How do you convince a spouse to get tested for dementia when they do not believe they have a problem?

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How do you convince a spouse to get tested for dementia when they do not believe they have a problem?

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My husband's personality has been changing -- CONSTANT temper tantrums (yelling and cursing) over next to nothing. He also cannot remember things that he has known for years, or has been told repeatedly. He gets angry over ridiculous things that he imagines (like me going into his medicine cabinet and stealing his toothbrush, and putting another one in its place -- Huh???).

He is only 73, but has had Type 2 diabetes for years. His mother, who was also a Type 2 Diabetic, eventually died of Alzheimer's. No one realized the state of her mind until she was hospitalized for something else, and they had to go into the family financial records she managed to try to put together the tax return. Invoices were paid YEARS into the future (every time she would receive a statement acknowledging a payment, she would pay it again); a tenant who had not paid rent for 1 1/2 years; no record (or any idea) of who was living in some of her rentals - and many other examples.

Anyway, that is probably WAY too much information -- But I am frightened. If it is dementia, maybe earlier medical intervention will help? Or maybe he is just becoming grumpy as he ages, and these things are normal? I just do not know what to do.

Alzheimer's & Dementia Behavior Change Signs of Dementia

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Hi,
First, your concerns are valid.
Second, don't try to convince him that he needs assessed. He won't believe you, and amping his emotions up around this issue will make things harder. You just need to get him to the doctor's for a routine 'checkup', and let the doctor take it from there. Don't discuss your concerns with him. Part of the disease can make it so that the person is oblivious to their losses (anosognosia). If you try to disagree with his 'reality' he'll get angy (That's what's happening with the toothbrush-he doesn't recognize the current one as his because his short term memory isn't working. So the story that makes sense to him is that you replaced it.) Just agree with him as much as you can and try to divert his attention if you can't. Do NOT try to reason, argue, or explain your decisions.
This really helped me understand the changes my mom was going through (you'll have to paste the address here into your browser's search window): http://www.dementiacarestrategies.com/12_pt_Understanding_the_Dementia_Experience.pdf

It's important to have him assessed by his physician, who will rule out other causes (thyroid, depression, low vitamin D, a UTI) and who may refer him to a specialist for further assessment. You'll have to let the provider know your concerns in advance. Many people give the office a heads up about the reason for the visit when scheduling it, and then slip a note for the provider to the staff at check in that details the behavior you see. It's ok to tell 'fiblets' to get him to the doctor's office-I told my mom that it was for her Medicare wellness check.
I do recommend that you also head over to the Alzheimer's forums as well, and utilize the resources there as needed. There is an excellent 'spouse' forum over there, and you will see that others are in the same boat. There are a wide range of folks, with great advice.
Here's the link: https://www.alzconnected.org/discussion.aspx
This is a site that lists the changes seen in Alzheimer's disease, which is just one of many types of dementia. Still, it might help you identify some additional changes you see: https://tamcummings.com/stages-of-dementia/

Legally: It might be a good time to talk to a certified elder care attorney about future plans, power-of -attorney for your husband, finances, medicare/medicaid, advanced directives for healthcare. If you don't have arrangements for yourself set up as well, (for instance, if this is dementia, and something incapacitates you, who will help your husband) now is a good time to do those too.

I like these videos as well:
Early signs: https://www.youtube.com/watch?v=pqmqC-702Yg
Losses besides memory: https://www.youtube.com/watch?v=awBm4S9NwJ0
Anosognosia: https://www.youtube.com/watch?v=5nw3YUDQJuY
Stage 3. https://www.youtube.com/watch?v=TIkTO4d8YyI
Stage 4 https://www.youtube.com/watch?v=coiZbpyvTNg

Best wishes,

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Elizabeth - I cannot thank You enough. Your timing in answering and putting together the resources is much appreciated. Thank you.

