Refuses to be evaluated

hannah12345

I’m looking for some advice or to hear from anyone who has been through something similar with an aging parent or grandparent.

My loved one is 80 and has been experiencing noticeable changes with her memory and behavior that have gotten progressively worse over the past year. It initially seemed like normal short-term memory issues, such as forgetting where she put her keys, but it has progressed quite a bit. She has gotten confused about how to get home from my house, which is only about 10 minutes away, forgotten to pay bills to the point where her Wi-Fi was shut off, and sometimes forgets what school I attend or even whether I’m currently in school.

More recently, I’ve started noticing some balance and gait issues as well. She has always been a little sassy and outspoken, but she has also started having verbal outbursts and becoming verbally aggressive, which is new for her.

The biggest challenge is that whenever anyone brings up concerns about her memory or behavior, she becomes very defensive and insists that everything is fine and that she knows exactly what she’s doing. She absolutely refuses to see a doctor specifically for these concerns and does not want to take any medication. She does still see her PCP, but I’m not sure how to approach this or get her evaluated without making her feel attacked or embarrassed.

I’m wondering if anyone has advice on how to handle this situation, especially when the person doesn’t recognize or accept that there may be a problem. What were your next steps? Is there anything you wish you had known earlier? Any advice or personal experiences would be really appreciated.

Lornals

If you accompany your mom to her doctor, see if you ask the doctor (without her knowledge) to give your mom a cognitive assessment. That way she won’t know you have interfered in any way.

H1235

Many with dementia have anosognosia. This is an inability to recognize symptoms or limitations. Trying to convince her there is a problem is only going to upset her and frustrate you. I know it sounds wrong, but use a fib. Her insurance requires this checkup, the doctor needs to see her to check her diabetes, blood pressure, whatever you think might work. I communicated with moms doctor through a patient portal and that worked very well. If that’s not an option I would bring in a note for the doctor. Maybe bring it a few days before the appointment. I would explain everything you are seeing that is concerning. I will attach a staging tool that lists symptoms. Ask for a hipaa form, fill everything out for her and ask her to sign without giving her an explanation of what she is signing. Has anyone been appointed DPOA. This is very important. If not, I would suggest you make an appointment with a lawyer. Because of the anosognosia I would just explain that because she is getting older it’s important to have legal matters in order. Hopefully it’s not too late. I found the lawyer set a pretty low bar for competency. It doesn’t sound like she is safe to continue living alone. Start thinking about a plan. Some facilities can have a waiting list to get in. If this is the route you will go, I would start looking into options now. It’s important to protect her finances. Some with dementia have purchased brand new cars, when they shouldnt have even been driving. Others have been scammed out of a life savings. She will never say “I’m not safe to live alone. I think I need a facility. I can’t manage my money anymore or it’s time for me to stop driving.” There is so much to do in the beginning to get her safe, diagnosed, and life back under control. It’s a lot of work. The changes will be hard! She will be mad! You (or the DPOA) will probably be blamed for everything. Safety in my opinion has to trump her happiness. Dementia sucks!

understanding-the-dementia-experience.pdf

DBAT.pdf

Anosognosia and Dementia - AgingCare.com.pdf

https://iona.org/therapeutic-fibs-ok/

https://www.creditkarma.com/credit/i/how-to-freeze-credit

https://www.consumerfinance.gov/consumer-tools/managing-someone-elses-money/

JulietteBee

If she has Medicare Traditional or an Advantage Plan, let her PCP know of your observations a d have him start by giving her an inhouse mini-cog test. It is MANDATORY for Medicare clients over 65. If she has not had one before, now is a great time for her PCP to let her know of her insurance plan's annual requirement.

That is exactly what I had to do. Though my mom's PCP of 20 years proved to be an imbecile. After begging him for 2 years to test her, I had to discuss my concerns with his partner who was then tasked with impressing upon him the severity of my mom's cognitive decline. She did and mom was tested in Dec. 2024.

I changed PCP after that and continued my quest for specifics. New PCP ordered tests and made referrals, now I know mom has Vascular Dementia and Alzheimers.

All the best going fwd.