Cognitive decline in aging parents isn’t always easy to recognize, especially when Mom or Dad still seems perfectly capable of managing everyday life. Sometimes, the signs are hiding in the routines we’ve grown so accustomed to seeing.
I met with a local physician recently who, surprisingly-not-surprisingly, I played softball against in high school. I went to Penn. She went to Elkhart. We were friends for a while, life happened, and now all these years later, we’ve reconnected in the medical world. Funny how life works, isn’t it?
During a recent visit, she told me a story I haven’t been able to stop thinking about. Her daughter had gone to a friend’s grandparents’ house. When my physician friend introduced herself to the grandmother, she said something along the lines of, “Hello, I’m Dr. L. What’s your name?”
Grandma confidently gave her a name. The wrong name. Not kind of wrong, not a nickname and not a name she had gone by years ago. Just…wrong.
Later, my physician friend asked the girl’s mother if everything was okay with her mom. The interaction had concerned her, and she wondered whether there might be some cognitive changes happening. The response?
“She doesn’t have dementia. She’s fine.”
Except there was reason to look a little closer. And that’s where I’m going to challenge you today. Because we throw around the words “Mom is fine” an awful lot.
But What Does “Mom Is Fine” Actually Mean?
She still lives alone. She makes her own breakfast without burning the house down. When you visit, she’s watching the same television shows she’s always loved. She still knows exactly how to get to her favorite channels.
Her Sundays are spent at church, followed by brunch with the same church friends she’s known for years. She never gets your name wrong when you stop by.
Her pantry is full of her favorite foods, so she’s clearly still managing those trips to Kroger just fine. And she pays her bills. On time. Every time. So she’s fine.
Maybe.
But what happens when you change the script? That’s one of the tricky things about cognitive decline in aging parents. The everyday routines may look perfectly normal, even when handling something unexpected has become more difficult.
Can she find what she needs when Kroger rearranges the shelves? What about when the doctor changes a medication, can she understand and follow the new instructions?
What happens when someone calls and tells her she owes money? If the power goes out, does she handle it the way she always has, or does it create more confusion and panic than it used to? Is she willing to go somewhere she hasn’t already been 427 times?
Does she sometimes respond to an unexpected question in a way that doesn’t quite make sense? Has she started having more difficulty following conversations?
That’s where the information lives.
Not necessarily in the things Mom has done the same way for 40 years, but in what happens when something changes.
Familiar Routines Can Hide Changes We Don’t Want to See
People experiencing cognitive changes can sometimes function remarkably well inside a familiar routine. In fact, cognitive decline in aging parents can be especially difficult to recognize when they’ve spent decades doing the same things in the same places. Think about it.
Mom has lived in the same house for more than 30 years. Nobody has moved the furniture in at least 25 of those years. She’s shopped at the same grocery store for decades. She’s made her favorite meals so many times that she could practically prepare them with her eyes closed.
The roads may look a little different, but she knows where she’s going. The people who visit are usually the same people and even the conversations tend to follow a familiar pattern.
“How are you doing, Mom?”
“Fine.”
“Everything going okay?”
“Yep.”
“Need anything?”
“Nope.”
And everybody goes home feeling pretty good about things.
But here’s what I want you to understand.
Being able to follow a deeply practiced routine isn’t necessarily the same as being able to think through a new problem, make a decision, or adapt when something unexpected happens.
Those are different abilities.
Now, before somebody comes after me with a pitchfork, yes, some people are simply creatures of habit. They’ve eaten Raisin Bran from the same bowl at 7:14 every morning since 1986, and they see absolutely no reason to renegotiate that arrangement. Fine!
There’s nothing inherently wrong with liking a routine. But when someone becomes increasingly rigid about that routine, struggles with unfamiliar situations, or has difficulty managing changes that never used to bother them?
It’s worth getting curious. Not suspicious. Not accusatory.
Curious.
And one of the best places to start is with the questions you’re asking.
Stop Asking Questions That Only Have One Easy Answer
If you ask Mom whether she’s managing everything okay, what do you think she’s going to say? “I’m fine.”
She may genuinely believe everything is fine. Or perhaps she doesn’t want you to worry. Admitting that something has become difficult could feel like the first step toward losing her independence. And sometimes, she may not even recognize that anything has changed.
Whatever the reason, a yes-or-no question often tells you very little. Instead, ask open-ended questions that invite Mom to explain how she’s doing something. When you’re trying to understand whether cognitive decline in aging parents might be affecting everyday decisions, you need to hear more than a simple “yes” or “no.”
And please, don’t turn this into an interrogation. You’re not conducting an investigation. You’re having a conversation with someone you love.
Here are five questions that can help you learn a whole lot more:
1. “Mom, How Do You Keep Track of All Your Medications?”
Instead of asking: “Mom, are you taking your medications okay?”
Try: “Hey Mom, I was thinking about all the medications you have now. How do you keep track of which ones you take in the morning and which ones you take at night?”
Then let her tell you. Maybe she has a pill organizer, maybe she has a written list, or maybe she has a system that works beautifully.
Fantastic. But don’t stop at the first answer.
