Help Getting Parent to See a Doctor

dragonslayer

Mom has some form of dementia. Sometimes recognizing to a small degree. Won't go to a doctor. I am struggling with helping as she doesn't like accepting help so most often won't. Gets angry when I don't go along with delusions. Just struggling.

SusanB-dil

Hi dragonslayer - welcome to 'here', but sorry for the reason.

You will really need to start using fiblets. Do you have DPOA and HIPAA accesses?  If you can make the doc appointment, then tell her "Must go to doc. It is for insurance purposes." "Insurance is requiring it." Whatever works.

Yes, she would get angry when you don't go along with what she is believing to be her truth.  What is delusional to you and us is totally factual to her. We resort to "oh, yes, yes, of course" or "oh, really? ok"

You say sometimes she recognizes deficiencies, but only to a point. She most likely doesn't like assistance because she does not recognize her own limitations. She doesn't see herself as having much trouble at all.

Two 'rule #1's' Don't argue with a PWD, it only leads to frustration for both of you.  and... Do take care of yourself and get respite when needed.

Iris L.

dragonslayer wrote:

 she doesn't like accepting help so most often won't. Gets angry when I don't go along with delusions. 

 

You are describing anosognosia, which is a feature of dementia.  She truly believes she is fine.  The above-mentioned work-arounds can help.  Avoid confrontation about having dementia.

Iris L.

Anonymousjpl123

Dragon slayer I am in the same boat. I have no way to get my mom to go to doctor or, when she does, to be honest. It’s come down to fiblets and it’s getting easier and easier for me to be ok with it. Anything else will no longer work. It feels counterintuitive to lie, but it’s not the same when you are dealing with someone who can no longer process information or logic. It’s hard I understand. It’s ok you are struggling.

dragonslayer

Thank you for the tips. I believe I have a limited DPOA but state law requires a doc's diagnosis to invoke. Things are better when I go along, but she does remember my tacit agreement sometimes, so I am trying to be more noncommittal. I will try to invent a few fiblets to get her to a doctor. Thanks again.

dragonslayer

Thank you.

Mint

I’m in the canoe with you. For me there has been no easy solutions so far.  My mom would see through a fiblet still and could care less what the insurance company or doctor says, that would just inflame her.   Such simple things are constantly challenging.

Do my very best not argue with her so I’m quiet a lot and personally prayer and singing for strength and help not to worry so much about things I didn’t cause and can’t control.  Now and then I don’t do my best, slip and try to reason with her. Quickly get reminded why I must try and not ever reason with her.

You do the best you can and that is all you can do.  You take care.

gisselletdean

Hey everyone, I'm new here and wanted to chime in on this topic. It's a tough situation for sure. I'm sorry to hear what you're going through. I'm sure it's hard to get your mom to see a doctor, but she must get the help she needs. Have you thought about taking her to a sport medicine clinic? It might be a more comfortable environment for her and it could be easier to talk to the doctor in a more relaxed setting.   My mom had a similar situation a few years back and it was really hard for her to accept help, too. She got really angry when I tried to suggest she see a doctor. Eventually, I managed to get her to go to an appointment. It turned out that the doctor was kind and understanding and was able to talk to her in a way that she felt comfortable.

Jo C.

Hello DragonSlayer and a very warm welcome.  You are facing a significant challenge and I can well understand; it is one that I also faced with my mother.  It was both frustrating and stressful as her need was great and the dementia behaviors were over the moon.

The first thing I learned the hard way, was never, ever, to mention to her that there was anything wrong with her memory or thinking and NEVER to mention dementia or Alzheimers.  In fact, it was best to never mention she had anything wrong with her health whatsoever.  To raise such an issue was to cause acting out and digging her feet in even harder.

Another thing I learned the hard way was never, ever to argue about her delusions, (rigid false beliefs), or to try to correct such statements or to point out facts.  Your mother's delusions are as real to her as the chair you are sitting on.  Just best to let go of that even though we have a strong urge to try and make sense of the false beliefs. Her brain is damaged, so logic, common sense, judgment and reasoning capabilities are all very damaged.  In such a situtation, our Loved One no longer functions in real world reality, so we have to try and enter theirs.

One thing we can do, is to say we have an appointment with the doctor for ourself, and that you are going to go out for lunch (or dessert or whatever) afterward and invite her to go with you for YOUR checkup so you can go out to eat together afterward.  Sometimes that is helpful. 

If that is an option, then it is best to notify the physician ahead of time as to what fiblet you have used to get your mother to the appointment, and he/she can take your blood pressure, etc. and pretend that you are the patient AND the doctor can say; "as long as you are here with your daughter, Mrs. C., let's take your blood pressure too, it will be no cost to you at all."  (With this option, it is best to write a detailed but succinct memo and get it to the doctor in advance of the appointment regarding your mother's changes, behaviors, function, and other issues; be sure to get it to him/her a few days in advance of the appointment. Bring a copy with you in your handbag should it be necessary if doctor did not receive or read the previously sent memo - excuse yourself "to go to the bathroom," and give the second copy to a staff member to get it to the doctor prior to his/her entering the exam room.

