Losing a Parent to Dementia One Conversation at a Time

Caring for a mother or father with dementia brings a long, quiet grief. For daughters at midlife, that grief can turn into depression worth taking seriously.

The first sign might be small. A mother who calls three times in an hour to ask the same question. A father who gets lost driving home from a store he has visited for thirty years. Then the diagnosis comes, and for many women in their forties and early fifties, a new job begins that nobody applied for: caring for a parent with dementia.

If you or someone you know is thinking about suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline, available 24 hours a day. If someone is in immediate danger, call 911 or go to the nearest emergency room.

Dementia care is different from other kinds of caregiving. The person you are helping is still here, and also slowly leaving. Some days your mother knows you. Some days she calls you by her sister's name. Some days she is angry at you for things you never did. Many daughters say the hardest part is not the tasks but the steady, unnamed grief of losing someone who is still sitting across the kitchen table.

A grief with no funeral

Counselors sometimes call this anticipatory grief, or ambiguous loss. There is no service, no casseroles, no week off work. The loss keeps happening in small pieces, and the caregiver is expected to keep functioning through every one of them.

For a woman who is also dealing with perimenopause, a demanding job, teenagers or a marriage under strain, that grief can settle into something heavier. She may stop sleeping. She may feel numb when she expected to feel sad. She may start to wonder, in the middle of the night, how much longer she can keep going.

Those thoughts can be frightening to admit, especially for someone who sees herself as the strong one. Caregivers can reach this point, and it is a reason to reach out, not a reason for shame.

Warning signs to watch for

Family members and friends of a dementia caregiver can watch for changes like these:

She says she cannot do this anymore, or that she feels trapped with no way out.
She talks about being a burden, or about not wanting to be here.
She has withdrawn from people she used to lean on.
Her sleep, eating or drinking has changed in a noticeable way.
She seems hopeless about the future, not only about her parent's illness.

When you sense your sister or friend is slipping, try asking during a quiet moment, maybe in the car after a visit with her parent: are you thinking about suicide? It can feel too blunt to say. It is not. Asking plainly does not plant the idea, and it shows her she can tell you the truth about how heavy the dementia years have become.

Practical ways to share the load

Get respite on the calendar. Adult day programs, in-home aides and family rotations give a caregiver hours back. Many Missouri counties have aging services offices that can point families toward local options.

Split the roles. One sibling handles money and paperwork. Another takes weekends. A grandchild covers Sunday dinner. The person doing daily care should not also be the one doing everything else.

Find people who understand. Dementia caregiver support groups, in person or online, let her say the things she cannot say at home.

Protect her own health. A caregiver's own checkups, therapy and medications are not optional. If depression is part of the picture, a doctor can help, and treatment does help many people feel like themselves again.

During a rough stretch, it also makes sense for families to store medications and firearms safely and out of easy reach, both for the parent with dementia and for anyone in the house who is struggling.

One treatment option a doctor may discuss

When a caregiver's depression has not responded to earlier treatment, or includes thoughts of suicide, her clinician may talk with her about Spravato. Spravato (esketamine) is a nasal spray the FDA has approved, taken along with an oral antidepressant, to treat depressive symptoms in adults with major depressive disorder who have acute suicidal thoughts or behavior. It is also approved for treatment-resistant depression. It is not a crisis treatment: it does not replace emergency care or a hospital stay when one is needed, and it has not been shown to prevent suicide or to reduce suicidal thoughts or behavior. It is given only in a certified clinic under a safety program called the Spravato REMS. The patient takes it there under supervision, stays at least two hours to be monitored, and does not drive until the next day after a full night of sleep. It is never dispensed for home use. Whether it fits is a clinician's decision after an evaluation.

If you are caring for a parent with dementia and your own mood has been sinking, one step is simply to have a conversation. Many clinics that offer this treatment start with a free consultation, where you can ask questions and learn whether an evaluation makes sense for you. You can bring a sibling, your partner or a friend along.