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Helping Grandchildren Understand Dementia and Alzheimer's

How to discuss changes caused by dementia or Alzheimer's and continue to have meaningful visits with your grandchildren

By Michele C. Hollow

Brian, age 7, wondered why his grandmother forgot his name. The two always had a close relationship. "My mom used to babysit when my husband and I went out," Brian's mother says. "She doesn't do that anymore since moving to memory care."

"Over the past three months, my mom's behavior got spotty. She would be warm on some visits and agitated during others. Brian was clearly upset. He didn't understand why one of his favorite people would be indifferent toward him."

An older adult holding a young child's hand. Next Avenue, talking about dementia alzheimers
"Young children know something's wrong and older children have a better understanding. These talks should be age appropriate," says William T. Hu, M.D., director of the Center for Healthy Aging Research at Rutgers-RWJ Medical School  |  Credit: Fellipe Ditadi

Behavior Changes

Alzheimer's disease and other forms of dementia start slow and can worsen overtime. A loving grandparent may not recognize their grandchildren or other family member. They may become forgetful, anxious and even hostile.

William T. Hu, M.D., director of the Center for Healthy Aging Research at Rutgers-RWJ Medical School, tells his patients' adult children to talk to their children about grandma's and grandpa's behaviors. "We have to normalize these behaviors and we do this by talking about them," he says.

Hu recommends Maria Shiver's book, "What's Happening to Grandpa?" He uses it in classrooms when talking to elementary school children about Alzheimer's and dementia. Hu counsels the adult children of his patients to continue visiting their parents with their children. "Grandchildren are part of their lives and we don't want to take that away from them," he says. "They bring them joy."

"The key is to explain these changes in simple, compassionate terms,"

"That's why we need to openly discuss what's happening," he continues. "Young children know something's wrong and older children have a better understanding. These talks should be age appropriate. I tell small children that their grandparents' brain has a boo boo."

He tries to make these mood changes relatable by asking them how they feel when they're hungry or sleepy. "Most children understand that they get cranky when they're hungry and tired," he says. "I explain that there's a change in their bodies."

When grandparents don't communicate, Hu suggests grandchildren sit quietly and draw or bring old family photos. Sometimes this sparks a memory. Other times, it brings people closer together. It's also important that mom and dad tell their children that their grandparents still love them.

It's important to understand that "these conditions can be confusing and even frightening," says Barbara Sparacino, M.D., an adult and geriatric psychiatrist with The Aging Parent Coach, where she counsels adults who care for their older parents. "The key is to explain these changes in simple, compassionate terms that help kids feel both informed and reassured."

"Encourage children to go with the flow if their grandparent is confused. It's OK to gently correct them or simply move on without emphasizing the mistake."

When a grandparent becomes forgetful, confused, irritable or behaves differently, "explain that these changes are part of an illness, not something the grandparent is choosing to do," she adds.

Patience and understanding are key. "Remind them that their grandparents may not always remember who they are, but the love is still there even if it's not always expressed," Sparacino says. "Encourage children to go with the flow if their grandparent is confused. It's OK to gently correct them or simply move on without emphasizing the mistake. Let them know it's OK to feel sad or frustrated, and encourage your children to talk about those feelings."

Children may feel hurt if a grandparent forgets their name or says something out of character. "It's crucial to explain that this behavior is not their fault," Sparacino says. "The grandparent isn't trying to be mean or hurtful; it's the illness affecting their brain. Reassure them that it's OK to feel a mix of emotions, and encourage them to talk about those feelings with a trusted adult."

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Coping Strategies

Here is more advice on how to teach children about grandparents with dementia or Alzheimer's.

  • Lead by example. Show a calm demeanor and relaxed behavior during visits.
  • Talk to your children about conversations they can have when visiting their grandparents. These talks can include what happened at school, a new book your child read, after school activities, or even a new food your child tried.
  • Teenagers may find these visits more difficult. If your parent is able, your teenage child and parent can take a short walk. Your teen can bring in a book or magazine and read to their grandparent. If your parent is up for it, a simple card game also strengthens the relationship between parent and grandchild.
  • Encourage your children to ask questions about the changes they witness. The more they talk about the changes they see, the more normal and less frightening it becomes.
  • Consider having your child talk to school counselors, therapists and your parents’ doctors.
  • Contact the Alzheimer’s Association and ask about support groups.
  • Have your children read books about Alzheimer’s and dementia. The Alzheimer’s Association lists children’s and middle grade books about the disease.

"Ultimately, the goal is to help children maintain a connection with their grandparents in a way that's meaningful for both of them," Sparacino says. "These moments of connection can still be valuable, even if the grandparent is no longer able to fully remember or engage as they used to. Keeping the focus on love, patience, and understanding can help children navigate this challenging time with compassion."

Michele C. Hollow Michele C. Hollow is a freelance writer, editor and ghostwriter specializing in health, climate, social justice, pets and travel. Her book, Jurassic Girl, about the life of paleontologist Mary Anning, was published in September 2024. Read More
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