“Okay, and when you get a refill, how does that work? Do you call it in, or does the pharmacy handle that automatically?”
“What happens if the doctor changes one of your medications?”
Now you’re learning something about the process, not just whether Mom says she’s taking her pills. Can she explain her system? Does she understand what happens when something changes? Does what she’s telling you match what you’re observing?
You’re not trying to catch her making a mistake. You’re trying to understand whether the system she relies on is still working.
2. “What Would You Do If You Couldn’t Drive Tomorrow?”
Instead of: “Are you still okay to drive?”
Try: “Mom, if you woke up tomorrow and couldn’t drive anymore, what would you do? How would you get to Kroger or your appointments?”
She might immediately say: “Well, I can still drive!”
“I know, Mom. I’m not saying you can’t. I’m just curious. What if your car wouldn’t start tomorrow? What would you do?”
Now you’ve taken the conversation away from whether she should be driving and toward something much more useful. Sometimes, cognitive decline in aging parents becomes more noticeable when they have to think through a situation they haven’t encountered before.
Can she come up with another option? Would she call someone? Does she know who could help? Can she think through the situation without becoming overwhelmed? And remember, we’re not evaluating her driving ability based on one hypothetical question.
We’re simply learning more about how she approaches an unexpected problem. That’s information worth having.
3. “Mom, Show Me How You Pay Your Electric Bill.”
Instead of: “Are you keeping up with your bills?”
Try: “Mom, I swear there are twelve different ways to pay a bill now. How are you paying your electric bill these days?”
If she says online, you might respond: “Oh, you do it online? Show me how you do it. I need to get better about keeping track of mine.”
Or: “When does that one usually come due?”
Maybe she shows you her entire system, complete with a spreadsheet that would make an accountant jealous. Wonderful! But maybe she struggles to explain something she says she does regularly.
Maybe she can’t remember which bills are on automatic payment. Maybe she seems unusually confused about a process she previously managed without difficulty.
Again, you’re not looking for a gotcha. And one unfamiliar technology or confusing bill doesn’t automatically mean there’s a cognitive problem. You’re paying attention to whether something has changed from what was normal for her.
That’s the important part.
4. “What Would You Do If You Fell and Couldn’t Reach Your Phone?”
Instead of: “Mom, you know to call me if you fall, right?”
Try: “Okay, random question. Let’s say you fell right here and your phone was sitting on the kitchen counter. What would you do?” “Well, I’d get up.” “Okay, but what if you couldn’t?”
Then wait. Let her think. Don’t immediately rescue her from the question.
“How would you get someone’s attention?” “Is there another way you could call for help?”
You may discover that she has a perfectly reasonable plan, or you may discover that the plan everybody assumed she had doesn’t actually exist. And that’s important, whether Mom is experiencing cognitive changes or not. Knowing to call someone in an emergency and having a realistic way to do it are two different things. This conversation can also help you identify practical safety changes before an emergency happens.
Mom Says She’s Fine. But How Can You Really Know?
Maybe Mom is still managing most things on her own. Maybe Dad insists he doesn’t need any help. And maybe they’re right.
But what about those little things you’ve started noticing? The forgotten appointments, the confusion over something that used to be simple, or the hesitation when you ask a question they should know how to answer?
It’s hard to know what’s a normal part of aging, what deserves a closer look, and when it might be time to consider additional support.
That’s why I created the Care Readiness Checklist.
It’s a practical resource to help you take a more thoughtful look at how Mom or Dad is managing everyday life, recognize areas where their needs may be changing, and identify questions worth exploring before a small concern becomes a much bigger problem.
Because you don’t need to wait for a crisis to start paying attention.
GET THE CARE READINESS CHECKLIST
5. “Mom, What Did the Doctor Actually Tell You Yesterday?”
This is one of my favorites. Mom went to the doctor yesterday. Don’t ask: “How did your doctor’s appointment go?”
Because you already know what you’re probably going to get. “Fine.” Instead, try: “Mom, what did Dr. Smith say yesterday?”
“He said everything was good.”
“Good. What did he say about that swelling in your legs?”
“He said something about my medicine.”
“Okay. What did he want you to do with it?”
Now you’re having a conversation. And you’re getting information. Maybe Mom remembers every detail and tells you to mind your own business.
Fantastic.
But what if she can’t explain what happened? What if the details don’t make sense? What if she gets frustrated when you ask another question? Or what if she tells you the doctor didn’t change anything, but there’s a brand-new prescription sitting on the counter?
You may realize that she didn’t understand or retain important instructions from the appointment. That doesn’t automatically tell you why. Hearing difficulties, stress, complicated medical information, medication effects, and other health issues can all play a role. But it does tell you something needs attention.
Maybe she needs written instructions, maybe she’d benefit from having someone accompany her to appointments, with her permission, or maybe it’s time to bring your concerns to her healthcare provider.
That’s information. And information gives you a chance to help before a misunderstanding becomes a much bigger problem.
The Most Important Part? Stop Talking and Start Listening.
I mean that lovingly. Because sometimes we ask a question and then immediately start answering it for the other person.
