How do you get someone to acknowledge that he has dementia?

[redbiker]

My Father behaves normally most of the time, but often makes wild accusations and gets paranoid about things that he believes have gone missing. He has upset many members of the family by accusing them of bizarre acts, threatening police action, etc.
We are very concerned as he is caring for his Wife who has been invalided for many years, and he frequently upsets her.
He won't admit that he has a problem, and instead blames it on everyone else. We have asked the Doctor to assess him but he says he cannot discuss his condition with us unless my Father gives his permission - which he has declined.
How can we get help for him if he won't admit his problems and won't even discuss it with us?

 

[carpe diem]

Hi, unfortunately I think the short answer to this is you can't. But I hope someone can disagree. My Mum has had dementia for over 10 years and still doesn't accept it. I'm not even sure how the diagnosis came about! We phoned and wrote to her GP many times. The more I press any issue the more upset my Mum gets so I have learned to try and keep her happy with what I say to her and then I just have to be shrewd to get what she needs. I make up lots of stories to get her to go to the GP or accept some care. Good luck

 

[ellejay]

Hi Redbiker, I'm sorry you have this worry.

It's a good idea to write down all your worries and concerns about your dads behaviour and also how it affects his wife (after all, she is vulnerable too, I assume she relies on your dad for her care)

You can take or send it to the GP. I know the GP doesn't have to talk to you but he can read what you have written.

The GP should take notice and engineer a meeting with your dad, even if he uses your dads wife as the excuse.

At least you will feel as though you've done something to move things forwards.

Good luck

Lin x

 

[pop]

hi i am in exactly the same position as you and would like some answers to. i to have have been in touch with my dads doctor who says that we have to get him up there. if you get some answers pleeeease let me no and i will do the same 4 you

 

[Grannie G]

Please take ellejay`s advice and see your father`s doctor. It will not be a breach of confidentiality if the doctor listens to you or reads a letter you have written.
Make sure you express your concerns about your father`s care for his wife and write down all your concerns about your father..

 

[Fiona890]

Hi all,
I did manage to get my Mum to go to the doctors using emotional blackmail. I am very close to her and said that if she wont do it for herself then can she do it to put my mind at rest. I told her that if she didn't think she had anything to worry about then there would be no problem or diagnosis apart from a neurotic daughter.
It worked for me, hope this helps
Fiona

 

[Nebiroth]

The short answer is thatyou can't. It's actually fairly rare for someone with dementia to have insight into their condition. For the great majority I'm afraid it come to nothing more that a vague feeling that something might be wrong, if that - "there is nothing wrong with me" is, sadly, the usual response. The disease itself tends to take away the ability to recognise the failings the disease is causing.

The cause of the accusations is usually memory or delusion related. Either he is putting things away (often in bizarre places), forgetting having done so, then unable to find them - the only rational answer is that "someone" has moved or stolen them. Even though this may make no sense, in that a well person would recognise the more likely explanation is themselves rather than phantom burglars entering locked doors or still less that loved family members are stealing from them, this doesn;t matter. It is a rationalisation, a way of making sense of a world that no longer really does.

The same result comes from delusions (false beliefs), for example, a delusion of having sums of money that never existed, when they "go missing", again out come the accusations

The result is often paranoia, they are only reacting as anyone would if they genuinely thought people were stealing from them etc. The beliefs are real, only the events are not.

A few people may recognise there is a problem, but then go into denial. They are afraid to acknowledge the problem, in the hope it will go away - or because they are aware of what it may mean, or fear going to a doctor for having this confirmed or worse still, being "locked up" or condemned as "mad". Espescially the older generation, who have grim memories of the stigma of mental illness and how such people were treated by being put into institutions.

As has been said, there is nothing in confidentiality that prevents a doctor from listening, either face to face, or in writing. You should emphasise the risks to your invalid mum (use the term, "vulnerable person")

Left untreated, paranoia does not go away, it usually gets worse and can spiral out of control - and the person with it may, eventually, decide to take drastic action against his "enemies"

 

[lillibet]

sorry

sorry to hear you're in this difficult situation
It sounds like you are not going to get anywhere with your dad, so may have to try from a different angle. If you are seriously concerned for your stepmother's wellbeing you could write to the social services regarding the situation, as they have a duty to safeguard vulnerable people. You would have to be quite specific about incidences when you suspect she has being emotionally abused and it's not an easy thing to do. But if you really believe your father's mental state is putting her at risk it might be the only thing you can do
good luck

 

[optocarol]

Redbiker, I so know what you mean about paranoia, even if just in a small way. My husband is convinced a certain person has done things to 2 boats he owns - no longer using. His daughter, who is in the police, reasons with him, but it's no use. I now try to change the subject or just nod and not say much.

