Need Therapeutic Fib

BassetHoundAnn

I got my mom an appointment for a memory assessment at a geriatric clinic at a medical center not far away. I think she's at Stage 5. She's suffering night-time anxiety, delusions, hallucinations just for starters. A thorough assessment is the first step to get her geriatric psych help. The paranoia is the biggest deal and she's especially paranoid of doctors, and extremely paranoid about doctors who do memory tests. It is difficult to get her to doctor appointments. She has been known to melt-down and refuse to get in the car. 

Beyond the dementia she has no other health issues, and takes no medication. So I can't say to her "Mom we need to get your heart checked again" or "I think we should have a doctor take a look at your allergies." Migosh, she doesn't even have any allergies! 

I took her to her primary-care physician several times a few months ago for a physical and memory evaluation and she's still grumping about that, insists she's never going to see him or anymore doctors again. She insists she's all done with doctors. 

Do any of you have any suggestions for a fib I can use to get her to her memory-assessment appointment? It would have to be a good story because she's very wary, suspicious to the point of paranoia and still has a few wits about her. 

Since it's going to be a 45-minute drive I'm taking DH along to keep her distracted in the car. He's good at that. But I'm concerned about how I'm going to get her in the car in the first place. 

In advance, thank you for any suggestions! 

Quilting brings calm

Since she doesn’t take any meds and is otherwise healthy.... how about telling her that she is unusually healthy for a person her age and the place wants to interview her about what she is  doing right.  They are hoping to develop a program encouraging healthy lifestyle habits for those who aren’t as fortunate.  Maybe even tell her there’s cash involved?  Yes, you will supply the cash, but whatever works.

BassetHoundAnn

Quilting brings calm wrote:

Since she doesn’t take any meds and is otherwise healthy.... how about telling her that she is unusually healthy for a person her age and the place wants to interview her about what she is  doing right.  They are hoping to develop a program encouraging healthy lifestyle habits for those who aren’t as fortunate.  Maybe even tell her there’s cash involved?  Yes, you will supply the cash, but whatever works.

Funny you should suggest this because this is exactly what I was thinking. She's in her 90s and this geriatric center does do research on super-agers. But would she fall for it? She can be a pretty sharp cookie sometimes--even though these days she sometimes can't identify what cookies are. 

star26

You know best what you can get away with or what her reactions might be, but here are a few ideas. Can you say that DH is accompanying you (BassetHoundAnn) to a doctor’s appt and tell her you’d like her to come along too for support? Either name a personal symptom she’ll believe or say you’re just not feeling right. In the office with the doctor (preferably not the waiting room if you can make it that far) tell her “Mom, I’m sorry I lied to you. Dr PCP wanted you to have this follow up appointment and I was afraid you wouldn’t go. I love you...”. And let the doctor see any meltdown or maybe she’ll hold it together since she has an audience. Then hopefully you’ll leave with some pills to help deal with any aftermath once you get home. 

OR: Leave out the lie about you, and tell her the insurance company will drop her if she doesn’t comply with the required “follow up visit”. “I don’t know what it’s for, I just know they require one-time follow up visits now.” Minimal discussion, no big deal attitude, and don’t tell her until the day of the appt or on the way if you think that will help. 

AND/OR: If it weren’t Covid times I’d say just get her in the car to go out to breakfast or lunch and then do the appt afterwards. Maybe you can go out for ice cream or “a short drive to get out of the house.” 

The appt is important enough and her symptoms severe enough that I think outright lying, even if she gets mad, is warranted just to get her there. I hope this medical office knows you are expecting to talk with a geriatric psychiatrist (MD) and get a prescription that same day instead of lots of long testing and more appointments needed in the future to “discuss findings” blah blah blah. You don’t want to have to do this all again. 

BassetHoundAnn

star26 wrote:

You know best what you can get away with or what her reactions might be, but here are a few ideas. Can you say that DH is accompanying you (BassetHoundAnn) to a doctor’s appt and tell her you’d like her to come along too for support? Either name a personal symptom she’ll believe or say you’re just not feeling right. In the office with the doctor (preferably not the waiting room if you can make it that far) tell her “Mom, I’m sorry I lied to you. Dr PCP wanted you to have this follow up appointment and I was afraid you wouldn’t go. I love you...”. And let the doctor see any meltdown or maybe she’ll hold it together since she has an audience. Then hopefully you’ll leave with some pills to help deal with any aftermath once you get home. 

OR: Leave out the lie about you, and tell her the insurance company will drop her if she doesn’t comply with the required “follow up visit”. “I don’t know what it’s for, I just know they require one-time follow up visits now.” Minimal discussion, no big deal attitude, and don’t tell her until the day of the appt or on the way if you think that will help. 

