Three suggestions on how to get your resistant loved one evaluated for dementia

Scenario: My father has been showing signs of dementia, but he refuses to be evaluated and denies there is a problem. He gets mad at me for bringing it up and we end up arguing over it. How can I get him to agree to go to the doctor before things get worse?

In my experience in long-term care, I often run into these situations with families. One of the biggest fears that aging adults have is their fear of “getting dementia.” Because of this fear, people tend to be defensive and deny there is a problem. There is no cookie-cutter answer or solution to this, but the following tips may help: 

• You could mention that at a certain age, it’s wise to have our thinking skills checked during our yearly medical check ups – just as one has blood pressure and lab work done. The physician will likely use a brief screening test called the Mini-Mental State Examination (MMSE) to get a general reading on cognitive status. If your parent does poorly on this screening test, the physician will then refer him/her to a neurologist for a more extensive evaluation.
• Talk with your siblings and find out if they have noticed the changes as well. Chances are they have and it may be helpful to have a family meeting; first amongst yourselves to compare notes and get a game plan together and then with your parent to present your fears and concerns. There’s no doubt that he/she will be very angry, but will also be less able to dismiss your concerns when you are all describing similar facts.
• Sometimes a significant cognitive error such as getting lost or failing to manage finances correctly can open a door for discussion about how his thinking skills are changing and you would hate for something serious or life threatening to happen. This must be handled with empathy and validation of how scary it must be for your parent. You can mention that not all changes in cognition necessarily mean a diagnosis of dementia. Sometimes it is as simple as an electrolyte imbalance or a urinary tract infection causing the problem.

There are geriatric care managers available that can also help in these situations and it may be worth speaking to one. Many industry professionals are qualified GCMs, including social workers, nurses and psychologists. To learn more or locate a GCM, visit the National Association of Professional Geriatric Care Managers at www.caremanager.org.