
Do not make them perform for a third party. Go on, tell him what you were telling me. Nothing shuts a person down faster.
Make the environment carry some load. One place for the keys, a visible calendar, a pill box. That is not surrender; it is removing friction so that what is actually going on becomes easier to see.
Where an assessment comes in, and what it will not do
If the pattern holds, the useful next step is a structured look at how attention, memory, language and planning are actually working — rather than how they seemed on a bad afternoon. What that produces is a description: what is intact, what has slipped, what it explains about daily life, and what is worth doing about it.
The assessment is always carried out in person, at home. It is never done by video call: the tasks need physical material, timed conditions and someone in the room watching how each one is approached. Language tests in particular cannot be run down a screen and mean anything.
And the boundary matters: a medical diagnosis is made by a doctor, with their own examination and investigations. A cognitive profile can support the suspicion that something has changed. It cannot name a disease, and it cannot rule one out by itself.
When to ask
When the words have started to slow you down at home, at work or when you go out. When the family has been noticing it steadily rather than once. When you would rather look at it properly than carry on worrying about it, which is the version that costs the most and settles nothing.
You do not need to be sure first. Not being sure 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 — which matters more than usual in this particular case, because assessing someone’s words in a language they have to translate into first tells you very little.
The first conversation is free and can be by phone or video call, from here or from abroad. It is a chance to describe what you have been noticing and to find out whether an assessment is the right next step at all.