How to get my mom to the doctor for dementia diagnosis

LauraJF

At my mom's yearly health exam my mom's doctor had provided a referral for a neuropsychological test to see if she does in fact have dementia.  My mom stated that she'll not go because she doesn't feel that she has any issues.  I have the ability to make appointments for her and have done so for the test.  I'm thinking that she'll need this diagnosis to obtain any future aid (financial or medical).  Any suggestions on how to get her to this appointment?  

With gratitude,

Laura

SusanB-dil

Any way you could really cajole her into going? Could you suggest that they want to be sure that everything is ok, maybe?  Perhaps tell her the Primary doc wants a follow-up.

We had pretty much same issue come up a couple of years ago with mom-in-law.  Her Primary doc made the referral to neurologist.  She didn't/wouldn't go.  Long story short - finances became a mess by the time we did get her to go, maybe 10-11 months later. (and a formerly-trusted family member was capitalizing on the situation - we don't have much to stand on, because there was no diagnosis for another year)

Anosognosia - the firm belief that nothing is wrong, despite evidence to the contrary.

Michael Ellenbogen

WWhat if it is tumor creating the issue. Someone  else waited to long and when they finally got there relative to the doctor  he said it could have been  reversible but you wanted to long and now it is stage 4. Make plans for death as they only have 3 months.

Anu bis

HHi. I am categiver for a lady that lives alone both sons are out of town. She lives in silence unplugs everything. CANT get her to the doctor for anything I am beside myself trying to figure out what to do

AASH

Hi LauraJF,

We had this same problem with my mom. She absolutely did not want to go however we told her that it was a general check up with a doctor and that if nothing was wrong we wouldn’t have to worry about anything but wanted to make sure she is healthy. She ended up going but was so upset about it that she failed all testing due to not trying at all (perhaps trying to fail). The doctor  could tell she wasn’t trying and re-tested her. They noted that she was having cognitive problems but that they would need further testing for a diagnosis. It took us 3 years to get the Alzheimer’s diagnosis. I know it’s difficult but don’t stop trying to get your mom to that appointment. 

Iris L.

Most PWDs (persons with dementia) develop anosognosia, which is a characteristic of dementia that causes the PWD to be unaware of having limitations.  She truly believes she is fine, and sees no need for doctors or tests.  If you try to convince her otherwise, she will become upset.  So you will have to learn to use work-arounds to accomplish your goals.  Make up another reason for seeing the doctors as discussed above.  Read more about anosognosia, it will help you to understand this important feature of dementia.

Iris L.

harshedbuzz

Michael Ellenbogen wrote:

WWhat if it is tumor creating the issue.

A PCP would not turf a patient to a neuropsychologist to rule out a tumor. A neuropsychological examine can tease out what type of dementia is most likely based on the pattern of impairments and give a sense of where in the disease process the person might be. 

Someone  else waited to long and when they finally got there relative to the doctor  he said it could have been  reversible but you wanted to long and now it is stage 4. Make plans for death as they only have 3 months.

This is sad. I had similar happen to a friend's mom. Her mom's tumor was particularly aggressive and she died fairly quickly. 

That said, I would assume a PCP would have done the necessary bloodwork to rule out a treatable vitamin or hormone deficiency and ordered a CT scan to rule out a lesion of any kind.

One of my dad's dementias was eminently treatable and was missed for quite some time. Because he split the year between 2 states the continuity of care was lacking. They seemed to have a new PCP every 24 months in one place and an outright creep in the other. When mom took dad to the local small town ER for an altered mental state, they did not run the necessary tests to diagnose his WKS. I often wonder if his quality of life, and my mom's,  could have been improved if he'd been treated earlier by more competent professionals. At the time of his diagnosis, his Alzheimer's was fairly early stages. In the end, Alzheimer's was going to win but maybe he wouldn't have suffered as much. 

MN Chickadee

This is common in our PWD. Sometimes they have a good dose of denial if their brains are still functioning to that point, but often once their brain damage reaches a certain point it can no longer process consequences of their actions (or inaction) or recognize the brain's own deficits. Sometimes I think of it as how I would approach my kids when they were 3 years old. I didn't tell them about the doctor's appointment with the needle pokes a week in advance so they could fret about it and spend their time getting worked up. And I didn't ask them if they wanted to go get a shot, I just made it happen. You will have to find therapeutic fibs and work arounds. Make the appointment, don't tell her in advance to get all worked up about it. When it's time to go, maybe it's a routine check up that Medicare or insurance requires. Maybe it's to check that hip or knee that's been hurting. Maybe it's an appointment for you or her spouse and she's along for the ride. Maybe you are just out for a drive and get a call that the clinic has a cancellation and can see her. Whatever it takes to get her into the appointment. Down play it, don't talk about dementia or Alzheimers or anything of the like just try to soothe. It's just a quick appointment and then we're going to get lunch at your favorite place. 

When taking our loved ones to a doctor for diagnosis it can often be helpful to get a note to the neurologist or other professional working with our LO ahead of time. It can be difficult and embarrassing to bring up their symptoms in front of our LO but the doctor needs to hear what has been going on at home and for how long, these details help parse out what is going on. You might send a letter, fax, or email to them ahead of time with these details and also bring a copy with and quietly ask the receptionist to make sure they have seen it. In this note you could also express how difficult it was to get her to come in and the ruse you are using. Some will kind of play along to keep everyone at ease.