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Not to frighten you, but this does not sound like just old age behaviors. He sounds like he is definitely showing signs of some mental decline which could be Alzheimer's/dementia, and as today there are really no medical interventions to stop either. And the fact that your husband has diabetes, makes him at a much higher risk for any of the dementias. Yes, there are some drugs to try and slow down the progression, but often they don't work at all, or the side effects are not worth it.
Your best bet is to send a message to your husbands neurologist via the patient portal sharing what exactly your concerns are about your husband, and that way when you take him in for his appt. his Dr. will be well aware of what's going on, and will ask your husband the appropriate questions and order the necessary tests.
I had to do that with my husband several years back, and it worked out really well because he didn't know that I had contacted his Dr. prior to him going.
This is hard I know, but you really need to know what exactly you're dealing with as it will make it easier for you to plan for yours and your husbands future.
If you're not already his POA for both medical and durable, do that ASAP, because once he's diagnosed with any of the dementias he can no longer legally appoint anyone to be his POA's. Make sure that he also has his wishes notated in a living will and any health directives too, as that will make any decisions down the road that you'll have to make on his behalf a little easier, knowing that you're honoring his wishes.
I wish you the very best as you travel this road with your husband.

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Thank you SO MUCH. Great advice. Despite our age, we have never formally put together a will/trust -- just have all of our separate assets POD to the other, and our house as community property. Lots to do and think about. Thank you.

(3)

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Excellent information! Especially not arguing with your spouse. It is futile. I hope you can cut 'n copy Elizabeth's reply-a great road map of information.

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Also on YouTube, is an excellent set of videos by Teepa Snow that covers a wide range of areas on dem/ALZ……hope you have a moment to take a look. Blessings, Liz

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Scared, don't blame you.. tough times!

Firstly, support for yourself?Are there adult kids, a close friend you can confide in, not for medical advice, just to keep your own boat afloat?

Secondly, medical opinion & tests (as mentioned by the wise folk already). The old 'check-up' routine. Doctor has called & wants to see him for *diabetes check/renew prescriptions/new blood tests for chol* whatever works. Pre-warn Doc as mentioned.

Diabetes. I believe it is linked to kidney function. This should be looked into. Kidney function being 'off' may cause confusion & anger.

For markedly new symptoms a thorough medical will rule all other causes, never just state 'age-related decline' or Alzheimer's Disease. Never accept an Alz dx without a Neurologist input.

I have read many times people throwing those terms around. If incorrectly - maybe this causes a missed opportunity to locate the actual problem? Something that could be treatable.

Best of luck getting the info you need. Then you can chart the course required.

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Good advice … rule out anything medical first … !!!!
if it’s dementia there’s some meds that may improve behaviour and anxiety .. slow it down
for awhile … but there’s nothing that will stop the progression or reverse it. He’s obviously frightened and confused cause he knows there’s something wrong with his brain…and that would cause anyone to lash out especially if they’ve always been
in charge and in control.
good luck with it all .. truly a nightmare journey

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Ask his doctor to refer your husband to a psychologist for a "neuro-psychological" test. This is the only reliable test to diagnose early dementa. Of course, he could be having other psychiatric issues too.

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Thank YOU. It is a big help to know the terminology. We are with an HMO, and many times you need to ALREADY know what you need, and be assertive, to get to the right place.

(5)

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See a neurologist immediately. Sounds like Alzheimer’s or vascular dementia. Same symptoms my husband started with . Good luck

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I had the same with my mother who refused to believe there was anything wrong with her I called her doctor and they got someone to call her and asked her questions over the phone she didn’t pass and is still in denial it’s hard but you can only try unfortunately they are hard to convince

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It's a little different to denial (a sort of emotional protection).

It's lack of insight. The brain becomes a little faulty in parts & cannot understand.

I think of denial like if I don't turn the light on in the bathroom at night, there won't be any spiders.

Lack of insight is like walking right past the spider & seeing it but not being able to recognise it, understand it or remember you just saw
a spider.

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He may resist getting a neuropsyc eval, many patients going down the dementia path do because a part of them knows there is a problem and don’t want to know so the way it’s presented is important. If you have a good relationship with his primary ask him to recommend the exam as a baseline, something they always recommend for patients at 70 and something you both should do because having a baseline will help diagnose and treat in the event either of you develop signs of dementia, have a stroke or other maladies we don’t hear about as much. Sell the importance of doing it for the future not for a current problem. If that isn’t possible focus on using it to eliminate dementia rather than proving it. This test sounds much scarier than it is, just the name and “psychologist” or “psychiatrist” make people resist but the experts that administer this test at least in my moms area, only administer and interpret this test they don’t treat or provide long term counseling, this isn’t about changing who you are or exploring how your parents damaged you it focuses more on your reasoning skills, memory and how information is interpreted in your brain.

