I spent Thanksgiving trying to convince my friends' elders that their short-term memory loss needs to be evaluated and treated ASAP, to delay the progression of dementia and hopefully keep them out of a nursing home. Eighty-year old Dora dismissed everything I said with, "Ohhh, I'm going to die soon anyway, next year for sure, so it doesn't matter." Then she spent most of the dinner complaining about all her pains from head-to-toe.
She was clearly depressed. But when I asked if she took anything for the pain or her mood, she said, "Nooo, I hate taking pills."
Her daughter apologized, "Sorry Jacqueline, she's so stubborn and won't do anything we suggest to help herself-we've given up."
For many years, eighty-five year old Kate has politely listened to me trying to get her to get tested, but she's never consented to go - until now. I was so surprised! When I asked what finally convinced her, she related numerous examples of how bad her memory has gotten and said that she was frightened. Unfortunately, she is now much farther into her dementia and the medication isn't going to work as well as it would have earlier.
The experience reminded me of the importance of letting families know to insist on getting their elders evaluated and treated early, even if there is resistance. I always say to the adult children, "When you were a kid, if you had a condition that could be helped with medication, would your mother have made you take it?" The answer is always, yes, of course. "Well, you have to be the competent parent now and do what's best for your mother, even if she protests."
The initial problem is the life-long relationship of an elder who has always been competent - and a respectful adult child who continues to go along with their wishes. Only when dementia has progressed so far that it is obvious that the elder is not competent to make decisions, does the role reversal occur - but usually too late to make a significant difference.
My own obstinate elderly father refused all help for years and even flushed medication down the toilet before I could stop him. Here's how I was finally able to get him in for evaluation, which required a little creative "fib-ology!"
1. Never use the words Alzheimer's or Dementia, rather say there are several new medications that can help keep memory from fading!
2. Ask the primary care physician to rave about the dementia specialist and how much this new doctor has helped so many patients. Have him say that unfortunately there is a long waiting list, and you will need to go in person to sign in to get on the list.
3. Secretly make the appointment, clueing the doctor's office in about your reluctant elder and explain your upcoming plan.
4. Take your elder to the doctor's under the guise of having to sign the waiting list-but then the doctor will suddenly have a "cancellation" and will see you right now!
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