How do you deal with a person in denial of dementia?

One of the most frequent and important questions I am asked is how can I help someone that is displaying dementia, but doesn’t believe they have cognitive impairment.

First, dementia results from damage to the brain which is created over time. People with early dementia i.e. the presence of damage many times does not yet show on an MRI or CT Scan. The result is Doctor will them they don’t have dementia without the evidence showing in the MRI or CT Scan. They may schedule a cognitive test; which takes about 3 ½ hours; and will also be looking for behavior issues as well which far too many people try to hide, even from their doctor and spouse.  Given issues with the cognitive test and behavior issues the Doctor may diagnose a patient as having Mild Cognitive Impairment (MCI), i.e., Early Onset Dementia.

See the last show or podcast on Dementia Talks or the the last Article for the early signs of dementia.

Early Signs of Dementia

1 – memory problems, particularly remembering recent events.

2 – increasing confusion

3 – reduced concentration.

4 – personality or behavior changes

5 – apathy and withdrawal or depression

6 – loss of ability to do everyday tasks.

Robin William’s tragic ending and the book and movie named Still Alice are but a few current examples of people denying their dementia and not getting help. Denial is only the tip of the iceberg. Each day a person with dementia does not get help is like moving two days closer to Phase 2 where help is kind, but not as effective.

My Experience

I know from my experience that even thinking that losing my mental capabilities and all that is wrapped up in it, gave me cold shivers. I prized my intellect more that my mobility, sight, etc. I was not prepared to think it could happen to me. My first real introduction to even the beginning stages of Dementia was having dinner with a dear neighbor.

Mark was quiet and withdrawn, he engaged when he was supposed to, but I knew something was wrong. I still strive every day to not be that way, but Mark like me had Lewy Body Dementia. I knew Mark had a strong professional career and the Mark I was talking to was a different Mark then years before. Sadly, Mark died a few of years ago. Yet here I sit here knowing the clock is ticking, but I am willing to take whatever the doctors suggest to help my memory and my Parkinson’s.

The answer like it was for me is AWARENESS.  Once you know people with early onset dementia you understand better what it is. You also can build a determination to make the most of the time you have left.

But, back to the Problem

What do you do with someone that refuses to get help?

The Alzheimer’s Association of the UK list 8 things to keep in mind.

Dementia can be the elephant in the room, with everyone afraid to talk about the issue.

Eight Suggestions from the Alzheimer’s Association UK

1 – Have conversation without conflict.

2 – Find the facts. …

3 – Get help. …

4 – Work together. …

5 – Be positive. …

6 – Don’t force it. …

7 – Be kind to yourself. …

8 – Practical planning

These are strong recommendations. But as I look back…I would add a few more.

My Recommendations from Experience

1 – Don’t gang up on the person.

2 – Support and understand their speed to process their issues.

3 – Keep a journal, not for the person but for the doctors

4 – Be gentle. Remember, if you present their issues as cold hard facts, you can come across as the Prosecutor trying to convince them they have lost or are losing their mental faculties.

5 – Don’t correct or escalate a fight. Their understanding is solid. What they think they remember are facts to them.

6 – Go to a clinic that keeps the doctors connected so that they patient as one person. With one Doctor on point.

7 – Take time to understand, what it feels like. Listen.

8 – Come back a few days later. Let them have time to process information.

9 – Learn the benefit of early diagnosis so they can see them as a plus.

10 – Don’t challenge their views, give them the option to change their mind later if they like.

You can see from the two lists above personalities can have a big play in this especially if you have already created conflict in your relationship, and if this situation has been the source of underlying conflict.

Put love back in your relationship. Proving you are right is not the goal. The goal is having a relationship is based on trust and love. Believe me, this is just the beginning, there are hard times for yu and your loved one ahead. You want to be on the caring side of the relationship.

If you can’t do this step back, take a breather, and let got of the past. This is something that will reshape your total relationship.

I know that my relationship with Christy my wife of 43 years and my caregiver is based on trust. What we are facing we don’t have all the answers to, but we will figure it out together. I have to learn; I am not always right (in fact, I find I am frequently wrong) and let go and trust her.

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