Few moments land quite like the one where you realise a parent or close relative is not quite themselves: the repeated question, the word that will not come, the appointment forgotten, the small confusion that you cannot entirely explain away. It is frightening, and the two most common responses are equally human: to panic, or to quietly look the other way and hope it passes. There is a calmer middle path, and most of it is practical. This is a UK guide to walking it.
In a hurry? The short version
First, it might not be dementia
This is the most important thing to know before you assume the worst. A surprising number of things can look like dementia and yet be entirely treatable, which is exactly why the answer is never to guess and brace, but to get a proper assessment. Common culprits include a vitamin B12 deficiency, an under- or over-active thyroid, depression (low mood in older people can blunt memory and concentration so convincingly it used to be called "pseudodementia"), the side effects or interactions of medication, and infections, a urinary tract infection in an older person can produce sudden confusion.1
One pattern is worth singling out. If the change came on suddenly, over hours or a few days, rather than creeping in over months, that points away from ordinary dementia and towards delirium, which is a medical situation that needs prompt attention.1 So a sudden, sharp decline is a reason to contact the GP or NHS 111 quickly, not to wait and watch.
What early signs actually look like
The early signs of dementia are usually mild and gradual, and easy to rationalise one at a time.2 The ones people most often notice in a relative are:
When these are mild and not yet interfering much with daily life, doctors often call it mild cognitive impairment, which sometimes, but not always, progresses to dementia.2 It is also worth knowing that early cognitive change is often erratic rather than steadily downhill: good days and bad days, fluctuations that can make you doubt yourself. Keeping a simple, dated note of what you observe is genuinely useful, both for steadying your own sense of what is happening and for the GP later.
The single most useful first step: a GP
Everything else, assessment, tests, referral, support, runs through a GP, so the practical foundation is simply making sure your relative is registered with one and can actually get seen.3 This sounds obvious, but it is the step that most often quietly blocks everything else, particularly for older people who have moved, who rarely go to the doctor, or who have drifted off a list. If that is the case, helping them register, in person if need be, is the most useful single thing you can do, and you do not usually need to see a doctor to register; it is often a form and a short administrative visit. Get that in place first, because nothing else can happen without it.
How to raise it, without a row
This is the part people dread, and often the reason nothing happens for months. A few principles make it much easier, and they come straight from how these conversations actually go.
What the GP does, and the memory clinic
At the GP, expect a physical examination, blood and urine tests (to rule out the treatable causes above), some questions about what has been happening, and a short memory or thinking test.3 It really helps if someone who knows your relative well is there, or has sent a note in advance, to describe the changes, because the person themselves often cannot, or will not, see them. If the GP cannot account for the symptoms another way, they will usually refer on to a memory clinic, where a specialist (an old-age psychiatrist, a geriatrician or a neurologist) can make a fuller assessment.3 None of this is fast, the NHS rarely is, but getting into the system early is what matters.
Why early really does matter (and a word on the new drugs)
It is worth being honest about what an early diagnosis does and does not buy you, because there has been a lot of headline noise about new treatments. The genuine benefits of acting early are: ruling out the treatable causes, accessing existing medications and support that can help with symptoms and quality of life, qualifying for help and adaptations sooner, and, above all, doing the planning while your relative can still be fully part of it.
On the much-publicised new Alzheimer's drugs, lecanemab and donanemab: both have been licensed by the UK regulator (the MHRA), but as of 2025 the National Institute for Health and Care Excellence (NICE) has decided they are not cost-effective for the NHS, so they are not available on the NHS.4 I mention this only so you are not chasing a treatment that, for almost everyone, is not currently an option here. The case for early diagnosis rests on support and planning, which are real and valuable, rather than on a wonder drug.
The one piece of groundwork to do early: power of attorney
If you do nothing else after reading this, look into setting up a lasting power of attorney, because it can only be done while your relative still has the mental capacity to make the decision.5 Leave it too late and the alternative is a slow, expensive court process. In England and Wales there are two lasting powers of attorney, one for property and finances and one for health and welfare, registered with the Office of the Public Guardian (currently around £92 each to register, and several months to come back). Scotland has its own system under the Adults with Incapacity (Scotland) Act 2000, with a continuing power of attorney for finances and property and a welfare power of attorney for health and care; these can be granted as two separate documents or combined into one, and are registered with the Office of the Public Guardian (Scotland). Northern Ireland uses an enduring power of attorney for finances. Setting this up early, together, while it is still straightforward, is one of the kindest and most practical things you can do.
Supporting from a distance
Many people are trying to help a parent who lives a long way away, which adds its own helplessness. A few things make distance more manageable. Get them registered with a local GP and, where you can, line up a visit around an appointment so you can be in the room. You can often join a GP appointment by phone if you cannot be there in person. Build a small local network, a neighbour, a nearby friend, a relative, who can be your eyes between visits. And keep that simple, dated record of changes, so that when you do speak to professionals you have something concrete rather than a vague worry.
Look after yourself too
Watching a parent change is one of the harder things a person goes through, and it tends to be carried quietly. You do not have to hold it alone, and there is support designed precisely for the relatives, not only the patient. Admiral Nurses, the specialist dementia nurses run by Dementia UK, offer a free helpline for exactly this kind of worry, and the Alzheimer's Society runs a dementia support line. Carers UK and Age UK can help with the practical and financial side. Using them early, before things reach crisis, is what keeps you well enough to keep helping.
UK helplines and resources
dementiauk.org.
alzheimers.org.uk.
nhs.uk/conditions/dementia.
gov.uk/power-of-attorney; Scotland:
publicguardian-scotland.gov.uk.
Carers UK and
Age UK.
A closing word
The helplessness most people feel in this situation is partly a lack of a map, and there is a map. Make sure they are registered with a GP, raise it gently and with care rather than a label, get the treatable causes ruled out, get into the system early even though it is slow, sort the power of attorney while you still can, and lean on the services built for families like yours. Small, steady, early steps achieve what panic and avoidance cannot.
This article is general information, not medical or legal advice, and it cannot replace an assessment by a GP or specialist or advice from a solicitor. If you are carrying this worry for someone you love and would value some support of your own, the grief of watching a parent change is very real, and a good reason to talk to someone. The
free 10-minute consultation
is one place to start.
Sources and further reading
nice.org.uk/guidance/ng97
nhs.uk
nhs.uk
nice.org.uk
gov.uk/power-of-attorney