The Best Approach to Medical Appointments

By Jane Verity ©dementiacareinternational.com

‘I Won’t Go & You Can’t Make Me!’

A commonly asked question from someone caring for a person with dementia is, ‘How can I get my loved one to go to the doctor?’

A person with dementia may adamantly refuse to go to the doctor. The issue of obtaining a diagnosis is not the one we wish to address here, but rather the person’s fear and reluctance to visit a GP in general. Firstly, you need to decide in your heart, what is the true purpose of the visit to the doctor?

A refusal to see the doctor is a common reaction of a person in the early stage of dementia. The person may feel that they are losing control and are fearful of what the future holds. For those in the later stages, this does not seem to be such an issue.

Medical check-ups are very important because symptoms of many conditions such as infection, dehydration, constipation, medication poisoning, or pain, can manifest in dementia symptons. These conditions can also increase existing symptoms, creating unnecessary concern. A medical check-up may allay doubts and prevent further deterioration caused by an underlying illness.

Two Main Fears Behind The Person’s Refusal to Visit the Doctor
  1. ‘The doctor is going to tell me something is seriously wrong‘
  2. ‘The doctor will confirm that I have dementia and I may lose my house/control/independence’

Acknowledge

Acknowledge and validate the person’s fears. Check the basis of these fears using the compassionate language of NeuroLinguistic Programming. NLP questions open new ways of thinking. These questions may not always observe usual grammar conventions or make normal grammatical sense but are specially designed to gently move behind our defences.

What You Say & How You Say It Are Paramount to Success

When you validate a person’s fears, acknowledge them in a gentle and compassionate way.

For example:

‘You seem worried about going to see the doctor.’ Wait for their response.

Then gently probe the person’s fears, ‘If you were to go to the doctor, what would stop you?’

If you know they hold an unfounded fear, you can reassure them that it is not an issue and then repeat the question again. ‘I know your fear is real to you. But I wonder if seeing the doctor could help alleviate your fears. If you were to go to the doctor, what would stop you now?’

If it is a fear of being diagnosed with dementia, you could then ask, ‘If that was to be true, do you prefer to be told or would prefer not to know?’

It is absolutely necessary to repeat the question in exactly the same words as the first time. Avoid using words such as, ‘Would you like?’ or ‘Would you..?’

Avoid Reasoning

No matter what stage of dementia the person is experiencing, reasoning does not work. For example, if you say, ‘You need to go to the doctor – your blood sugar is low and I’m concerned you may have diabetes,’ or ‘simply, ‘You need to go to the doctor!’ a person with dementia will only dig in their heels.

The reality is that it can be a relief for some people to receive a diagnosis of dementia because it explains the reasons behind the symptoms they have been experiencing. For others, it is their worst nightmare. Ensure you check the person’s wishes regarding this before you visit the doctor, as it is too late after a diagnosis is announced.

By compassionately validating the fears of the person with dementia, you may be able to allay their concerns about visiting the doctor and take the stress out of scheduling medical appointments.  Careful and gentle questioning enables the person with dementia to express their concerns and retain a feeling of control in the process.