Deep denial

Pocahauntis

What do you do when someone has dementia but part of their dementia is that they are in deep denial that there is anything wrong with them at all? My father in law is 89 and routinely forgets things, can't carry on a conversation, makes horrible financial decisions, tries to drive and gets in accidents--it's a slow motion train wreck. But he gets really insulted and angry any time anyone tries to broach the subject that there is anything wrong and he thinks he's just fine. He is losing his assets and slowly eroding everything around him, including us. How do you deal with a person who refuses to admit they have a problem?

mommyandme (m&m)

Welcome to this place but sorry for the reason!

My first thought is does someone hold a DPOA for your FIL? He sounds like he’s at the stage that he cannot make decisions on his own, financially or driving among other things. If someone has POA then he/she needs to take over his financials immediately and remove the car privileges.

My very close second is your FIL is not in denial, he has Anosognosia. “Anosognosia is a neurological condition in which the patient is unaware of their neurological deficit or psychiatric condition. It is associated with mental illness, dementia, and structural brain lesion, as is seen in right hemisphere stroke patients.” Many dementia patients have this. There comes a time when trying to reason with someone that has brain damage (dementia) is futile and just frustrates everyone. Trying to convince him of his deficits will not work. This is also the time to try to keep peace and calm as best you can. Therapeutic lies (fiblets) go a long way during this journey. Validating feelings, taking blame when not your fault, lots of pleases/thank yous, smiles/hugs and I love yous, we’ve got your back etc…are usually a necessary tool. Even though there are similarities in the disease between patients, each person and family dynamic is different so tools that work for some do not work for others. “When you’ve met one dementia patient, you’ve met one dementia patient.”

This quick read, “Understanding the Dementia Experience” by Jennifer Ghent-Fuller, is free and has been helpful for myself and others.

I hope you and yours can find some peace soon.

Pocahauntis

thank you so much for the information. We had no idea such a condition exists, and it seems to fit his symptoms.
He gets so angry and defensive that it's not possible to get POA. He thinks even a medical POA is an attempt to take over his finances and steal from him, even though no one has remotely indicated that motive is there, ever. Again, thanks for your thoughts and concern.

JeriLynn66

? Perhaps guardianship is in order?

M1

Hi Pocohauntis. You need to consult with a certified elder law attorney (CELA, look at nelf.org). Guardianship is more expensive to obtain than POA, but may be necessary. Someone needs to disable his car in the meantime and get him off the road. The rule is that safety has to drive the decision making, he is no longer capable of making rational choices and therefore should not be given a choice. You need to learn to use white lies-whatever response will keep him calm. Paranoia and delusions of theft are common and may respond to medications. If you have hippa privileges his doctors can discuss with you, if you dont, you can still tell them your concerns but they may be more limited in how they can respond.

CaliforniaGirl-1

Sometimes it is Anosognosia. Sometimes it is defensiveness and fear because they know things are not quite right and it's terrifying to them. (Sometimes it can be both one after the other. The disease never stands still). The bottom line is whatever the underlying cause of the denying, it is very common.

And it doesn't really matter which because as much as we all want to be able to convince our loved ones of what's happening and get them to buy in and cooperate, they can't. That degree of function is gone and often the memory that goes with it. Unfortunately paranoia and delusions are not rare. Fear of loss of control is very common. What helped with us was pointing out that the PoA would only be valid when my LO was incapable of making decisions. (they were thinking unconscious, we were thinking impaired)

Get the documentation you need, if you can.

If the doctor can't give you information because you don't have the medical PofA, tell them that you don't want them to give you information they can't but you want to share your concerns and what you have observed. That can open a dialogue that can be helpful.

Good luck.

JDancer

Please stop the driving immediately, lives depend on it. Thank you.

mommyandme (m&m)

https://alzconnected.org/discussion/comment/195364#Comment_195364

I should have said, “may” have anosognosia, agreeing with Californiagirl-1. If the POA prospect or whomever gets a consultation with a CELA, (hopefully first contact would be free), consensus here says to speak with the lawyer without your PWD to start. The attorney should hopefully have skills to work with your FIL and his person(s) and the strategies needed to complete legal paperwork. Sometimes people have shared here that they told their LO they were getting their own POAs in order too, at the same time.

I must say that without POA or guardianship (the more costly and difficult option), your FIL’s supporters kind of have their hands tied.

The learning curve can be quite steep, at least it was for me. Doing my own research and coming here helped more than the medical community IME. Giving a call to the Alzheimer’s Association was also helpful for us.

harshedbuzz

Stop talking. You've already seen how ineffective it is in your circumstances. This does sound like a classic case of anosognosia, btw.

You don't need a diagnosis to act, but somebody needs to step in or an already difficult situation or risk making it really complicated.

Job one is safety. If he's driving that needs to be shut down today by whatever means necessary short of theft. One fiblet, aka therapeutic lie, that works for many is removing the car and informing dad is been recalled by the dealer and is unsafe to drive until it's fixed. This allows you to kick the can down the road as you "waiting for a part" to complete the work. Other options are lending it out or disabling it somehow assuming he's not on-the-ball enough to fix it or call AAA.

Also, check to be certain his meds are filled and being taken. Look at his pots and dish towels for evidence of forgotten pots or fires. You may need to cut the gas or breaker to disable it. Check his fridge and pantry for rotten food that could make him sick if consumed.

If he won't give you a POA, then emergency guardianship is your route to keeping him safe and solvent. A CELA can help with this. I know of 2 instances where this was done-- in both cases the court ordered extensive neuropsych testing for competency and a medical exam. One of the PWD had a lot of cognitive reserve and hired his own lawyer but the court still sided with his sons who became co-guardians. This is more time consuming and expensive, but in the cases I know about, the guardianship was paid out of the assets of the PWD.

If he's using a computer or smart phone as a means to make these terrible financial decisions, you need to shut that down too. Dad managed to lose $360K day-trading while mom was fighting me on getting him evaluated. There's no do-over-- the money is gone. If possible, change the WiFi password, if not slip any devices into Airplane Mode. At one point dad's phone became such a problem, I disappeared it.

HB

H1235

It is so hard to go against what your parent wants. It’s a tough adjustment for us as the child. You have received some great advice above. I agree with safety first. Fibs are also helpful but hard to get used to. Our parents taught us to tell the truth, it just feels wrong. I like the idea of disabling the car. Another thing might be to contact your Secretary of State and see if you can report an unsafe driver. In my state there is an online form. I wouldn’t expect this to be a quick process. Good luck.

JDancer

You say he gets in accidents, please don't wait until one of those accidents kills some one.