“Mom, how are you keeping track of your medicine? You’re still using that little pillbox I bought you, right?”
Well, there goes your opportunity to learn anything. You’ve just handed her the answer. Or maybe Mom pauses for a few seconds, and you rush to fill the silence because it feels uncomfortable. Don’t.
Ask the question. Then be quiet.
Let her think, let her explain, and let her find her own words. Have a conversation that requires more than a yes, a no, or an answer she’s given you a thousand times before. And listen to what she’s actually saying.
Not what you hope she’s saying. Not what you think she means. What she’s telling you. Pay attention to whether her answers make sense, whether they match what you’ve observed, and whether anything seems different from the way she used to manage these situations. Recognizing possible cognitive decline in aging parents often starts with noticing those small differences over time, rather than waiting for one dramatic event.
One unexpected answer isn’t a diagnosis. Look for patterns, changes over time, and difficulties that affect everyday life. And if something concerns you, talk with a qualified healthcare professional rather than trying to figure out the cause on your own.
You’re Starting to Notice Changes. Now What?
Sometimes the hardest part isn’t recognizing that something may be changing with Mom or Dad. It’s figuring out what you’re supposed to do about it.
You don’t want to overreact. You don’t want to take away their independence. And you certainly don’t want every visit to turn into an argument about what they can or can’t do anymore. But you also don’t want to ignore something important and find yourself wishing you’d acted sooner.
That’s exactly why I created the Prepared Daughter Survival Kit.
It’s designed to give you practical guidance and support as you navigate the questions, responsibilities, and difficult conversations that come with an aging parent.
You don’t have to have all the answers today. But you can start feeling more prepared for whatever comes next.
EXPLORE THE PREPARED DAUGHTER SURVIVAL KIT
Sometimes “She’s Fine” Is What We Need to Believe
There’s an enormous difference between respecting someone’s independence and refusing to look more closely because we’re afraid of what we might find. And I understand why families do it. Even the possibility of cognitive decline in aging parents can be frightening, especially when you know it may lead to conversations and decisions nobody feels ready to face.
If Mom is fine, nothing has to change. You don’t have to start an uncomfortable conversation, you don’t have to figure out how to add another responsibility to an already full plate, and you don’t have to worry about whether she needs more help, whether it’s still safe for her to live alone, or whether your family is approaching decisions nobody feels ready to make.
If Mom is fine, you have more time. You can deal with all of that later. Here’s the thing.
If Mom really isn’t fine, later may pick the date for you.
Monday at 2 p.m., when the police call because she got lost on the way to Kroger. Or Friday at 10 p.m., when she’s panicking because she thinks she needs to get to work but can’t find her car keys. Suddenly, everybody wants to know: “How did we not know it had gotten this bad?”
Sometimes you truly didn’t know. But sometimes? You didn’t ask. Or somebody did raise a concern, and the response was: “She’s fine.”
We have to do better than that. Not by taking away independence at the first sign of difficulty, not by treating every forgotten word or unusual answer as proof of dementia, and certainly not by making Mom feel like she’s being tested every time you visit. But by being willing to notice changes, ask thoughtful questions, and follow up when something doesn’t seem right.
Get Curious Before You Get Concerned. Get Concerned Before You Get a Crisis.
Brain changes don’t always announce themselves by making someone forget their daughter’s name. Some conditions develop gradually, and the earliest changes may be subtle enough that families explain them away for quite a while. That’s why understanding the possible signs of cognitive decline in aging parents matters. It gives families an opportunity to notice changes, ask questions, and seek professional guidance sooner. Especially when familiar routines are still working. That’s why I want you to change the conversation.
Ask about the process, not just the result. Pay attention to what happens when something unexpected interrupts the normal routine. Notice when a task that used to be easy becomes unusually difficult. And if you’re seeing repeated changes, don’t dismiss them simply because Mom can still make breakfast, watch her favorite shows, or get herself to church.
Bring those observations to her healthcare provider. Some causes of confusion and memory difficulty are treatable, and an evaluation can help determine what is happening. You don’t have to have all the answers. You just have to be willing to ask better questions.
Get curious before you get concerned. And most importantly, get concerned before you get a crisis.
Because “I didn’t know” is heartbreaking when there truly wasn’t a way to know. But when the signs were there and nobody wanted to look? That’s something I don’t want any family to have to live with.
The Questions Don’t Stop Here. Neither Should the Conversation.
One conversation with Mom or Dad can tell you a lot, but navigating the changes that come with aging isn’t something you figure out in a single afternoon. New questions come up. Circumstances change. And sometimes you don’t even know what you should be asking until you’re already facing a difficult decision.
That’s why I created the Save Our Sanity Society newsletter.
I share real-life stories, practical advice, expert insights, and resources to help you recognize what matters, ask better questions, and make more informed decisions for yourself or someone you love.
Think of it as a little extra guidance from someone who’s spent more than 26 years working with older adults and their families. And the best part? It’s completely free, whether you prefer digital or print.
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You don’t need to wait until something goes wrong to start learning what questions to ask. Sometimes, the right information at the right time makes all the difference.
Your partner in care,
Shelley
