One of my dearest friends, who was 29 years older than I, developed brain atrophy dementia, caused by multiple mini-strokes. I took her to the doctor and was with her when the doctor gave her the results of the MRI and the diagnosis. She was devastated.

She forgot it within a day and kept confabulating new reasons for her symptoms. Whenever anyone reminded her of the diagnosis, she was devastated all over again and spent a day in complete misery and weeping. It was cruel to keep telling her and the doctor finally asked her family to stop and urged them to accept the confabulation and do their best to keep her safe.

She spent the last five years of her life in assisted living and didn't recognize me at all for the last 4 years. She thought I was a caregiver and frequently commented that I should dress more appropriately for the job. I always thanked her and she'd smile. That was our conversation for four years.

The advice the doctor gives might depend on how advanced the cognitive decline is. In the early stages, the person can make arrangements with their attorney and others for their care. They can also monitor blood pressure and blood sugar and take care of themselves in other ways that will extend their high functioning days. Once they're very far advanced, things change. They're not storing new memories. Like my friend, they forget they've been diagnosed. Telling them again over and over ... it's not to anyone's benefit.

Jimi, I'm sorry about your friend. It's kind of you to maintain contact and accept him as he is and to continue caring.