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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)