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Notes:
In my experience as a physician, I find that family members are often slower to notice cognitive decline than is the patient, and when the physician hints that all is not fully well between the ears, object strenuously with sometimes bizarre and fantastic rationale for not labeling Granddad or Grandma as senile.
The key is to avoid the label and to focus on what the patient can actually do and what functions actually require assistance. Often no one in the family has even looked into crucial areas of function
And why should they? It's intrusive and potentially demeaning, so it's hard for each of us to find a way.