How to get People with suspected Dementia who are Reluctant to get a Diagnosis to visit the GP?
Background Information
Newly released figures from the RBWM show that the estimated number of People over 65 in the Borough, affected by Dementia is 2,193. In neighbouring Slough, that number is less than half of this 1,018, likely reflecting the RBWM Borough’s ageing population. Meanwhile, the actual number of diagnosed People in the Borough is 1,522. That means that 31% of People suspected to have the condition are going undiagnosed (Source: The Maidenhead Advertiser https://bit.ly/MADemDiag ). This is a concerning gap.
When someone shows signs of Dementia or has been recently diagnosed, they and their loved ones often face significant challenges in accepting this reality. Denial—a defence mechanism to manage fear and anxiety—is common. This refusal to accept the situation can manifest in both the individual and their family, who might attribute symptoms to ageing, stress, or other health issues rather than Dementia. Younger individuals or those with rarer forms of Dementia may particularly struggle with denial, as Dementia is often wrongly associated solely with much older age.
Reasons Behind Denial
Early diagnosis is important
Denial is influenced by several factors:
Fear of losing independence
Worries about the future
Misconceptions about Dementia
Stigma
Additionally, anosognosia, the medical name for brain damage which can affect People with Dementia, prevents individuals from recognising their impairments, complicates matters. This lack of self-awareness can make it difficult for Carers to convince the Person to seek a medical diagnosis.
The Importance of Early Diagnosis
Despite these challenges, obtaining an early diagnosis is vital for several reasons:
Timely Support: Early intervention allows access to treatments that may slow progression and extend period of improved quality of life.
Ruling Out Other Conditions: Symptoms could be due to treatable conditions like vitamin deficiencies for example.
Mental Health: Addressing uncertainty of symptoms can reduce anxiety and depression.
Future Planning: It enables preparation for legal, financial, and Care arrangements before the individual loses mental capacity.
Safety and Relationships: Early diagnosis can prevent unsafe activities, such as driving, and improve family dynamics by fostering understanding and support.
Encouraging a GP Visit
Approaching someone reluctant to see a GP requires patience and sensitivity. Here are practical tips:
Leverage Trusted Relationships: Speak to their GP to get support or trusted friends to advocate for a visit.
Highlight Alternative Explanations: Explain that their symptoms might stem from treatable issues.
Suggest General Health Checks: Frame the visit as a routine check-up to reduce resistance.
Use Creative Approaches: Arrange a casual outing that includes a stop at the doctor’s office to ‘make an appointment’, involve GP staff with little white lie that ‘a last minute cancellation means they can be seen straight away’ to help smoothen the experience. ( Also, ask GP staff for ideas, as they may have experience of approaches that work and help reduce anxiety).
Address Specific Concerns: Tackle fears about implications of diagnosis for driving or work by researching adaptations and practical solutions so these can be discussed.
Communicate Gently: Explain that early diagnosis and support can help maintain independence and quality of life. Use person-centred language to avoid triggering defensiveness. For example: ‘I’ve noticed some changes lately, and I care about your health. It might help to see a doctor as it might be something that can be easily addressed like a vitamin deficiency?’ Or ‘Getting more information can help us find ways to make life more comfortable and enjoyable for you.’
Support Strategies for Carers
If a loved one continues to resist, consider the following:
Contact their GP Directly: Share your concerns with their GP, who could invite them for a ‘general’ health check avoiding using the word ‘Dementia’ if it is triggering.
Engage a Different Perspective: Sometimes, input from another family member or friend can help.
Be Patient: Acceptance takes time, and self-awareness may fluctuate.
Carers can also benefit from speaking to a Dementia Advisor who deal with these situations daily and can provide advice tailored to the person (as every person is different). Support networks at Dementia Support Groups can also be useful sources of ideas from families who have dealt with similar situations and may have valuable suggestions.
Final Thoughts
Differentiating between denial and anosognosia is crucial. While denial is an intentional avoidance of reality, anosognosia involves an inability to recognise the condition due to brain changes. Understanding this distinction can guide how Carers approach their loved ones. Above all, kindness, patience, and support are essential in helping individuals navigate the complexities of a Dementia diagnosis and Care.
