Late one night I was deeply engrossed in writing a short story about three parakeets when the phone rang. Must be Ed I thought. But it wasn't. It was a woman calling to tell me she'd found Ed driving on the wrong side of the road.
In my deep denial I thought it was just because he was driving after dark. (He wasn't supposed to drive after dark.) I thought it was just a temporary confusion -- not a sign of something more ominous. Not an early sign of Alzheimer's.
In its 2014 report, Alzheimer's Disease Facts and Figures, the Alzheimer's Association states that someone in the U.S. develops Alzheimer's every 67 seconds. The report also says that an estimated 5.2 million people in the U.S. are living with Alzheimer's, and that 500,000 people die [each year] because they have the condition.
Overcoming Denial -- The First Hurdle
As I wrote in a previous article here, Alzheimer's and the Devil Called Denial, the disease is, above all, an insidious one. Its symptoms often begin so mildly and progress so slowly that it's easy for friends and loved ones to deny them. There is a tendency to make excuses for the person, to push the symptoms to the back of one's mind, or to try to explain them away.
The person with the symptoms is often in denial as well. In my Alzheimer's memoir, Come Back Early Today, I discuss this. As their brains slowly deteriorate, they struggle to adjust and continue functioning. During this time symptomatic people usually realize something is wrong and try to understand it in any way possible that doesn't involve the words "Alzheimer's" or "dementia."
Why to Get the Person to a Doctor
It's critical for everyone involved to overcome their denial and take the first difficult step of consulting a physician about the symptoms. Some people think there's no reason to seek a diagnosis because there's no cure for the disease. Yet it's is important for several reasons.
The first is because the person may have some other condition that's treatable or even reversible.
According to an article published by Dr. Oz and Dr. Michael Roizen:
"Many conditions can mimic Alzheimer's, including vitamin deficiencies (such as folic acid, niacin or vitamins B-1, B-6 or B-12), normal pressure hydrocephalus (NPH), depression, urinary tract infections, an underactive thyroid, and reactions to certain drugs."
The Alzheimer's Association lists these other advantages of early detection:
"1) You can explore treatments that may provide some relief of symptoms and help you maintain a level of independence longer.
2) A diagnosis of Alzheimer's allows you to take part in decisions about care, transportation, living options, financial and legal matters.
3) Care and support services are available, making it easier for you and your family to live the best life possible with Alzheimer's"
In Alzheimer's and the Devil Called Denial, I added to that list that early diagnosis helps you and your friends and family members adjust to the person's condition, rather than becoming angry at their unusual actions and possible negative personality changes. It allows everyone to be more understanding and compassionate with the person.
How to Convince the Person to Go to the Doctor
Unfortunately, in many cases people experiencing symptoms of Alzheimer's flat out refuse to consult a doctor. This may be because they are so much in denial they think nothing is wrong with them. It may also be that they are secretly afraid that it may, in fact, be Alzheimer's. Many strategies can be tried to convince the person to visit a physician.
You may be able to reason with those who have mild symptoms, although it may take several discussions before they agree to be seen. You might also ask a good friend or favorite relative to speak with the person. Sometimes people will pay more attention to someone other than the primary caregiver. You could also ask the person's physician or attorney to talk with them about it.
The Alzheimer's Association St. Louis Chapter has published a PDF that gives several possible strategies for solving this problem. Among the suggestions are to "Seize the opportunity. Suggest a check-up if your loved one expresses any concern about 'not remembering things lately.' You could explain that there are new medications that may help with memory, but they must be prescribed by a doctor."
Another piece of advice in the PDF is to "Ask for a personal favor. At times, loved ones will do something for others that they would not do for themselves. Ask them to see a doctor as a favor to you."
Those with more advanced symptoms may not be amenable to a logical discussion of the issue. Carol Steinberg, then Executive Vice President of the Alzheimer's Foundation of America, told me in an interview that you may have to use what we call 'therapeutic fibbing.' She gives an example: "Tell the person you have a doctor's appointment and ask them to go with you. This of course would have to be prearranged so the physician would know the real reason for the visit."
The Alzheimer's Association Northern California and Northern Nevada Chapter has several suggestions as well, in a blog entry entitled, How do you convince your loved one with memory loss to see a doctor? Among the ideas put forth is to "write down concerns and observations and mail them to the person's physician. Then you could suggest they call that person for an appointment based on something else in their medical history." The article states that a doctor may not follow through, but it is worth a try.
According to Paula Spenser Scott, writing on Caring.com, you may want to "try calling the doctor in advance of a routine check-up to express concerns and ask about a memory screening. Or use another health complaint (fatigue, arthritis) as a pretext for making a physician appointment."
Ms. Scott also says you should acknowledge the person's fear by saying something like, "It's not pleasant to think about and I am a little worried, too. But if we can find out what's behind the mix-ups, then the problem can be treated."
Finally, as a last resort, the St. Louis Alzheimer's Association chapter PDF says you may have to call Protective Services. "If your loved one has become a danger to themselves, or if their well-being in in jeopardy, outside help might be required. Protective Services may be able to help convince your loved one to see a doctor."
No one wants to have a loved one evaluated for Alzheimer's. There's nothing more chilling and painful than to find out a loved one has the disorder. But when symptoms are present seeing a doctor is critical, and the sooner the better.
Does anyone have any other ideas about how to convince a loved one with symptoms of Alzheimer's to go to a doctor?
Marie Marley is the award-winning author of the uplifting book, Come Back Early Today: A Memoir of Love, Alzheimer's and Joy. Her website (www.ComeBackEarlyToday.com) contains a wealth of information for Alzheimer's caregivers.