How do I tell my son about his grandmother’s dementia? He’s just a child, and they were close.

Care and Feeding is Slate’s parenting advice column. Have a question for Care and Feeding? Submit it here.

Dear Care and Feeding,

My husband and I have a 5-year-old son and a 1-year-old daughter. Last year, my husband’s 90-year-old grandmother was diagnosed with dementia. Within the last few months, she has experienced a drastic decline in her ability to recognize people. She was very close with our son, and he doesn’t understand why she can no longer remember who he is. Can you offer any advice on how to explain this to him?

—Wishing I Could Make It Better

Dear Wishing,

It’s really important to explain what’s happening to your son in a way he can understand. You might start with something like: “Your grandma is sick with something called dementia—which is not the kind of sickness that will get better, like when you get a cold. Her dementia means that her brain doesn’t work in all the ways it used to. That’s why she is sometimes confused, or doesn’t always remember your name. But your grandma still loves us very much.”

Give your child plenty of space to process and talk with you about his grandmother’s illness. Make sure he knows it’s okay to feel sad or worried or upset about the changes he sees in her.

I always found books to be quite helpful when introducing my kids to new concepts. If you’re not sure where to start, I’m sure the children’s librarian at your local library will be able to help. Here is one list of suggestions I found (with the caveat that I haven’t read these books myself).

If his grandmother’s dementia worsens and she starts to behave differently as a result, you should talk about that with him, too, so he understands that it is her disease causing the changes. While he’s still so young, it might be worth trying to talk with him every time you’re planning to go visit her, whether there’s been a change or no—both so that you can remind him of the situation, and give him an opportunity to share what he’s feeling or ask you any new questions that may have occurred to him.

Dear Care and Feeding,

I’ve got a 14-year-old son and 9-year-old twin daughters. My son lives primarily with his mom, but has always spent plenty of time at my place, and the kids are all quite close. But there is a real problem with how he treats one of his sisters. The two of them share many traits and are quite similar in disposition, and when things are good, they have a very sweet relationship. They’ll go on walks together and chat and laugh the whole time. They also really enjoy play-fighting—e.g., hitting each other with foam swords. But at other times, my son will relentlessly pick at his sister, teasing her for things like not being as good at video games as he is, or questioning her abilities in other ways. It’s unkind, and although she sometimes claps back or does her best to ignore him, more often it sends her into a rage.

I’ve talked to him about it repeatedly (and yelled at him about it), and he has said he has trouble controlling himself. Maybe that sounds like a cop-out, but having observed it so many times, I believe him. It seems like an impulse-control thing, like the comments pop into his head and are out of his mouth before he can stop them. We have a good amount of neurodivergence in our family, and I strongly suspect that, like the sister in question, he’s got ADHD. I’ve wanted to get him assessed, but his mom—with whom I have a good relationship—is resistant, and he hasn’t had any issues in school yet that would offer more reason to push for it. I’ll tell him to knock it off and he’ll be chastened, but then 30 seconds later he’s picking on his sister again. What do you think I should be trying to do here? Yelling obviously isn’t the answer, and I can tell my son is feeling demoralized. I feel like this is about their similar personalities to some extent, because he doesn’t have the same issue with his other sister. But even if that’s the case, I want him to stop cutting his sister down, because she adores him and I’m pretty sure he actually adores her too.

—Bro, Chill

Dear Bro,

You didn’t mention what you’ve tried in terms of establishing clear limits or disciplining your son, but it’s clear that just talking to or reasoning with him hasn’t done the trick, nor has the fact that his treatment of his sister is having a negative impact on his relationship with the sister he presumably cares for.

While I’m obviously not trying to diagnose him (plenty of neurotypical teens also have impulse control issues!), you shared that you strongly suspect he has ADHD or some other type of neurodivergence, and I don’t think you should ignore that instinct. You mentioned that you haven’t pushed for an assessment for your son because he doesn’t appear to be struggling in school. But a kid can be doing fine academically and still need help in other ways.

Even if his apparent impulse control issues are not affecting his grades, they are contributing to unkind and/or uncontrolled behavior and negatively affecting his relationships at home. You’re constantly frustrated with him; your daughter is hurt; if things go on like this or get worse, there could be more serious harm done to those relationships. And if your son is really “unable” to control himself, you are probably not the only ones who will have to deal with his behavior—at some point, if it’s not already happening, others will too.

Again, I’m not saying that your son has ADHD. I also understand that you’re co-parenting with his mom and the decision of exactly how to help him change his behavior isn’t up to you alone. But when you’re truly stuck, when you’ve tried everything you can think of as a parent and nothing is getting better, that’s when it’s time to seek out more information and professional advice. I think you and your son’s mother need to have a serious conversation about this, and how to get your son the support he may need to better control himself, because the current situation is making at least two of your children unhappy and seems unsustainable.

—Nicole

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