Takeaway
Families facing a loved one’s cognitive decline need help planning for the future, including support to nurture their interpersonal relationships.
Lifelong Learning in Clinical Excellence | February 12, 2026 | 2 min read
By Art Walaszek, MD, University of Wisconsin School of Medicine & Public Health
I take care of many patients who are experiencing cognitive decline that could be a harbinger of dementia. Usually, they’re worried. Sometimes their loved ones are even more worried, especially if they’ve already cared for other relatives with dementia. After an evaluation, sometimes I have good news. Maybe obstructive sleep apnea is causing cognitive impairment that will resolve once sleep apnea is treated. Perhaps my patient is taking anticholinergic medications—once these meds are stopped, their cognition will improve. Other times, the cognitive decline is due to a neurodegenerative condition like Alzheimer’s disease. This will be a serious matter, an understandable cause for concern for both the patient and family members.
Caring for an aging loved one can be physically draining and emotionally challenging—and can have profound effects on family relationships. The prospect of becoming a caregiver—or needing to be cared for—can be daunting. Here are some things I recommend to caregivers:
Preparing for the future
One way to respond to this worry is to prepare for the future. This includes practical matters such as financial preparations, advance care planning, health insurance, adapting a home to the aging loved one’s needs, or moving to a new residence. There’s almost something superstitious about this, like rituals to stave off what is feared. “If I pack an umbrella, it won’t rain.” But it’s also a way to try to control what can feel like an uncontrollable situation. And being prepared is better than the alternative.
Self-care for caregivers
Self-care is at least as important as preparation. Before a plane takes off, a flight attendant intones, “Put on your own oxygen mask before assisting others.” Before your loved one starts to have physical, cognitive, emotional, and functional problems, make sure you have your health in order. Good sleep, regular exercise, nutritious meals, less alcohol, more intellectual stimulation, regular contact with friends and family, faith and spirituality, meaning and purpose—these will ensure that the oxygen is flowing and that you’re ready to assist.
Nurturing relationships
The relationship between the caregiver and those they are caring for will need care, too. 20, 30. 40, 50 years of patterns, habits, expectations, approaches to addressing problems—aging will challenge and change these. If you need couples therapy now, imagine what it may be if your loved one develops chronic medical problems and you become a full-time caregiver, or vice versa. Address relationship issues now, when you have more time, energy, and patience.
Worry can be paralyzing. But we can also channel it so that we can face what is worrying us—by preparing, taking care of ourselves, and tending to our relationships.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.