How to talk about the past with a parent who has dementia

When a parent is living with dementia, conversations change. They may ask the same question three times in ten minutes, or lose the thread of what you said a moment ago. It's easy to start avoiding the past altogether, in case it ends in confusion or tears.

Yet many families find that the past is where the best conversations still happen. Someone who can't tell you what they had for lunch may still describe the kitchen they grew up in, the smell of their father's workshop, or the song that played at their wedding.

This guide is about those conversations: how to start them, how to keep them kind, and how to hold on to what your parent shares.

What the research says, briefly

Talking about the past with someone who has dementia has a formal name: reminiscence work. The UK's Alzheimer's Society describes it as encouraging a person to talk about a period, event or subject from their past, often using prompts such as music, objects and photos. It can be done in a group or one to one, by a professional, a friend or a family member.

The Society says this kind of work can help maintain a person's self-esteem, confidence and sense of self. It also gives a fair warning: it may sometimes bring back sad or difficult memories, and the person may become upset.

The strongest summary of the evidence is a 2018 Cochrane review, which looked at 22 studies with 1,972 participants, as reported by the National Elf Service. Cochrane's own summary says there is some evidence that reminiscence can improve quality of life, thinking, communication and possibly mood, though all the benefits were small and depended on how and where it was done. The reviewers found no evidence of harm.

So it's worth being honest: reminiscing won't slow dementia down. What it can do is give you and your parent good time together, on ground where they may still feel capable.

Why the old memories often last longer

In many types of dementia, recent memories tend to fade first, while much older ones can stay clearer for longer. That's why a parent may forget your visit last week but describe their first job in detail.

Music seems to be especially durable. A 2015 study led by Jörn-Henrik Jacobsen, described by the Max Planck Institute for Human Cognitive and Brain Sciences, found that brain regions linked to long-term musical memory are among those least affected by Alzheimer's-related changes. It's one study, and the mechanism isn't settled, but it fits what many carers notice: a song from someone's teenage years can open a door that questions can't.

Before you start

A little preparation makes these conversations easier for both of you.

• Pick a good time of day. Many people with dementia are brighter at certain times. You probably already know when your parent is at their best.
• Find a quiet spot. The Alzheimer's Association recommends one-to-one conversation in a quiet space with few distractions, and keeping eye contact. Turn off the television.
• Bring something to look at or hold. A photo album, a school report, an old recipe card, a piece of costume jewellery, a record. Objects do a lot of the work.
• Keep it short. Twenty minutes of easy talk is better than an hour that ends in tiredness.

How to ask without testing

The single biggest change you can make is to stop asking questions that have a right answer.

"Do you remember Aunt Joan's wedding?" puts your parent on the spot. If they don't remember, they may feel embarrassed or anxious. Instead, offer the memory yourself and let them join in.

• Instead of "Do you remember our holidays in Cornwall?", try "I was thinking about those holidays in Cornwall. I loved the beach with the big rocks."
• Instead of "Who's this in the photo?", try "This looks like a summer garden party. Everyone's very dressed up."
• Instead of "What year did you move to Leeds?", try "Tell me about moving to Leeds."

Open, gentle prompts about feelings and senses tend to work better than questions about names and dates. What did the house smell like? What did your mum cook on Sundays? What music did you dance to? Who made you laugh?

The Alzheimer's Association also suggests asking one question at a time and giving the person time to respond without interrupting. For a parent in the middle stages, simpler questions, including yes-or-no ones, may be easier.

When the details are wrong

Your parent may tell you they met your father in 1962 when you know it was 1958. They may mix up two houses, or say a sibling was there when they weren't.

Let it go. The Alzheimer's Association advises against criticising, correcting or arguing. Correcting a date rarely helps anyone and can end the conversation. What matters is the feeling of the story: the nerves of a first date, the pride of a first pay packet.

If you're keeping a family record, you can note the facts separately later. In the moment, the story belongs to them.

When a memory is painful

Sometimes reminiscing brings up grief, war, a lost child, a hard childhood. This is the risk the Alzheimer's Society mentions, and it's real.

If your parent becomes upset, stay with them. The Society's guidance is that the person should be supported to express their feelings and to talk about the memory if they're comfortable doing so. You don't have to fix it. A hand on the arm and "That sounds so hard" is often enough.

If they want to move on, follow their lead. A gentle change of subject, a cup of tea, or a favourite song can help. If certain topics upset them every time, it's fine to leave those alone.

Ideas that tend to work well

Here are some starting points families often find easy:

1. Music from their teens and twenties. Play it, sing along, ask what it makes them think of. Or just listen together.
2. Food and cooking. Make a family recipe together, or ask how their mother made it. Smell and taste are powerful cues.
3. Seasons and holidays. Psychologists Michael Nadorff and Mary Dozier, writing in The Conversation, suggest open questions such as what family traditions were like around the holidays when they were growing up, along with old photos and seasonal music.
4. Work and skills. People often light up talking about what they were good at: fixing engines, sewing, nursing, teaching, running a shop.
5. Places. A street name, an old map, a photo of their hometown on a tablet.
6. A life story book. The Alzheimer's Society describes life story work as making a personal record of important experiences, as a book, photo album or something digital. Building one slowly, a page per visit, gives each conversation a small purpose.

Keeping what they tell you

Many families say the same thing afterwards: "I wish I'd written it down." Stories told on a good afternoon can be gone by the next visit, from their memory and from yours.

A few simple ways to keep them:

• Write a short note after each visit. Three or four lines in a notebook or on your phone: the story, a phrase they used, how they seemed.
• Record their voice, with their agreement. Ask first, in plain words, and respect a no. If your parent can no longer really understand what you're asking, think about what they would have wanted and talk it over with the rest of the family.
• Bring in the wider family. Brothers, sisters and grandchildren will each get different stories. If you have a shared set of questions, everyone can add to the same picture. Our list of questions to ask your grandparents works for parents too, as long as you soften them into prompts rather than tests.
• Start sooner rather than later. If your parent has just been diagnosed, the early stage is often when longer, richer conversations are still possible. It's also a time when they can choose for themselves which stories they want kept.

If your parent can still answer questions in their own time, one option is Eternix Memory Circle. You write a few questions and send a private link from your own phone by WhatsApp, text or email, and they answer by voice or in writing, with no account and no app to install. Their answers come back to you encrypted, so only you can read and hear them, and you can keep asking new questions over time. You can start for free here. For many people with dementia, though, a family member sitting beside them, holding the phone and asking the questions aloud, will work better than a link on their own.

The point of it all

These conversations won't always go well. Some days your parent will be tired, muddled or sad, and you'll leave feeling you got nothing. Other days you'll hear a story you've never heard before, in their own voice, and laugh together the way you used to.

Both kinds of day count. You're spending time with your parent on the ground where they still feel most like themselves, and keeping a little of who they are for the people who come after.