Dealing With Denial

6 Ways to Work Around Someone Else's Denial
Speak no evil, See no evil, Hear no evil
Image by Rose Davies used under the creative commons attribution license.

Does the relative you look after accept the reality of his or her situation? What about the other family members in the orbit of concern? Do they realistically get what's what – or are they in the throes of denial ?

Dealing with denial ranks among the more stressful frustrations for caregivers:

  • Denial can prevent someone from getting effective care. I'm thinking of the family who make excuses for a grandparent's memory loss and confusion ("It's not that bad") -- right up until the day he's found lost on the highway, having driven two states away.
  • Denial can make everyday life harder on primary caregivers, hastening burnout. Here I'm thinking of the sibling who insisted Dad was up to a big family vacation to his hometown, even though at the care facility where he lives, it takes 24/7 care to help him use the bathroom or eat. (And she wasn't planning on hiring any help because "everybody can pitch in.")
  • Denial can strain relationships. It's stressful when two people don't see eye-to-eye about a remedy ("What kind of assisted living would help Mom best?") because one isn't even seeing the problem ("Mom is fine!"). That stress can even devolve to severed family ties.
  • Denial can interfere with quality of life. A friend recently told me how her family forbade the word "hospice" to be spoken, even as the latest scans indicated their father's tumors had spread throughout his body and the doctors were recommending palliative care – again. His final days were spent not in peace and drawing together, but in a whirl of last-ditch treatments and pain.

Anyone within a care circle is subject to denial: the sick or aging person, his or her primary caregiver(s), other family members. No matter where it starts, it sends out dangerous ripples. What to do about it?

Three Things You Can Do to Deal With Denial

1. Be patient.

Denial is, at best, a coping mechanism. Willfully ignoring facts helps some people maintain sanity in insane situations; for others, it postpones the need to deal with them. Call it a shock absorber for the soul. Some people need more time than others to face the realities of a given situation. Vexing for you, but necessary for them.

2. Distinguish denial from lack of knowledge.

Ignorance can be remedied by gathering information that allows you to make better decisions; denial is refusing to acknowledge the facts. So make sure, at least, that the person having a hard time accepting a situation understands the options, symptoms, treatments, what to expect. Share articles. Encourage conversations wit h experts, or with others who've been in similar circumstances.

3. Calmly repeat the facts.

Without sounding judgmental , calmly present the facts that led you to your own conclusions: "Mom, Dad is repeating himself every five minutes. You told me yourself he made big errors with the checkbook for the past three months in a row. He got lost driving to the grocery last week. I think the doctor should hear about these changes and check them out."

Write them down, if that helps. Repeat. And repeat again, as necessary.

More on Dealing With Denial

4. Disentangle your own ego.

When denial leads a family member to criticize your choices ("you're overreacting!" "you're enabling!"), try not to take it personally. Many caregivers report a satisfaction and strength that comes from knowing their decisions are rooted in careful eyes-wide-open consideration.

5. Encourage talk about the very things being avoided.

Tricky though this may be, gentle questions can help the person explore what they're running from: "Why do you think Mom will be able to live on her own again after the doctor said she'll never walk?" "What would be the worst that would happen if we talked to the hospice worker, just to learn more about it?"

6. Don't confuse denial with giving up hope.

Denial means avoiding the factual realities because they are simply too painful to behold, and to the extent that in doing so you also deny help (stronger pain meds, the comfort of an assisted living situation, palliative care ).

Hope, in contrast, means moving forward based on a clear grasp of factual realities, the dire as well as the unknowable, that's seasoned with faith. Hope is a commodity most people feel is a help, not a hindrance, and one that shouldn't be abandoned in any situation.


9 months ago, said...

I work for a mother and daughter who are both in denial that is as deep as the ocean. I take care of the mother who 92 years old and is going down hill fast. Her daughter is a nurse and thinks that since is a nurse she can take better care of her mother better than anyone else. The mother is only able to feed herself and put on her shirt. She not able to walk, get out of bed, clean herself, and she can barely see. I provide care for her in the day time while daughter is at work. The daughter is hoarder. She does not keep the house full of nasty things but nice things. I also believe she is shopaholic, because a lot of things in millions on piles of stuff is new and never been used. When I started working for them a few months ago I knew she was a hoarder and I knew they were in denial about the mother's failing health and hoarding, but I needed a job and I thought I could help them with transition from home to assisted living. Oh I was so wrong. Now the mother need constant 24/7, the daughter tries to still work 50- 60 hours a week. I never signed up to work that many hours, I'm a full time college student. The only grandson was helping out but has become so anger at his mothers hoarding that if he come around it upset everyone. I can't blame him. The hoarding is out of hand now, it make my job almost impossible. I truly believe that if I was not here that the mother would end up sleeping on piles of stuff. The mother believes she just needs a few weeks more to get better than we all get back to our lives. I know this not true. I don't what to do other than to quit and report the situation to adult protective services. Is there anything else I could do? I have tried talking to them and the act like I'm crazy when I even bring up assisted living.


over 2 years ago, said...

recommendations very beneficial!


over 3 years ago, said...

