What if just one conversation could shift the course of someone’s life? That’s exactly what we’re diving into in this episode of This Is Getting Old, where I’m joined by Dr. Melissa Armstrong, a neurologist and researcher specializing in Lewy body dementia, to talk about one of the most emotionally charged moments in healthcare: receiving a diagnosis of dementia. It’s a conversation that touches everyone—whether you’re a caregiver, a clinician, or someone noticing changes in memory and thinking. And while nothing can fully prepare you for that moment, understanding how to approach it with empathy and clarity can make all the difference.

Dr. Armstrong explains that “dementia” is an umbrella term that covers several diseases, including Alzheimer’s, and that what we often call “normal aging” may, in fact, be something more serious. She also emphasizes how stigma and fear can delay diagnosis—even though early answers can lead to better care, support, and opportunities for research participation. It’s critical to include the person being evaluated in conversations early and often, while also gathering insight from caregivers and loved ones. In her clinic, Dr. Armstrong makes it a point to hear directly from the person living with memory challenges before speaking with family members.

One of the more difficult issues families face is a lack of insight from the person living with dementia. Sometimes that’s mistaken for denial, but in many cases, it’s a direct result of changes in the brain. Visual hallucinations or delusions—especially in conditions like Lewy body dementia—can be very real to the person experiencing them. Rationalizing or arguing rarely helps. Instead, distraction and redirection are often the most effective ways to reduce distress and maintain calm for both the person with dementia and their caregiver.

When it comes to delivering a diagnosis, Dr. Armstrong stresses the importance of clarity, compassion, and setting the tone for what comes next. People generally want a specific diagnosis—not just “memory problems”—because that guides them to the right treatment options, support groups, advocacy organizations, and future planning. And while misdiagnoses can happen, a thoughtful, evolving evaluation process can help ensure accuracy. A diagnosis isn’t a one-time event; it’s a starting point on a constantly shifting path.

Once a diagnosis is given, leaving the doctor’s office with written information, action steps, and a plan for follow-up is key. Beyond medical treatment, things like regular exercise, diet changes, and social engagement play a huge role in maintaining quality of life. Support groups, advocacy organizations, and even adult day programs can help preserve the very social connections that keep our brains healthy. I always say: build your care team early and don’t go it alone. Isolation is the enemy here.

If you or someone you love is noticing changes in memory or thinking, don’t wait. Get checked out. The road may not be easy, but you don’t have to walk it alone. Let’s keep moving forward—together.

If you found this helpful, don’t forget to subscribe to my YouTube channel, Melissa B PhD, for more insights on dementia care and aging.