I have done some virtual cognitive screenings recently. And I have one important observation.

This should not be news to anyone, but people want to be listened to.

It’s not just about administering formal tests. It’s not just about assigning numbers. It’s about listening.

I have worked with several people who have been insisting to family and friends that there is something wrong with their brain. But their loved ones make comments like, “Everyone forgets stuff,” or “I think I’m more absent-minded than you are.” In other words, their concerns are dismissed.

People think they are being reassuring when they say things like that to those who are concerned about cognition. It’s not reassuring. It’s frustrating.

How do you feel when you express a concern and you aren’t listened to?

When I do cognitive screenings, I tell people that I trust their observations of their own brain. After all, they’ve had that brain their whole life.

If they tell me something is wrong, I believe them. I don’t know if it’s dementia. Maybe it’s depression, anxiety, a physical health condition, or a sleep disorder. Perhaps it’s a result of a stressful marriage or excessive alcohol use.

But when you tell me something is wrong with your brain, I believe you.

You know how your brain works. And, sure, there are cognitive changes that occur as people get older….typical age-related change.

Maybe you forget to get gas in your car. I’m not too worried about you, but if you forget how to get gas, I am concerned.

If you call your kids by the wrong name occasionally, I don’t think much of it. But if one of your kids tells you that they are Carrie and not Kelsey–and you don’t believe them–I’m concerned.

Not every moment of forgetfulness means dementia is on the horizon, of course. But if you are insistent that your brain is significantly changing and impacting your daily function, I want to talk about it. I want to know what’s different than 2 or 5 years ago. I want to know why you are concerned.

As dementia progresses, many individuals are not reliable reporters of their own symptoms. However, I find that many people in earlier stages are quite helpful in their own diagnostic process if we only listen.

A gentleman I know went to his doctor’s office and asked for a cognitive assessment. He had been concerned about his confusion for several months, and it took a lot of mental energy for him to make this appointment.

The doctor asked him a couple of questions and then asked him to draw a clock. At the conclusion of the test, the doctor reassured him that his responses indicated he was “normal” and left the office.

And that was that. He paid his co-pay and drove him.

He was never asked for his perceptions of how his brain was changing. He was never even asked why he wanted a cognitive assessment.

And it’s too bad. Rather than leaving the doctor’s office with a sense of relief, he left feeling unimportant.

He felt like a score or a number. Not like a human being.

He scored fine on a test. Therefore, he was fine.

But he didn’t feel fine.