I'm sure this is a separate article, but when I read your intro I thought you were talking about getting those diagnosed to stop being in denial about their condition.


over 3 years ago, said...

Most helpful was the "plain talk" Nothing emotional .... just the facts. I plan to make a copy of this article and distribute it to the other family members involved in my elderly parent's daily care. Thank you!


over 3 years ago, said...

My dad, who cares for my mom, constantly denies what is obvious. She needs to seriously be put in assisted living, as he is of an age that he cannot care for her adequately. We are all very sad to see her progression, but his denial of her needs makes us question his ability to be her caregiver. Many of her needs are neglected on a daily basis, either because he does not notice or because he cannot take care of it. We have some agency help, but it is not enough. Her needs are so large. We are just not sure what to do.


over 4 years ago, said...

I still can not identify with my own situations, I know one will be present. Thank you


over 4 years ago, said...

I really needed this info badly!


over 4 years ago, said...

A good summary and useful suggestions.


over 4 years ago, said...

It was thoughtfully written, informative and straight forward.


over 4 years ago, said...

My care recipient still thinks she's able to do all the things she used to - even though she is mentally & physically disabled & has not so much as bathed herself in three years and can barely walk! I also encounter denial w/a few family members who say I won't let them help, when they know fully well they are physically and emotionally incapable of doing so.


over 4 years ago, said...

Unfortunatly, I can not identify with these situations Thank you....I know there is one out there.....Care Giver Child


over 4 years ago, said...

it has helped ease my guilt. Tho still not sure what to do about siblings not helping out, because they are blind to the realities of caring for mom on a daily basis


over 4 years ago, said...

To read that denial is common and difficult. Helpful to hear that financial matters can get screwed up. Helpful to hear driving and getting lost can get screwed up. Helpful to hear family members will not realize these concerns fully. SO helpful for myself to not feel alone in these realizations.


over 4 years ago, said...

Yes & No! I am a CNA working at a nursing home. I moved up to live with, help & care for my mother 6 yrs. ago. At the time she I moved she was doing pretty well. She didn't like driving & dad had always taken care of all the finances, etc. She has had heart problems & has been on coumadin since she was 68. Luckily, I had taken her to a lawyer at that time, got her living/financial wills & POA taken care of, she is now 84. She got macular degeneration in her right eye first (the doctor's after many laser & avastin treatments finally have to surender (it was not helping). Then she developed it in her right eye, we are trying the avastin injections again (but it seems to becoming a losing battle also. She was also developing dementia at the time. Last Oct.1st she fell & broke her hip, they did a hip replacement. The medications & pain pills caused her dementia to worsen. She was in the Nursing Home where I work, for 1 month for rest & rehab (they are very understaffed). While there she became very depressed & aggitated. She didn't understand why she would have to sit in a chair or lay in her bed for long periods of time, she didn't understand why the alarm was going off everytime she moved or tried to get up by herself, because of her dementia she didn't understand to use the call light. Everytime I would go into her room she wanted me to take her to the bathroom, but told the other aides & nurses she didn't have to go. She said she didn't want them to wait on her & doesn't like anyone to see her unclothed. The staff was getting irratated by her behaviors also. My mother has always been a very active person. She wants to do dishes which she does sitting on a stool with back, I had more therapy for her when she got home, so now she walks with a cane instead of a walker. I cut my working hrs. to 3 days a week. My aunt or cousin comes over on those days to watch her. Lately I can see mom is getting worse, she get dizziness & headaches a lot, but my aunt says shes find alone for just a few hours & says it she leaves she calls every .5 hrs. I want her to come talk to the doctor with us, but she won't. This is very upsetting to me. What can I do to get some help in this situation.


over 5 years ago, said...

Patience and hope


over 5 years ago, said...

I dont even know how to begin this-My mom is 63 and in the last 3 years has turned into a COMPLETE alcoholic-We've tried EVERYTHING from interventions to pleading,to trying to make her see its the reason for her trips to jail and to the hospital with multiple injuries... She refuses to acknowledge there is a problem...Talk about denial...I guess we just have to watch her die a slow painful death because to her,there is no problem:( And there is NOTHING we can do from a legal,criminal or health standpoint-you cant force someone to stop drinking,even though it basicly amounts to slow suicide. Hey,isnt suicide technically ILLEGAL,anyways?


over 5 years ago, said...

I think you also need to separate what might make someone happiest (living at home) from what is safest (in home care?). For example, my mother is obviously happiest at home (witthout any "strangers" around), but she constantly misses her medicine even with a pill dispenser with her pills put in their for morning, noon, and night. So, someone needs to check on her every day (which she thinks is great, and now expects son#1 in the morning, Son #2 in the afternoon, and daughter #1 in the evening for a 2-3 hour visit.)


over 5 years ago, said...

