Getting a memory assessment

Most people wait too long, and the waiting costs them the part of the process where something can be done.

The reasons are understandable. Nobody wants the answer. There is a belief that nothing can be done anyway, so why find out. And there is a real fear that the assessment itself takes something away.

All three are worth arguing with.

This is general information, not advice. Memory concerns should be assessed by a GP.

Why going early is better

A good share of memory problems are not dementia. This is the single most important fact on this page. Depression, untreated hearing loss, thyroid problems, vitamin B12 deficiency, medication effects, infections, alcohol and sleep apnoea all produce memory and thinking problems, and all are treatable. Assuming dementia and not checking means a treatable condition goes untreated.

If it is dementia, early makes a practical difference. It means the person can be part of decisions about their own life while they are clearly able to: where they want to live, who they want making decisions, what matters to them. It opens access to treatments where they are appropriate, and to support and education. And it lets a family plan calmly rather than in a crisis.

A diagnosis explains behaviour that families have been taking personally. That relief is real. A great deal of accumulated resentment about someone being difficult, lazy or deliberately awkward turns out to be a condition.

What to watch for

The signal is a change from how that person used to be, not a single lapse.

• Repeating the same question or story within one conversation
• Difficulty with familiar tasks: paying bills, cooking a known meal, following a recipe
• Getting lost or confused somewhere familiar
• Trouble finding common words, or losing the thread mid-sentence
• Poor judgement, particularly about money, or new vulnerability to scams
• Putting things in odd places and being unable to retrace steps
• Withdrawing from activities and conversation
• Personality or mood changes, including new suspicion or irritability
• Difficulty with sequences: appointments, medications, getting dressed in order

Forgetting a name and recalling it an hour later is not on this list.

How the process actually runs

Start with the GP, and book a long appointment. They will take a history, do a physical examination, order blood tests, review every medication, and usually do a short cognitive screening test. That blood panel is where the treatable causes get found, which is why it comes first.

Bring someone who knows them. This matters more than people expect. The person may not be able to describe the changes, and often genuinely does not perceive them. A daughter’s account of the last eighteen months is diagnostic information.

Write it down before you go. What changed, roughly when, and specific examples. “He got lost driving to my sister’s house in June” is worth ten times “his memory is not great”.

Expect referral onward if the picture is unclear. That may be to a geriatrician, a memory clinic, a neurologist or a clinical neuropsychologist. Scans are sometimes arranged.

A neuropsychological assessment is the detailed version: several hours of structured tasks measuring memory, attention, language and reasoning against expected performance. It is used when a short test is not enough, when the difference between depression and dementia needs settling, or when the specific pattern matters for treatment. It is tiring, and worth booking for a morning.

How to raise it with someone who does not want to

Rarely successful head-on, and there are better routes.

Go via the body. A GP check-up for tiredness, sleep, blood pressure or a medication review is legitimate, gets them in the room, and the memory conversation can happen there. Most GPs are practised at this.

Use a concrete event rather than a label. “You were worried about the car on Tuesday” is harder to dismiss than “I think you have a memory problem”, and it does not ask them to accept a diagnosis in the kitchen.

Do not make it a family delegation. Being outnumbered produces resistance every time.

And do not argue about whether there is a problem. Say what you noticed, say you would like it checked, and let it sit. Repeating it calmly next month works better than winning the argument today.

If safety is genuinely at stake, particularly driving or medications, that changes the urgency and is worth raising with the GP directly rather than negotiating at home.

Afterwards

Whatever the outcome, ask three things: what happens next, who is coordinating it, and when is the review.

If a treatable cause was found, that is the good outcome and it needs following up rather than filing. If it is dementia, the practical next steps are an aged care assessment, getting decision-making documents sorted while the person can be properly involved, and building routines that support them. Our guides to keeping routines that work when someone has dementia and documents worth sorting before you need them both cover that ground.

And get hearing and vision checked regardless, because both imitate and both worsen cognitive difficulty. See hearing and vision, the checks people skip.

For services and information start at myagedcare.gov.au. If you are trying to work out a first step, ring us and a person will answer. Getting the assessment arranged and chased up is part of what we coordinate.