You think your parent is showing signs of dementia. She lives alone; she rarely answers the phone or doorbell; the house smells like urine; and she isn't wearing clean clothes often. Obviously, the family is concerned and thinks Mom should be evaluated by a doctor. The problem is, she flat out refuses to see a doctor. What can a well-meaning family do in this situation?
Dr. Robert Stall, a practicing geriatrician for over 20 years in Buffalo, New York, says the first step is to try and understand what is behind your elderly loved one's refusal to go to a doctor. "Elders develop a level of trust and respect when they've been going to the same doctor for a long time. Adding a new person into the equation could bring on feelings of vulnerability, distrust and fear of the unknown."
Objective third party
In this instance, he suggests the caregiver ask for help from the primary care doctor. Have the doctor explain to your parent the reasons why he or she needs to see a specialist.
Although you may have said exactly the same thing that the doctor says, your parent might listen to a doctor or authority figure that's not related to them. "Don't take it personally," Stall advises. "It's human nature: it's easier to ignore the suggestions of loved ones. That's how family dynamics often work." In an elder's mind, a doctor, who is removed from the personal situation, carries more weight than a family member who knows the elder well and cares for him or her deeply.
Sometimes, caregivers want their parent to see a new primary care physician. Perhaps the caregiver feels their parent isn't receiving the amount of attention or proper care they need. Stall suggests considering a geriatrician – a doctor who specializes in treating elderly patient. "A geriatrician might lend a new perspective on a problem that other doctors have dismissed. Too often doctors take the attitude that its 'normal' as people age to have aches and pains, and they just have to live with it. This is completely untrue. Every health condition can be treated. The caregiver is right in wanting a new perspective."
To convince the parent, enlist the help of the parent's friends. If your parent knows someone who has gone to see a geriatrician, ask the friend to talk openly with your parent about their experience. Talking to a friend makes the experience more personal. If the doctor has helped the friend, your parent may be more open to giving the geriatrician a try.
The "just try it" technique
Another method to try is the "just try it" strategy. Don't ask for a long-term commitment from your parent to give up their regular doctor. Rather ask them to "go one time, just to hear what the new doctor has to say. Just give it a try. You don't have to do anything, and you never have to go back." That helps the elder feel in control of the situation, and less afraid of losing what is familiar to them.
Dr. Robert Stall has been a practicing Geriatrician for more than 28 years, owner of Stall Geriatrics in Buffalo, New York and serves as a mentor for medical students who are considering entering the field of geriatrics.