Forgetfulness is part of growing older – dementia is something different: it changes memory, orientation, language and behaviour so much that everyday life suffers. If you notice such changes over a period of months, you should have them medically assessed. An early diagnosis rules out treatable causes and buys time for powers of attorney, benefits and planning.

Details

“Dementia” is an umbrella term for more than 50 conditions. The most common is Alzheimer’s disease, followed by vascular dementia (the result of circulatory problems), mixed forms, dementia with Lewy bodies and frontotemporal dementia, which often begins before the age of 65 and first shows itself through changes in behaviour. According to estimates by the Deutsche Alzheimer Gesellschaft (the German Alzheimer association), around 1.8 million people across Germany are living with dementia; the great majority are looked after at home by relatives. In Berlin, 87 per cent of all people in need of care are looked after at home (Landespflegeplan Berlin 2025, the Berlin state care plan) – which makes dementia above all a question of care at home.

Normal forgetfulness or a warning sign?

The difference lies less in the forgetting itself than in its consequences:

• Normal: you look for your keys but remember where you last were. A name comes back to you later. You need longer to learn something new, but you do learn it.
• Cause for concern: recent events are missing completely; the same question is asked several times within a short period; familiar routes or even the area around the person’s own home become uncertain; everyday sequences of actions (making coffee, using the washing machine) go wrong; words are missing and are described in a roundabout way; appointments, bills and medication get muddled up.
• Also typical: withdrawal from hobbies and social life, mistrust (“someone has taken my money”), irritability or apathy, declining personal hygiene, restlessness in the evening, unsafe driving.

A single sign says very little. If several changes last longer than six months and affect everyday life, an assessment is called for.

Why an early assessment matters

1. Ruling out treatable causes. A considerable proportion of memory problems have other reasons: depression (“pseudo-dementia”), an underactive thyroid, a lack of vitamin B12 or folic acid, side effects and interactions of medicines, dehydration, infections, sleep apnoea, untreated hearing loss or normal pressure hydrocephalus. Much of this can be treated well.
2. Deciding for yourself while you still can. A Vorsorgevollmacht (lasting power of attorney), a Betreuungsverfügung (a statement naming who should be appointed as your legal guardian) and a Patientenverfügung (advance directive) all require legal capacity. After a diagnosis there is usually still time for this – years later there is not. See Vorsorge & letzte Lebensphase – planning ahead and the final phase of life (in German).
3. Securing benefits. With a diagnosis it is easier to justify a Pflegegrad (care grade); the assessment expressly looks at cognitive and communicative abilities as well as at behaviour. See Applying for a Pflegegrad.
4. Starting treatment. Medication, occupational therapy, speech and language therapy, physical activity and cognitive stimulation all work best early on. Since 2025, antibody therapies for very early stages of Alzheimer’s have been approved in the EU for the first time; they are an option for only a small proportion of those affected, require precise diagnostic work-up and are prescribed at specialist centres (as at July 2026).
5. Sorting out safety. Fitness to drive, the cooker, the front door key, banking – all of this can be settled calmly at an early stage rather than after something has gone wrong.

How the diagnostic process works

• GP practice: a conversation, information from relatives, short test procedures (for example the clock-drawing test, MMST or DemTect), blood tests, a review of medication.
• Specialist assessment in neurology or psychiatry, or at a Gedächtnissprechstunde (memory clinic): detailed neuropsychological testing, brain imaging (CT or MRI), and where necessary an examination of the cerebrospinal fluid or nuclear medicine procedures.
• Result: a diagnosis, the form of dementia, the stage – and a plan for treatment and advice. Ask for the findings in writing; you will need them for applications.

Talking to the person affected

Many relatives hesitate to raise the subject. It helps to stick to observations rather than judgements (“I have noticed that the bills are piling up”), to choose a specific, harmless occasion (“at the next check-up we could have your memory looked at as well”) and to go along together. If an assessment is refused, a preparatory conversation at the GP practice or advice from the Alzheimer association can help.

What to do

1. Write down your observations. What did you notice and when, how often, and with what consequences? Two A4 pages are enough and are worth their weight in gold for the diagnostic process.
2. Draw up a list of medication – including over-the-counter remedies and sleeping tablets. Side effects are a common cause and one that is easy to put right.
3. Make an appointment with the GP and expressly ask for the memory problems to be assessed and for a referral to a Gedächtnissprechstunde (memory clinic). Go with the person if they agree.
4. Have hearing and eyesight tested. Untreated hearing loss considerably increases confusion and withdrawal.
5. Sort out powers of attorney while legal capacity still exists: Vorsorgevollmacht (lasting power of attorney), Betreuungsverfügung, Patientenverfügung (advance directive) and authority over the bank account.
6. Apply for a Pflegegrad as soon as independence in everyday life is limited – even with Pflegegrad 1 there is the Entlastungsbetrag (monthly relief amount) of 131 euros a month (as at July 2026).
7. Look for advice and exchange. Groups for relatives demonstrably reduce the burden – and they answer the practical questions that no medical report can settle.

Where to get help

• Alzheimer-Telefon of the Deutschen Alzheimer Gesellschaft – free advice throughout Germany: 030 259 37 95 14, Monday to Thursday 9–18 Uhr, Friday 9–15 Uhr, anonymously if you wish.
• Alzheimer-Gesellschaft Berlin e. V. – Selbsthilfe Demenz: free psychosocial advice for relatives and for those affected, appointments by telephone on 030 89 09 43 57.
• Alzheimer-Gesellschaft Brandenburg e. V. / Kompetenzzentrum Demenz, Potsdam: information line 0331 27 34 55 99 (Monday and Friday 9–12 Uhr, Wednesday 14–17 Uhr), putting people in touch with self-help groups across the state.
• Gedächtnissprechstunden (memory clinics) at hospitals in Berlin and Brandenburg – referral through the GP practice; waiting times of several weeks are usual, so enquire early.
• Pflegestützpunkte (care support points) give free advice on the Pflegegrad, on benefits and on services close to home: Find a Pflegestützpunkt. In the directory you can filter specifically for services with the specialisation “Demenz”.
• Information events, care courses and dementia cafés: See dates.
• Further reading: Alltag mit Demenz – Entlastung und Demenz-Cafés: everyday life with dementia, relief and dementia cafés (in German).

As at July 2026. This article is not a substitute for a medical diagnosis. Legal basis: §§ 14, 15 SGB XI (assessment, modules 2 and 3), § 45b SGB XI (Entlastungsbetrag). Professional sources: Deutsche Alzheimer Gesellschaft, S3-Leitlinie Demenzen, Landespflegeplan Berlin 2025. Contact details: own research, as at July 2026.