When my husband first went to the doctor, a few months ago, it was because he had to apply for a new driver's licence. I went too as I had a reason and while in there told him my examples of behaviour I thought was not normal. He told the nurse to take husband back in and do MMSE. That's how this all got under way. He also ordered blood tests. Now, I don't know if this could help you, but my step-daughter and I have power of attorney for personal care (may be different where you live), so when I phoned about these results and the nurse was reluctant to tell me, as soon as I said "power of attorney" there was a complete change of attitude.

 

[optocarol]

Sorry for duplication - still getting sorted.

 

[redbiker]

Many thanks for all your helpful advice.

After writing a long detailed letter to my Dad's Doctor (2nd one) he did agree to see him using an excuse of an over 80's routine check-up. After seeing him and having a long conversation with him he was very reluctant to discuss any of his findings with us.
The only way round this would be to get my Dad's permission, which he would never agree to as he made it clear to the Doctor that he did not want any of the family to know what they had discussed. I feel sure that he is convinced that we are all trying to make out that he is going mad as we are all after his assets. Whenever he raises any issues, ie, something going missing, he threatens to change his will as he knows what is going on and what we are all up to. Which is definatly not the case. He is so convincing and has possibly even got the Doctor believing that we are all up to no good.

Thanks for the idea of contacting Social Services that may well be an option.

Sorry to hear of everyone elses issues and hopefully in time we may all have the help and support that we need.

Redbiker

 

[FifiMo]

Redbiker,

Unfortunately, in circumstances like this, it is difficult to help. There are however a couple of things that you could do. In the circumstances, the GP won't be forced to do anything until a crisis arises. What we were advised is not to step in and take care of business but stand back and let the crisis arise - only then will the GP and the other authorities be required to step in and do something. Obviously you wouldn't not step in if it was a life or death situation, but other than that just let things come to a head. Recognise and tell relatives and friends that the police are your friend. Let him phone the police, they know how to deal with people with dementia and not only that they will be obliged to write a report and send it to his GP and SW department about each incident. Our GP said we should even encourage our mother to phone the police - as it is all good evidence to show she needs intervention. It might also be useful if friends or family who see him not coping in looking after your mother or really upsetting her to make a phone call to SW department too.

I know it sounds like subterfuge but sometimes it is the only way that help can happen. Sure his GP has to respect his wishes and patient confidentiality and that is fine. What is not fine is if the GP then hides behind this and does nothing to resolve the issues and challenges he is facing. So, you've tried the direct route - now change tactics and go the roundabout way - wait for a crisis to happen - then your challenge will be in not telling the GP "I told you so".

Fiona

 

[hollycat]

Had similar prob with dad years ago.

In the end, it took a longstanding close friend to come in for coffee and biscuits, paying a casual visit once a week for a couple of months.

In the end, the friend sought my dads advice as he pretended he had memory problems.

Dad replied, huff, puff.......my kids keep telling me the same, they don't have a clue.

A few weeks later over coffee, dads friend said he had been to draw a clock and tell doc who prime minister was etc etc and they had now given him some tablets. He then lied and said he had been back for a test and improved.

All a bit cloak and dagger, but in our case it worked.

The only problem doing it this way is if it goes wrong !

 

[NeverGiveUp]

A bit of caution

Could I just suggest a bit of caution when bizzare accusations are made, sometimes there may be some truth, particularly about intruders in the property. We had a strange burglary in which things did not add up, a chance conversation with a locksmith revealed interesting things, I would prefer not to go into details as investigations are not complete but it is possible for an intruder to get into a locked home, the methodology is shockingly simple.

Some years ago I had an elderly uncle who claimed 2 people entered his home early every morning, cooked a meal and left without speaking to him, he eventually booked himself into a nursing home. His friend did the shopping, the food bill had increased. I am ashamed to say that i didn't persue the matter with vigilence, several years later when looking at photographs taken in his house I realised that things had also gone missing.

I know exactly what dementia delusions are all about, so do exploiters of the vulnerable, the person might be too afraid of not being believed to report what has happened.

