The Decisive Moment

Purpose. The purpose of this study was to characterize the decisive moment, when caregivers recognize and acknowledge dementia. Design and Methods. Dementia caregivers (n = 100) were surveyed about early signs of dementia, time between first sign and diagnosis, and when they knew that their care recipient's memory changes or problems were pathology rather than signs of normal aging. Results. Caregivers were with a mean age of 67.5 years, 81% female, 55% married to care recipients, and 63% White/Caucasian and 37% Black/African American. Safety issues were the most common decisive moment (30.7%) for caregivers. Driving problems were both the most reported safety symptom (53.8%) and overall decisive moment symptom (16.5%). Implications. The decisive moment does not usually occur early in the disease and often comes in the form of a crisis response to a safety issue. There are generally multiple clues before the decisive moment. Our goal should be to provide education and support to help families recognize as soon as possible the difference between normal aging and pathology and potentially diminish the safety and emotional impact of the decisive moment.