How do you have that first conversation about your concerns?
“I am concerned about memory lapses and confusion I’m seeing in my mother. How do I get her to agree to go to the doctor?” This is a common question of staff on our 24/7 Helpline [6]. We would like to share several strategies that families have found to be successful. Maybe one of these will work for you.
Why is it hard to get my loved one to acknowledge the changes?
[7]Noticing changes in a loved one
Anyone who is aware of his/her own cognitive changes may be afraid that the symptoms [8] could be from Alzheimer’s disease [9]. This can be a scary thought.
It may be more comforting to deny that there is a problem. Sometimes changes in the brain from dementia can make it difficult for the person to acknowledge the symptoms.
The changes may not be due to Alzheimer’s
We suggest that you talk with your loved one about potential causes of these symptoms that are NOT related to Alzheimer’s. Alzheimer’s isn’t the only cause of memory loss and confusion [10].
Perhaps there is a vitamin B-12 deficiency or a urinary tract infection. Maybe the individual’s medication list needs to be re-evaluated by a doctor. If there is a reversible cause for the symptoms, it is best to find out so they can be treated.
Enlist support from a friend who also has concerns
Does your loved one have a friend he or she has known for years? Maybe it is a close neighbor or someone with whom your loved one plays cards or goes out to lunch. You could discuss your concerns with that person to see if s/he has noticed similar behaviors.
If there are shared stories of misplacing items or becoming easily confused, you could ask that person to talk with your loved one. Often we listen to life-long friends more than our children or partner. You two can decide whether you should be there for the conversation.
Ask for help from the doctor
[11]Doctor giving patient memory test
Maybe the person is still reluctant or you think that the above ideas aren’t feasible in your situation. Write down concerns and observations (use our Preparing for a Visit to the Doctor [12] form) and send them to the physician. While healthcare providers cannot talk to you without the patient’s consent, reading your letter may help them better understand the situation.
You could suggest that the doctor’s office call your loved one to schedule an appointment. It may be time to check cholesterol or blood pressure. Maybe an exam is needed to refill a prescription.
A doctor may or may not follow through, but it is worth a try.
Would you like me to tell you if I noticed something?
When one of our staff noticed changes in her mother, she had started the conversation with a question. She asked: “If I noticed something about your physical or cognitive health that concerned me, would you want me to tell you?” When her mother said yes, it opened the door for her to share her concerns.
If her mother had responded negatively to her question, then she’d know to try a different approach. Here are some other ideas.
- Suggest that it might be time for their annual wellness visit, which is covered by Medicare (and can include a cognitive screening).
- Pair the doctor’s visit with an enjoyable outing. “We can go to your appointment and then go to lunch.”
- If the person has dementia, his or her judgment may be impaired. You might have to get creative. Maybe you get in the car to go to lunch or shopping and then you “remember” that there is a doctor’s appointment. You could mention that there was a call/letter saying that your loved one needs a check up in order to get a prescription filled or an insurance policy renewed.
Choose your words carefully
[13]Individuals having a conversation
Use the words that are most comfortable for the person. It may be best not to mention “Alzheimer’s” or “dementia” when you are sharing your concerns. You might try: “let’s go to the doctor to see what might be causing these changes.”
Express your love. You might suggest that having him or her visit the doctor could clear up your worries. He or she may be willing to go to show that nothing is wrong and reduce your stress.
There may be a crisis
Sometimes none of this works and may even cause anger from the person you are trying to help. Your loved one may be afraid of losing his or her independence. Try to imagine how it would feel from his or her perspective.
Occasionally it takes a serious incident before a doctor gets involved – maybe a fall, a trip to the emergency department, or a wandering [14] occurrence. While unfortunate, this may happen.
If you are concerned about the safety of the individual and you are not nearby, we suggest that you call Adult Protective Services where the person lives and report that you are concerned about his/her self-neglect. Depending on the situation, they may be able to help get the individual connected with services.
We’re here to help
The Alzheimer’s Association is here to help with support and suggestions any time. We can discuss this or any other issue related to the Alzheimer journey, 24/7 at 1.800.272.3900 [15].
If you’ve successfully overcome a loved one’s initial reluctance to visit the doctor, please comment below to share what worked for you.
Learn More:
- Conversations About Dementia [16] online workshop
- 10 warning signs of Alzheimer’s
- Getting a diagnosis
- Safety issues
- Our programs and services [17]