It can be incredibly frustrating when a parent, partner, or another family member is denying, or unable to recognize, their own cognitive impairment. The goal is to help them get the right care and establish a plan for the future, but when acknowledgement or awareness is not forthcoming, providing assistance becomes a bit of challenge. Understanding that this is a common occurrence is a good first step in diffusing the situation to avoid quarrels and conflicts as much as possible. Not everyone is comfortable admitting that they have a condition that they have recently been diagnosed with, especially if they do not entirely understand what is happening.
Quite often when someone is denying a dementia diagnosis it comes down to one of two common factors:
Many people are terrified of a dementia diagnosis, and with good reason. Can you imagine being told your brain is in decline and you will lose the ability to remember those around you? That you will lose the ability to be in control of your life? And that there is no cure for the progressive illness?
When you really think about, it is not overly surprising that many people react to such shocking news with refusal or opposition. Denial and avoidance can provide a semblance of comfort in the face of fear. Denial is an often used coping mechanism to help the mind contend with a devasting diagnosis. Admitting that you have dementia makes it real, and sometimes people are just not ready to accept that reality immediately.
Anosognosia is the inability to recognize an illness or disorder that is clinically evident. The term anosognosia is sometimes referred to as “without knowledge of a disease” or “lack of insight”, meaning the individual may not have the mental capacity to truly comprehend the situation.
Dementia can cause damage to the brain, and your loved one may not know or have the capability to understand that they have dementia. This condition is not based in stubbornness or denial; it is more about a lack of understanding, awareness, or acceptance a health condition is present.
There are several useful tips and suggested steps that can help your loved one accept a distressing diagnosis.
Your loved one does not necessarily have to accept that they have dementia for you to help them, but getting a formal diagnosis can be incredibly beneficial. As a caregiver, it is crucial to have a professional dementia diagnosis performed as soon as possible. Steps you can take to assist with this process are:
A proper diagnosis will allow you to take advantage of therapies and medications that can help slow the progression of the disease. It also allows the time to make important financial and legal decisions, as well as prepare for the changes that will take place as the condition progresses.
Other experts, such as social workers, care managers, or even priests or ministers, can help alleviate the stress and anxiety of a loved one refusing care and assistance. An expert can explain how different therapies can benefit them. Professionals have a lot more experience in these matters and are often able to provide insight and accurate answers to any questions you may have.
It is essential to be honest and supportive in the face of adversity. It is important to keep in mind that your loved one has been making their own decisions and taking care of themselves for a lifetime. All of sudden being told what to do and how to live does not always go down as well as hoped.
If communication seems like a constant struggle, you might try asking gently probing questions while keeping an open mind and listening carefully to the answers. Non-threatening, open-ended questions can help shed some light on underlying causes for resistance. Slow things down, go at their pace, and see if you can work together to find common ground and understanding.
Making a list of priorities and goals can be a big help when it comes to making informed decisions and picking the right battles.
A high priority problem would include forgetting to eat while a low priority issue might be wanting to stay up later than usual. Creating an ongoing list of organized priorities is a good approach. Look at each point and write down what steps have already been taken and where some help would be useful. Caregiving can become a weighty burden, and making a list based on priority can help reduce stress and strain.
Denial is often part of the dementia journey, and accepting that your loved one may not be ready or able to understand a dementia diagnosis is often a component of the process. While we can try to help them gain acknowledgement and acceptance, cooperation and compromise are key to health and safety. A dementia diagnosis is generally devasting for the individual as well as friends and family. Home care assistance from a professional home care agency can ease the stress and burden to improve the quality of daily life for all involved.