One step at a time and the less you panic, the calmer and matter-a-fact you can be about it all the better for both of you. Good luck

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I agree that it is better to suggest that you both get a good check up and prepare for future illness or incapacity, If he says there is nothing wrong or some problem other than you suspect, don't disagree. Even if he says it's you and not him, agree it is possible.He might be right, and concede this. I am sure you would prefer another explanation and possible treatment. Do alert the doctor's office to the changes you have observed first. Good luck; it is a very scary problem to consider.

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The best thing to do is to contact the Dr. office and have them call for an annual check up. I used to write notes, and slip it in with the paperwork. The dr. would come in and have had already read the note and could address like it was coming from him.
Otherwise, I don't know what to tell you! This is so hard! Worst part of my life was seeing my Father succume to this disease.

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Good answers here as always, I would just interject that if you can get him to sign POA for health and financials, do it now, while he is able to sign in a recognizable way. This will help you no end when it really begins. I had no idea how much this would help us now. We did this previously and I could not have coped with him now without it. It is so important. Everybody who dealt with your husband in any financial endeavor, as in TV/cable account, health care, credit cards,pension plans, banking, will want a copy of your POA in order for you to make decisions. Believe it or not, I had to fax these documents to a well-know internet company before I could cancel that service to get a better deal elsewhere. I also had to fax them to our heath care plan in order to just talk about, just TALK about, his appointments, payments, and meds.
I know this is an added stress for you now, but see if you can just accomplish it before it gets later. God bless you, and hang in there.

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Oh my goodness dear. You are surrounded by many of just having gone through or are going through this horrible disease.
I agree with these points:
-Get Durable POA done asap for medical and financial.
-Stopping all conflict by agreeing as much as possible saved my sanity and decreased the amount of conflict.
-call his physician office and leave a detailed message of symptoms and concerns asking them to call him in for a check up. ( Say They do this with everyone).
- begin watching all the YouTube videos by Teepa snow, Care Blazers, and the Banner Health dementa videos to get ideas, and then also order the 36 Hour day book. It will be VERY EYE OPENING!! And it's excellent!! Worth every penny!
-If I could tell you also one more thing, begin to establish a counselor or therapy appointment to have someone to listen to all the crap you will and mostly are feeling so you don't take it out on him. I spent my first appointment nearly sobbing the entire hour..,.grief, anger, even hatred And vile cussing will pop up when you are stressed beyond your ability to hold it In .
God bless you and everyone of us with this stressful care giving life.
Take good care of yourself too. You now will need good health to care for your LO.

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I see aging and the onset of dementia - both are disgusting and there are no answers - it just gets worse. First of all, immediately check with an eldercare attorney who can advise you what you need to do legally so you can take over, i.e. Power of Attorney, etc. Second, speaking with the doctor and try to work out something with the medical people. Third, contact Adult Protective Services as they are trained to step in and help with these situations. Whatever happens, looking down the road, if this continues and he becomes abusive and torments you and makes life hell for you, DO NOT ALLOW HIM TO LIVE WITH YOU - HE SHOULD BE PLACED SO YOU CAN LEAD YOUR LIFE.

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People like this will never, ever admit to anything going wrong. In the meantime, set tough boundaries for him to follow and do not hesitate to "stand up to him" if he acts out - you keeping it in will destroy you. DO NOT LET HIM MAKE LIFE MISERABLE FOR YOU. Do whatever it take to stop him in his tracks. It is his problem - not yours.

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It’s possible he maybe just getting grungy as u say. I would schedule him an appointment with the primary doctor and take it from there. He can get a social worker to talk too. It’s best to get diagnosed. Also, diet plays a major part. Please go to plant based tele heath see dr Michael Klaper check out both web sites just type in his name plant based tele health check out Neil Bernard and most of all Dr. Charles F. Stanley on Intouch. Org

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These changes need to be addressed. Get your husband to the ER. His mental ability changes could be Alzheimer's disease but could also indicate blood chemistry imbalances, infections, poor oxygenation, or strokes.

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I made an appointment for him with a Neurologist who interviewed both of us. Agitation is a BIG part of the disease and there isn't much help offered. I now have chewable CBD for him to take whenever he feels frustrated. I no longer eat meals with him in the room because I refuse to live in a hostile Ground Hog Day life. Keeping the peace often requires keeping our distance.

