How to get a person living with Alzheimer's or a related dementia to go to the doctor.
Before I get into the details let me mention this. On average, I had to take my mother, Dotty, to the doctor an average of
27 times a year.
So I had no choice but to figure out how I could get her to cooperate..
By Bob DeMarco
Alzheimer's Reading Room
In the beginning, I made the most common and typical mistakes. I tried to explain over and over why she had to go to the doctor.
We made the doctor appointment and we have to go, I would say. Mom responded - there is nothing wrong with me, I don't need to go to the doctor. Followed by the keyword No. You may be having a similar problem if your loved one is refusing to go to the doctor.
You are sick and we have to find out what is wrong, I would say. Mom responded - there is nothing wrong with me I am a healthy old broad. Along with the key word No.
I can laugh about this now, but it did not seem funny to me at the time - it seemed burdensome.
Finally, I learned that the more I tried to explain the more frustrated I became. Most Alzheimer's caregivers know exactly what I mean, and how I was feeling at the time.
In addition, I learned that the harder I tried to convince my mom to do just about anything
the more frustrated, sometimes mean, and more recalcitrant my mom became.
She would dig in her heals.
Does this, or did this every happen to you?
Finally, I realized and accepted that what I was doing was not working and
it was never going to work.
When it was time to go to the doctor my mother never said, not once, okay. That is how I finally realized what I was doing was never going to work.
Eventually I came upon a new strategy.
Long before it was time to go to the doctor, the day before if it was a scheduled appointment, or early on the day of the appointment, I would start preparing my mother mentally.
I would say to Dotty as I put my arm around her and gave her a little hug - we are going to the doctor tomorrow. Dotty of course would say, I'm not going. I would smile and usually laugh, and keep my mouth shut.
So I began by using large doses of positive reinforcement -- by giving the hug, and associating that with the big negative words in the sky - doctor's appointment. Thereby turning the negative into a positive through high quality nonverbal communication.
When we neared the time of the appointment I would gently lead my mother to the shower. Of course that is an entirely different issue fraught with peril for the caregiver.
Me on my oh me. As I think back on this problem I realize it took me over 2 years how to figure out the solution.
Next up, and when it came time to head out the door, I became a guide. Instead of talking, I put my arm around my mother, added the squeeze (hug), and said, come on we are going out. She would usually respond, where are we going?
By that time, I had her up with her hand in my hand, and we were heading to, or out the door. Be a guide.
At this point I would say to my mom - after the appointment we are going out to breakfast (or lunch, or to get ice cream). Use whatever you think works best as the reward for cooperation. This is called persuasion and positive reinforcement.
What is the art of persuasion when it comes to a person living with dementia who is already deeply forgetful?
Well, if you are getting into a debate with an Alzheimer's patient you may as well bang your head against the wall; but, you already know this don't you?
If you are trying to convince a person who is deeply forgetful by stating all the reasons in a bullet point fashion like you are trying to convince them that a trip to the doctor is good and necessary,
Bang you head against the wall.
It is easier and simpler.
Don't feel bad. I was constantly banging my head against the wall for years before it finally dawned on me that my communication strategy was flawed and would never work.
1. Use as few words as possible. Don't make it a contest.
2. Learn now to use nonverbal communication (hugs, smiles and laughs) as your go to communication persuasion tool.
3. Be a guide, not a parent.
4. Don't bang you head against the wall.
The key to success - Change. You change. Develop a new set of communication skills. And, new communication tactics.
Take a look at, or review, these articles to sharpen up your Alzheimer's care partner skills.
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