Start before the questions get ahead of you
Children notice the repeated questions, the forgotten names, the grandparent who seems different. If no one explains, they write their own story — often a scarier one. A calm first conversation, before confusion becomes the family secret, gives everyone steadier ground.
What to say to kids
Use plain words for their age. For a young child: "Grandma has Alzheimer's. It makes her brain forgetful — she might ask the same question lots of times, or not remember your name sometimes. It's not because she doesn't love you. Her love is still there even when the memories get fuzzy." For teenagers: more honesty about the long arc, and room for their anger and grief.
Answer the blunt questions directly. "Will she forget me?" — "She might forget names and details, but she still feels happy when you're near. Being with her still matters." "Is she going to die?" — answer honestly based on what you know, and let them keep asking.
The question adults argue about: do we tell them?
Families often split on whether to tell the person with dementia their diagnosis — especially when the person doesn't seem to realize anything is wrong. There is no single right answer. Some people find relief in having a name for it; others find only distress, and the knowledge doesn't stick. Talk with the care team and with each other, and weigh what the telling is for: if it brings clarity and planning, it may help; if it brings only repeated fear, comfort and routine may serve better.
Agree on how you'll talk about it together
Decide as a family how you describe what's happening, so a child doesn't hear three different stories. One shared sentence helps: "Grandpa's memory is changing because of Alzheimer's, and we're all helping him." Keep the details with the adults; keep the honesty with everyone.
Let kids stay kids
Children can visit, draw pictures, hold a hand, share music — and then go back to being children. They should not be managing symptoms, supervising, or absorbing adult worry. If a child starts parenting the grandparent, or dreads visits, that's a signal to adjust the expectations, not to lecture the child about patience.
Keep it going
One conversation won't cover a disease that changes over years. Check in as things shift: "You've noticed Grandma's different lately — what questions do you have now?" The door stays open, and the story updates as the family learns.