AND/OR: If it weren’t Covid times I’d say just get her in the car to go out to breakfast or lunch and then do the appt afterwards. Maybe you can go out for ice cream or “a short drive to get out of the house.” 

The appt is important enough and her symptoms severe enough that I think outright lying, even if she gets mad, is warranted just to get her there. I hope this medical office knows you are expecting to talk with a geriatric psychiatrist (MD) and get a prescription that same day instead of lots of long testing and more appointments needed in the future to “discuss findings” blah blah blah. You don’t want to have to do this all again. 

Those are all excellent points and wonderful ideas Star26. I especially like the one about the insurance company. That might work. And since both she and DH will be two weeks beyond their second Covid shots at that point I could fib that we're going out to lunch to celebrate. Restaurants are still open in our area.

I really do need to find out what exactly the appointment will entail and whether they expect me to bring her back.  I was originally told that the appointment would last 2-3 hours. I said I didn't think my mom could last that long. I'm lucky if I can get her through a dental appointment without an ALZ meltdown at the unfamiliar place and people. Visits outside her residence stress her terribly. So I was told, after being transferred around on the phone, that the assessment would be "scaled back"--should have asked what exactly that meant, and that I could complete the social worker interview portion on the phone the day before. But after going through all the trouble of getting her out there I don't want to be hauling her back multiple times. 

Thank you so much for your ideas! 

M1

Ann, have you thought about how you are going to get her to take whatever medicine you're hoping they'll prescribe? That would seem to be the practical issue you'll face. I doubt she'll be very receptive...maybe something to discuss with the social worker ahead of time too so that they know your expectations before the appointment. Good luck.

harshedbuzz

I got my dad in to see a geriatric psychiatrist by posing it as a second opinion because I didn't like what the neurologist had to say. For whatever reason, in the midstages dad still recalled being told he had dementia by the neurologists.

jfkoc

Ann...I have long questioned the hours of testing. I did not find an answer online so I am going to start a new thread.

abc123

HI Ann, the issues you mentioned are serious ones. Will you be writing a letter ahead of time for the doctor to read before the appointment? You definitely want him to be aware of all the problems she is experiencing and you won't be able to discuss it in front of her. Good luck!

BassetHoundAnn

M1 wrote:

Ann, have you thought about how you are going to get her to take whatever medicine you're hoping they'll prescribe? That would seem to be the practical issue you'll face. I doubt she'll be very receptive...maybe something to discuss with the social worker ahead of time too so that they know your expectations before the appointment. Good luck.

I've considered that she will not be amenable to medication and it's going to be difficult to get her to take any regularly, but at this point I think she's suffering and it would be inhumane not to try to convince her to take something. She's very old and very frail and I've been reluctant to go down the path of medication because it's so hard to get it right for someone at her age. But her night-time anxiety has been increasing I figure we have to try something, we have to give it a shot. I am going to discuss it with the social worker. Maybe there's some pill I can crush and add to her night-time juice and ice-cream? 

BassetHoundAnn

harshedbuzz wrote:

I got my dad in to see a geriatric psychiatrist by posing it as a second opinion because I didn't like what the neurologist had to say. For whatever reason, in the midstages dad still recalled being told he had dementia by the neurologists.

That's a great idea! "We need to get a second opinion mom about your XYZ (arthritis? ear wax? toe fungus?)" She might go for that. No one has told my mom yet that she has ALZ and I think she would have a hissy-fit if they did. We tell her doctors to not go there. We're all cowards. <haha!>  

BassetHoundAnn

jfkoc wrote:

Ann...I have long questioned the hours of testing. I did not find an answer online so I am going to start a new thread.

Please do Jfkoc. That's such a good question. I really do need to ask the clinic what sort of testing they're going to do and how long it will go on. I was just so thrilled to finally get an appointment after months of calls and insurance hassles that I didn't ask many questions. 

BassetHoundAnn

abc123 wrote:

HI Ann, the issues you mentioned are serious ones. Will you be writing a letter ahead of time for the doctor to read before the appointment? You definitely want him to be aware of all the problems she is experiencing and you won't be able to discuss it in front of her. Good luck!

Thank you ABC for the suggestion of the letter! I will definitely write one. I assumed the pre-visit appointment with the social worker would cover those things, but maybe not. I wrote a long letter to her primary care physician and that was a good thing. The things she told him were ghastly confabulations, half-truths and delusions, and I was waving my arms and shaking my head emphatically all while she talked to him since I couldn't show facial expressions behind a mask. He kept looking at me and looking at the letter the whole time in surprise. So I will write another letter. Thank you for the suggestion!