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How to convince a loved one with dementia to see a doctor

Q How can I convince my mother to go and see the doctor? I'm sure she has dementia but she refuses to go. I live in another state and noticed her decline after a recent visit. My sister who lives close to my mum refuses to help as mum has been making cruel accusations about her ( I'm sure part of her dementia). I talked to the doctor he said he does not do home visits.

A Having someone suggest that you have dementia is very confronting and unfortunately often with Alzheimer's type dementia the person's insight into their decline is also effected. I usually try and focus on the fact that 'in the past if there were memory changes, nothing could be done', now new medication is available that can slow the progression of the symptoms. The earlier the better for getting this treatment started.

If your mum is less cognitively alert you may need to liaise directly with her GP to get a Geriatrician referral for a comprehensive medical assessment, without telling your mum the reason for the referral. Occasionally you will find some GPs who are not supportive of making a referral to a specialist or memory clinic for formal diagnosis. I would suggest that you enquire regarding the GPs thoughts on the matter first, otherwise you risk your first and only appointment not achieving the desired outcome. Cholinesterase Inhibitors are considered world wide as the first line of treatment, but to be eligible the diagnosis must be made by a Specialist. This is a Pharmaceutical Benefits Scheme (PBS)) requirement for subsidised medication.

It is at this time I raise another important issue. Has your mother appointed anyone, in the event of her loosing capacity, as her 'Enduring Power of Attorney', to manage financial issues, this is witnessed by a solicitor. An EPOA does not give you rights over health related decisions. Has she discussed and agreed with your family, who is her proxy decision maker in relation to care, services and health. Having an Advanced Care Directive completed helps everyone know what someone would want in the event of ill health. We should all have one!

Kathryn Goozee
Consultant Nurse Practitioner (Dementia)

 

2 comments

Malha wrote 2 years 18 weeks ago
I appreciate your input on this quiet giant of loss to tnamel health. I do not suffer from this but I have known some who did and a few who presently deal with this silent killer. For me, the statement of conditions of Alzheimer's has limited direct family impact for me but this disease floats like a haze that can settle on anyone. I quietly consider this for me, if for any other reason, the direct and indirect impact of this disease would have on me and those I care for. Thanks for your effort, Tom Harrison
jenni wrote 3 years 12 weeks ago
If your mum is reluctant to visit her GP you could ask the GP to attend a home visit with her. If you speak to the GP prior to the visit and advise him of your concerns he will do a MMSE and other assessments to gauge your mum's cognitive abilities and rule out any other conditions or infections that could be causing her confusion and memory loss. You might ask the doctor to tell her he is there for her annual check up (Just like every other one of his patients over 65 or whatever age is appropriate) in order to preserve your mum's dignity rather than him telling her about your concerns which may make her resentful towards you. Once the doctor has made his assessment he will probably refer to a Geriatrician, but if your mother is experiencing a cognitive decline and she has a good report with her GP I think once he talks to her she will probably open up to him. Most people with early symptoms of dementia are aware they are becoming confused and have some memory loss but it is scary so they hide and deny it to family, friends and even themselves but they do worry about it. Therefore a doctor offering treatment and support is a good opportunity to take the first step. Also if your mother believes this is just between her and the doctor and she can tell people in her own time when she has had time to accept it herself it will make her feel more in control of her own destiny. Dementia is a difficult journey but the support of family and friends to assist the person to remain as independent as possible in as many areas of their life as possible is very important in preserving their sense of worth and quality of life.

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