Anasognosia, denial, or fear?

Anonymousjpl123

I’ve seen a lot of threads about anasognosia, denial (LO deny there is anything wrong), and resistance to going to doctor for whatever reason.

I still feel a bit baffled by the concept. My mom usually loves going to the doctor (lunch out, time with me, feeling seen). Except for the neurologist. She has fought making this appointment since things got bad last year.

It makes wonder - does she know on some level and not want to know? Why else would she be so against this appointment yet willing, eager even, to go to all others?

It seems like the opposite of anasognosia. Yet her other symptoms (severe memory loss, can’t use any appliances, bouts of disorientation, incontinence, etc etc) all align with dementia.

Why else would she resist the neurologist unless she knew, or was concerned? And if she does know on some level, doesn’t that mean she isn’t experiencing anasognosia?

I’ll keep reading, just thought I’d post the thread.

N00dles

It can be hard to understand what is truly going on. Has she been to this neurologist before and maybe didn't care for their 'bedside manner'? Her brain may not be able to process the thoughts around going to the neurologist, but there could be the feeling attached with it.

harshedbuzz

@Anonymousjpl123

My father was diagnosed very late in the progression of his mixed dementia which was regrettable because one of them was a treatable condition and he (and my mom) could have had a much better quality of life for a time before his Alzheimer's hit the moderate stages. I noticed some personality changes which concerned me in 2006 followed by significant memory loss and confabulations by 2008 which was when I initially suggested mentioning this to his PCP. Rookie mistake.

Having revealed myself, dad went on the offensive. I think in the earlier stages of dementia, he did have a sense that his memory wasn't what it should be, but I also feel he didn't fully appreciate the changes in his personality, executive function and impact of his memory on learning new things. I think he knew but didn't appreciate the magnitude of what was going on. Perhaps that's where your mom is mentally.

He managed to con my mother into thinking he was fine-- any lapses in memory were written off as "a normal part of the aging process". He also behaved badly in an attempt to further isolate them from my scrutiny. Good Lord, the man tried it all including starting a fist fight with my 6'6" husband one night in an attempt to make me go away. He was also still with-it enough to refuse both his lawyer's and CPA's suggestions to get POAs and a Family Trust done because he didn't trust me and knew I would "put him in a home and steal his house". He clearly feared I knew something was afoot and could potentially upset his independent lifestyle at this point.

Things finally came to a head when mom almost died with him as her advocate in early 2016; the hospital called me as an emergency contact because they picked up that dad wasn't "all there". Not long after, he had a psychotic episode and I was able to get him to the ER and diagnosed in the moderate stages-- I would say Stage 5ish. FWIW, when he was diagnosed, he did recall having been told he had Alzheimer's but he didn't appreciate the ways in which he was impacted and didn't understand why he couldn't drive or handle his investments. He would routinely tell me he'd had a dream and all his memories came back to him, so he was OK now. He progressed fairly quickly, and once diagnosed seemed to go back and forth between partial awareness and full-on anosognosia.

In your shoes, I wouldn't telegraph the purpose of the new doctor or give her a lot of warning about it. I would say that one of her favorite doctors is on vacation and wants her to see this other guy for a prescription refill or something. A few families have gotten a parent in saying the appointment was for the caregiver and mom is coming as moral support or for lunch after. I have a friend whose dad was very resistant to seeing a doctor; his sons petitioned the court for guardianship which meant dad had to prove his capacity by submitting to a neuropsych workup. Dad had a fair amount of cognitive reserve (a retired PhD scientist) and even hired his own lawyer, but the sons prevailed.

Good luck.

HB

Anonymousjpl123

@harshedbuzz this:

”I think in the earlier stages of dementia, he did have a sense that his memory wasn't what it should be, but I also feel he didn't fully appreciate the changes in his personality, executive function and impact of his memory on learning new things. I think he knew but didn't appreciate the magnitude of what was going on. Perhaps that's where your mom is mentally.”

That is exactly where my mom is. Literally. Thank you!!! It is amazingly helpful to have someone articulate what I have been seeing and so baffled by! I’m so sorry your mom and you had to deal with that crisis - sounds like a nightmare.

Like your dad, my mom is a lot for most people. She’s alienated many of the few friends she had, or they live far away, and family, so it’s pretty much me, her, and her new friends at AL. As I mentioned I’m super lucky because this particular AL I think most residents have memory issues and are waiting it out until they transfer to memory care (located in same building).

Thank god, the worst episodes seem behind us, so now it is mostly me just trying to keep track of this ball of yarn flying down a hill.

Her appointment is on Wednesday and she has agreed to go on the condition that I not come in with her. This I find totally reasonable. If she is somehow able to showtime for the doctor I will let myself rest knowing she’s in AL, a safe place, and getting health care. At this point I doubt she will be able to do it, but whatever happens will give me a gauge.

I appreciate so much you sharing what you went through. It really, really helps me feel more sane and less uncertain.