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Scared170: Your husband should be seen by a neurologist posthaste, who can provide him with an M.R.I. of the brain functionality.

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That's what I said, too--based on firsthand experience.

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Let your doctor order the "test".

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That can get tricky--the doc may or may not ORDER a test based on your reporting alone.

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How close are you otherwise? Are you able to keep a diary of these things for two weeks, then sit with him and read him the things that are "frightening" you. You can tell him that you are fearful due to his medical conditions that may be contributing to changes you need to be aware of. Explain that you BOTH are of an age and it is good now to get a baseline exam so that things can be "addressed early if there are any concerns".
Do check if he is doing the Yahoo binging where he is getting a constant feed of social media rage. Get out and do whatever you can to remove yourself from that. Know that covid is having an affect on all of us.
Be honest with your husband. Tell him that you would like you both to have a baseline exam to put to rest any fears that there could be some vascular changes and etc. If he will not agree you basically have choices whether to stay or to go, sadly enough.
Meanwhile who handles the finances? What is already in place. DPOA for financial and medical? Will, and etc. What have you been doing as you age in place, what have you spoken about regarding the aging process, the history and the problems that may come along?
If you are medical POA you can write your husband's doctor of your fears. He may not feel free to discuss with you, but he may address with husband, and get back to you.
Meanwhile, do start a diary for YOURSELF, so you can more accurately assess what you are seeing and when.

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AlvaDeer,

This is happening to my husband:
" he is getting a constant feed of social media rage".

It has changed him.

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If you are frightened that your husband has an unstable state of mind, there are techniques you can learn, some of them mentioned here in previous posts.
Here is another one:

Never shame someone experiencing the symptoms you are describing.

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Hello, Scared. My former husband (of 30+ years), had a slow personality change over a few year period--he became impatient and was easy to anger. I attributed it to a few things: He'd never been a particularly easy-going guy (classic brilliant eccentric), and had been professionally and financially 'successful'--but as a sole practitionor, he never completely rebounded after the 2007-2009 recession, which caused him (us) immense financial stress. Over the course of about 5 years, it sort of snuck up on me that things were in a bad way; finally there was a medical incident (weirdly, a bloody nose that wouldn't stop), which led to the ER, revealing a high-blood pressure crisis/hospitalization. A brain scan revealed he had had about 3 'mini strokes' prior to that, which had affected his personality. Also, the scan revealed a large pituitary brain tumor, which aren't usually fatal, but DO affect personality. Sadly, by the time these two facts were revealed, we'd been fighting for the better part of 5 years--I believed he was just being a major arse, and was mad at him and told him so--often. At that point, things had deteriorated so badly that we had to split up. I would suggest an MRI for stroke(s) &/or tumor for this personality shift. I offer you support and sympathy. Good luck.

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First and foremost, he is your husband. If his actions aren’t normal, then he needs help. As a wife, we are on the brunt of it and truly their only lifeline. If aggression gets too bad, then call 911 they will send police and ambulance. If they can talk him into going, then the hospital (especially VA) should do a 72 hour hold and should check him out throughly. In Kentucky, you can get 72 hour hold from the judge and do a temporary guardianship until all is checked out. During this 72 hour hold, make sure they do brain scan, check him for urinary tract infection (yess this will affect how their brain functions ...couldn’t believe it) check for blood clots, strokes, tumors, etc . Get a complete picture. Don’t give up on him, but stay safe. If it is dementia/ Alzheimer’s, then it’s worse scary for him...not taking up for him ...it’s just the way lot of men react. The hallucinations get worse. My daddy went through this... I never been scared of him as an adult until over a year ago . He scared me so bad, I felt my life was in danger it got so bad. We called 911. The ems talked him into going to Er to “talk to his doctor about “ changing his medicine “ . He agreed. That wasn’t the first time. The earlier ems visits they would ask date, President, and their name. He could answer all those but still be acting out. They said they couldn’t take him. So finally ems that dealt with dementia patients helped get him where he could receive the care he needed.
Look and pray to God for wisdom and help, talk to a good social worker (preferably from VA), get temporary guardianship (not POA) so you can fight for your husband and get him the help he needs and that could only come from someone who loves him. This is when the vows kick in for better or for worse , in sickness and in health. He needs you. Go fight for him and help him fight this disease/ sickness . Praying for you and him.

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How do you convince a spouse to get tested for dementia when they do not believe they have a problem?

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