If ever she needs to be hospitalized for anything, ask the admitting doctor to order a consult with a dementia specialist while she is in the hospital; this way the assessment can be easily done and she will not realize specifically what it is for. Sometimes, we can create a fiblet that gets our Loved One (LO) to the ER to be seen. In one case with my mother, I did this BUT did it with a hospital that had a specific Geriatric Psych Unit.  While Mom was in the ER, a psych RN who looked like any other RN came and did a screening. The doctor had ordered that.   Mom was then admitted to GeroPsych for  assessement and to begin medication to help her. This of course fit the circumstances at the time.  It was very helpful and medication did make a difference.  Also found out that my mother did not have Alzheimer's Disease, but rather had one of the behavioral variants of FrontoTemporal Dementia which explained SO much including her persistent over the moon behaviors.  (Not all FTD patients have the full range of FTD symptom possibilities, Mom had the behaviors but not word loss or eating disorder.)

One other instance which was a lollapallooza of fibbing was:  My mother put great store in her blood pressure medication. She highly valued it. However, Mom really needed to be seen by her doctor in the worst way.  SO . . . I elicited the help of the doctor's staff.  They called Mom on the phone and said, "Mrs. Doe, doctor was reviewing charts today and he saw that he had not seen you in a long while.  He can no longer fill your prescription for blood pressure medication any more as it has been too long since you were in for an appointment and that is the law regarding your medication.   WELL . . . . Mom was instantly geared up . . . the staff member said they just happened to have some open appointments, did she want to have one of them while they were still open?"  Oh yes she did; she went in for an appointment the first one available . (Puff, puff, pant, pant!)

Therapeutic fiblets can be a helpful tool in the caregiver toolbox when necessary.  However, as one Social Worker stated, "The refusal to see the doctor is a difficult one.  You can try and use any fiblets or other methods to get her in to be seen, however; there are times when nothing you do will make a difference. The only choice then is to let go until the next shoe drops and when it does, then you can step in."  She was right. 

Getting mother to an actual dementia specialist was not easy; when getting her to the primary MD, he nicely said she had blood pressure and back pain issues he could not handle, so he was sending her to a nearby doctor that could help with that - an MD fiblet - he sent us to a good Neurologist who sees dementia patients as a routine part of his practice. Have to say that when an accurate diagnosis was made and appropriate medication was prescribed, it made a huge difference in so much and a reasonable quality of life was restored to my mother.

You will get good input from others, we all have stories connected to our LOs.  Do come here often, it is a wonderful place of support where you will be understood.  We are all here in support of one another and that now includes you too!

With warm thoughts being sent your way from one daughter to another,

J.

Enmmabern

Hey everyone, I'm new here and wanted to chime in on this topic. It's a tough situation for sure. I'm sorry to hear what you're going through. I'm sure it's hard to get your mom to see a doctor, but she must get the help she needs. Have you thought about taking her to a sport medicine clinic? It might be a more comfortable environment for her and it could be easier to talk to the doctor in a more relaxed setting.   My mom had a similar situation a few years back and it was really hard for her to accept help, too. She got really angry when I tried to suggest she see a doctor. Eventually, I managed to get her to go to an appointment. It turned out that the doctor was kind and understanding and was able to talk to her in a way that she felt comfortable.

Emily 123

Everyone has such great advice!  This helped me understand how my mother was perceiving things. https://www.alzconnected.org/uploadedFiles/understanding-the-dementia-experience.pdf

 I had been spending a lot of time spinning my wheels trying to use logic to make her see why she should go to the doctor, etc. So very many repetitive conversations, looking for her agreement, not understanding that she couldn't reason very well anymore (though she could resent my attempts to 'manage' her).  Your mom might look and talk like she always has, but her abilitiy to handle decision making and her reasoning have been affected.  Unfortunately, dementia takes away the person's ability to be independent, and flips the parent-child dynamic on its head.  Once I read the above and in the forums I realised that we were past a point where my mom could chart her course by herself

Initially telling the fiblets is difficult-one of the first things our parents teach us is not to lie to them.  You'll also have to become comfortable agreeing to statements you know aren't true.  You will be suprised at how far that will get you in keeping your mom calm and agreeable. You'll have to  simultaneously make her feel secure by going along to get along,  but also keep her from harm.  It's not easy, but you will be able to find a way that works for you.

serenac

Hi dragonslayer! Sorry to hear - I've been in the same boat. I found this resource incredibly helpful: https://remo.health/learn/articles/13/starting-the-diagnostic-process—a-path-to-clarity 

The article has 4 helpful strategies for bringing up the doctor's visit with your loved one. What worked well for us was me being able to frame the checkup as something that is routine. Assessing cognitive trouble is part of Medicare’s Annual Wellness Visit, which is a recommended annual visit for all adults over 65. 

I hope that helps!