 

[rev]

Unfortunately if someone won't admit they've got a problem there is very little you can do about it. Dad has never admitted there's anything wrong with him and even now he's in a home we think he's still struggling against his illness even though he has no grasp of what's going on around him. We knew he had memory problems years ago but he wouldn't see a doctor about it & when my husband 1st met him he kept on saying that Dad was constantly bluffing to seem 'normal'. We did eventually get him to the doctor but it still didn't help him to face things. In fact the doctor wouldn't give a prognosis directly as she knew he wouldn't accept it. I think her words were "I don't think we need to give a name to this do we"! Good luck with your Dad & I hope things get better for you but from personal experience I don't think you'll ever get acceptance from him as to his condition.

 

[JoshuaTree]

Hi there.
My Mum was relunctant to get help, but we were lucky, as soon as we contacted the DR he went straight into action. He was brilliant. He made up excuses to pop round and see her, got the CPN involved and continues to be a support now we are facing more difficult decisions

 

[Margaret W]

I'd hate to say "let a crisis arise", cos I don't think most people would want to risk it, but it was precisely the crisis of mum being reported on the street at 3 a.m. that got the police involved - and boy do they move fast! Social Workers, doctors, all the lot are marshalled as a result of one single exercise.

I hate the post by Never Give Up, so scary, and we should all take note of it, cos I am sure it happens. My mum admitted a stranger to her house one night, fortunately a neighbour spotted him going in and went round. When she asked for his ID he ran. What might he have done to my little mum, I dread to think.

Very strange, Never Give Up, my mum said there were two men and a woman living in her house, and her food bill shot up too. I've only just thought about that. I used to take her to Tesco every Sunday for her weekly shop, but she started also buying stuff from the local co-op. I wondered where these two men and a woman might be sleeping in a two bed terrace, till mum said she had been sleeping on the couch in the living room. Now I wonder........ Oh, it doesn't bear thinking about. Dear me, I am upset. Maybe it was all true. I never checked her bedrooms to see if the beds had been used.

I'm sure it was all fiction, but heck, it might not have been.

Love to all of you

Margaret

 

[NeverGiveUp]

Margaret W

Sorry if I scared you, I want everyone to know that these things are possible, in our case I think we have someone playing 'mind games', the cruelest thing that can be done to a person with dementia, and they may know that they won't be believed. I have said as little as possible about it , I feel very strongly that this wasn't the first time this individual or individuals has done this.

I am sorry if I have caused upset but I feel it better that I warn those who are well and they can be vigilent. In our case food stuffs were also moved around/removed, many of those things were on shelves above the height that the person with dementia could reach, it was that which really got me thinking.

 

[Margaret W]

Never Give Up - yes you scared me, but I am glad you did. I like to think about what is the truth. I don't hide my head in the sand. It's all history now, and I'm sure mum's good neighbours would've spotted strangers around the house - unless the used the back door maybe. No, I'm sure they would have been spotted.

Eh, you don't think about such things happening, do you? Thank goodness I shipped her off to a care home, albeit with regrets.

Love

Margaret

 

[Neil C]

We have just taken the difficult decision to place my Mother into residential care, although we have not managed to get her there yet. The problem is that when she is good, normally during the day, she is nothing more than a little forgetful and mildly confused occasionally. She still manages most of the crossword for instance in the local paper. However, once dusk arrives things can take a drastic turn to the point that she doesn't know where she is or even why she is there. We have been with her round the clock for the past month as we wouldn't dare leave her at night and of course have sought medical advice. Apart from her poor mobility and the stairs she has attempted to leave the house on a couple of occasions. The quandry which is driving me to distraction is that during her "good" periods she absolutely will not consider a care home and is saying that we don't care about her, will leave her sat there on her own and that she thought that we loved her etc. When I try to explain her condition she just will not acknowledge it as she obviously cant remember the "bad" periods. We have tried a short visit to a care home but again the problem is that, although at the time she is extremely cross with the family, ten minutes after getting home it is forgotten. Consequently it is difficult to get her used to the care home gradually. Every time is the first time and she hates us for it. We have done a lot of soul searching to get to the point we are now but now I am questioning as to whether we have made the right decision. Should we try and keep her in her own home with 24 hour family and private care (if it were possible). I just don't know how to convince her that residential care would be the best option for her safety and wellbeing or what to do if during one of the good periods she simply says no. She is hopefully going for lunch at the care centre tomorrow but I'm not convinced that it will help or that she will even agree to go.