Grandma refuses to see psychiatrist

Hi BiedneysGrandchild. Welcome.

You note ''she refuses to listen to family (including both my parents who are MDs) about observations or concerns''

Meet her in her reality. The disease prevents her from meeting your family in theirs.

Don't argue with a broken brain, expect her to know there's an issue, or have the capacity to handle her own affairs.

You are spot on about the anosognosia. She doesn't think there's an issue. No-one will convince her. But she will retain the negative emotions around these discussions. That's not good because it will ramp up her suspicion and anger. Pivot to a goal of keeping her calm. If that means agreeing with her statements that don't make sense, that's ok. If she's calm, you will be able to work with her more easily. https://youtu.be/ncKhXQtnyfI

Don't be up front about the reason for the doctor's visit. Many here have had success scheduling an office visit by telling their loved one it's a drop in visit for something like ''a new insurance requirement'', or having the loved one with them when they run in to the provider for''a quick blood pressure check''. In the background, the provider will be aware of the real reason for the visit. Given that both your parent's are MD's and that your grandmother seems to already have a diagnosis, maybe her provider can prescribe based on a discussion with family? Grammie's not able to be a good judge of what's going on.

5 losses: https://www.youtube.com/watch?v=awBm4S9NwJ0.

At this point she's not able to make good decisions consistently and needs more structure. Most posters here will agree that putting structure in place can be tricky at first. For me, it was these things:

*As a society we very much cherish independence, and are reluctant to take it away. Dementia is stealthy, and can spare the person's social skills for a while, so it seems like they're doing ok, when the reality is that they are working very hard to navigate their day as their abilities slip.

*It's very hard to flip the parent/child dynamic.

*People with dementia can have good and bad days. On good days they may be aware and frustrated with the losses the disease is causing, and take it out on the caregivers (especially if they think they are being patronized, when the caregiver is actually operating in 'bad day' mode).

*We very much want our loved one's approval for plans, so we try to include them even though they have lost the capacity to evaluate the need for changes.

*The anosognosia often means we have to use fiblets to work around the disease. For example the loved one thinks they can still drive. As caregivers, we see that they are unsafe and incapacitate or remove the car and tell them it's at the shop being fixed. It still feels awkward to fib.

See if the videos and article below help, & please feel free to share. They helped me. This can be a long journey. Good luck! Sorry you're here.

https://www.youtube.com/watch?v=rO50pVUOlbE

Even though this is more Alzheimer's focused, it's an excellent article:https://www.smashwords.com/extreader/read/210580/2/understanding-the-dementia-experience/Medium,Arial,Black,White,One-and-a-Half

Teepa Snow series:

https://www.youtube.com/playlist?list=PL2E2lPBsUeBjA1Utglo8q6yANAijEf8cX

@BiedneysGrandchild

Hi and welcome. I am sorry for your to be here, but pleased you found this place. You've already gotten some excellent advice. The Understanding the Dementia Experience @Emily 123 posted was the single best thing I read on the topic in terms of helping me have the empathy and patience to meet my dad in his reality.

I feel like part of this situation might be related to your parents' lives as physicians. There's an old saw that most MDs are pretty clueless about the impact of dementia which results in caregivers venting.

The other piece is that it's devilishly difficult, as an adult child, to get all up in one's parent's business and force health and safety issues. IME, this seems to be especially tough in families from cultures where the elders are revered in ways the elderly are not by most Americans.

(Anecdote-- when my dad had dementia, I was commiserating with a man I know through a volunteer gig who shared that his wife was staying with her parents in another state because "MIL has memory issues and can't run the household anymore and FIL is abusive in his frustration believing if he forced her, she'd rise to the challenge". FTR, FIL was a recently retired neurologist. In this case, MIL and FIL came to this country as young adults from a different culture.)

From your description of Grammie's anxiety driven behavior, it sounds like she would be a good candidate for a trial of an SSRI medication like Zoloft or Prozac. Does she have a PCP who would be willing to prescribe? If the PCP sees her regularly for other things, they may be willing to write the prescription. If you'd rather a geriatric psychiatrist, could you get her there using a fiblet that it's your appointment and you need her to come with you for moral support?

My dad had been told he had mixed dementia by his neurologist and could no longer drive or handle finances. He did not accept this. He was unaware of the range of losses he'd suffered by the middle stages and believed his memory loss was "part of the normal process of aging". I got him to the geripsych by presenting the appointment as a second opinion because I wanted to make sure he was getting the best care. He hated his neurology team and those appointments, but loved going to see his geripsych who was a warm and engaging character.

Good luck.

HB