Dementia affects both the present and future of individuals receiving the diagnosis, and of the individuals with whom they have relationships. However, little is known about how couples jointly talk about their future with dementia, and how they adapt to it as a couple and as individuals. Based on conversational analysis of video-recorded interactions among 15 couples living with dementia in Sweden, study findings show that either or both spouses can actively request knowledge about the progress of dementia, but that spouses without dementia express more uncertainty about the future. Further, either or both spouses alternate between epistemic stances of knowing and unknowing, ascribe these stances to one another, and display similar or oppositional stances. The findings suggest a need for developing communicative practices for couples to jointly talk about dementia, and findings ways for practitioners to provide emotional support to these couples.