The Arc of Conversation by
Amy Shaw, PA
When the Diagnosis Arrives, the Conversations Begin
A dementia diagnosis doesn't just change your loved one.
It changes every conversation you will have with their doctors, their care team, and your own family for years to come.
What do we do when they can no longer make decisions? What does hospice actually mean — and when does it become the right choice? How do we talk about what matters most when everything feels uncertain?
Most families are never prepared for these conversations.
They arrive at critical moments — a hospitalization, a sudden decline, a decision that cannot wait — without the language, the knowledge, or the framework to navigate them.
This book was written to change that.
What The Book Does
A Framework for Navigating Dementia's Most Difficult Moments
The Arc of Conversation gives clinicians and caregivers a clear, compassionate framework for the conversations that define the dementia journey.
Not just what to say — but how to think about what matters most.
When you read this book, you will understand:
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How dementia progresses — and how care needs shift as the disease advances
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How to prepare for conversations about safety, independence, and changing needs
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What hospice is, when it becomes appropriate, and how to know when the time is right
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How to navigate decisions about life-sustaining treatment with clarity instead of guilt
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How to communicate effectively with clinicians — and advocate confidently for your loved one
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How to align care decisions with your loved one's values and what matters most to them
This is not a book about giving up.
It is a book about showing up — informed, prepared, and ready to advocate for the person you love.
Who This Book Is For
Written for Clinicians. Found by Families.
The Arc of Conversation was originally written to address a gap in medical education — the absence of clear, practical guidance for navigating goals of care conversations.
But the families who have read it have found something unexpected.
A book that finally explains what the medical system should have told them from the beginning. This book is for you if:
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You are a clinician, PA, nurse, or social worker navigating goals of care conversations in your practice
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You are a medical student or resident looking for a practical framework for difficult conversations
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You want to understand the full arc of the dementia journey — not just where you are today, but where you are headed
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You want to feel prepared when difficult conversations arise — rather than blindsided
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You want to communicate more effectively with your loved one's medical team
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You want to make care decisions that truly honor your loved one's values and dignity
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You have a loved one approaching the end of the dementia journey and want to understand your options
“I’ve read a number of books about dementia, but none have come close to providing the practical, understandable guidance I found in The Arc of Conversation. I would highly recommend this book to anyone caring for a loved one with dementia.”
— Family caregiver
About The Author
Written by a Clinician Who Has Walked This Journey — From Both Sides
Amy Shaw, PA-C is a physician assistant specializing in dementia, geriatrics, palliative care, and hospice. She has guided more than 700 families through the dementia journey — from the earliest signs of cognitive change through end of life.
She is also a daughter. Her mother has Alzheimer's disease.
That dual perspective — clinician and family caregiver — shapes everything she writes and teaches.
The Arc of Conversation is her first book. Her forthcoming book, Better Dementia: From Overwhelmed to Empowered (publishing 2027), brings her full caregiving framework directly to families navigating the dementia journey.
Available Now Through Springer
Looking for More Support?
The Arc of Conversation gives you the big picture of the dementia journey and the conversations that come with it.
If you are looking for ongoing guidance — a complete framework for understanding dementia stage by stage, communicating in ways that preserve dignity, and navigating every decision with confidence — that is what Better Dementia™ was built to provide.