My mother has dementia. So, of course, there is some denial there. But my sister's denial is the biggest problem for me. Everyone in my family (which includes several medical professionals) believes my mother would be happiest and safest in a nursing home that has a memory unit. Everyone except my sister. She has been the closest to Mom for several years. This article does help me understand how my sister's denial is a coping mechanism to help guard against the pain of "losing" Mom. I will try to use the suggestions in the article...but dealing with my sister's denial is no picnic. My mother and my sister are the Delusional Twins. I don't know which one has the greater denial. At least my mother has the excuse of dementia. My sister's attitude and behavior baffle me. It is clear to anyone with a level head that mother needs to be in a nursing home. That is what would be safest for her and I actually believe Mom would come to be happiest there. She would have mental stimulation and some community with others her own age and circumstance, instead of being reminded of all the things she can't do anymore. But my sister refuses to even entertain the idea. She volunteered to "put her life on hold" to take care of Mom...yet only 4 days after she moved in with Mom, she is asking me to "set up a schedule" for the weekends, so I can help. Mother living at home is not something I support. I think it's wrong. I think my sister's denial is hurting our mother. It's not that I don't want to help my mother or be there for her...it's that I don't want to enable my sister in her denial.


over 5 years ago, said...

The situations mentioned by other responders really hits home with me - especially the one about the mother calling the Police and saying her daughter is stealing from her. The opposite is true of my situation. It is my father-in-law. He has went to the Police station on secral occasions to press charges against me. However, it is obvious to the Police and other Professionals that my father-in-law is showing signs of dementia and is in worse health than his wife who has Alzheimer's. Not only is he in total denial about his and my mother-in-law's situation. For the last seven years I have been the only caregiver for my In-Laws and I have made many scarifices in caring for them - even after having back surgery myself while my husband, their son, did basically nothing because it interfered with his Golf, work, or whatever excuse he wanted to use. To complicate matters worse recently their have been three people who have not dealt with taking care of my In-Laws who are coming into the picture stirring up things. When I could not give my father-in-law the answers he wanted he grabbed at whatever he could find. These people are not there to help my father-in-law. They have made matters worse - even one of then went so far as to tell my father-in-law thaT he needed to get a new cell phone because the one me and my husband gave him a few years ago is probably bugged so that I know all of his comings and goings. There is no reasoning with him. He has become very hateful and vindictive to me - especially since he convinced my husband who has recently become Guardian for my mother-in-law to let him move my mother-in-law to an assisted living facility. This was even after two weeks before Adult Protective Services told me that they would not let my mother-in-law go to this assisted living facility because it is not a secure environment and my mother-in-law wanders. On top of this, when my husband took his Mom to the assisted living facility, the Director was out of town, the Assistant Director was not there and the Attendants did not even know my mother-in-law and father-in-law were moving in that day. Also, the facility did not have the first piece of paperwork on either of my In-Laws and my father-in-law did not tell them my mother-in-law had Alzheimer's. I had mentioned to my husband the Friday before this happened that we needed to go by the assisted living facility to check things out before he signed my mother-in-law out of the Memory Unit because the assisted living facility is only a car space away from the road. His reply was, "We'll just wait and check it out when we move her on Monday." I told my husband that he was going to have a real fight on his hands with his step-father if it worked out to where his mother could not stay at the assisted living facility, but he did not want to hear it. When we got there we found out that they did not have a bathroom to their room. My father-in-law took every bit of my mother-in-laws belongings from the Memory Unit. I stayed with my mother-in-law while my father-in-law and my husband went back and forth to his parent's house to bring more belongings to the asisted living facility. My husband wanted me to go with him and his step-father because he did not want to deal with him. While they were gone my mother-in-law needed to use the bathroom. She did not know where to go since it was a new environment. If I had not been there she probably would have had an accident. While I was there on the first day that my In-Laws moved to the assisted living facility, my father-in-law seemed to be agreeable and talkative. The next day when I went after my husband had asked me to meet him there, I left later. My father-in-law was not there when I first came. However, when I was starting to leave, he was coming in the assisted living facilty. He became angry and started telling me to leave - that I was not to set foot in his house again. He said the assisted living facility was his house know and that I had better leave before he called the Police. The Assistant Director called my father-in-law into the office with me because he was getting my mother-in-law and the other residents upset. There just was no reasoning with him. All of this anger towards me is because I could not tell my father-in-law that APS was going to let him bring my mother-in-law home so things could go back to the way they were. Since then, he has had a wreck after driving dizzy. It has also been because these other people that have just recently came into the picture and only for a very short time are telling my father-in-law all kinds of lies about me and my husband. The only reason he is speaking decent with my husband right now is because he knows my husband and his brother have Guardianship over their mother. It is very hurtful with how my father-in-law is acting towards me now. What is really sad is that my mother-in-law with her Alzheimer's is not able to understand what is going on with my father-in-law. When he tries to turn her against me, she tells him that I have always been good to both of them and that she knows I would not do the things he says I am doing. This makes my father-in-law mad. I know his behavior is because of his dementia and other health problems, but it really hurts and is hard to not take it personally. My father-in-law has not only put a strain on our relationship. It is affecting my children. It has also put a big strain on my own family's relationship. Being an outsider, they are not aware of all of the details and feel sorry for my father-in-law. They make accusations that are not true. with my father-in-laws mental state right now, that only confuses him more. I have been trying to help my father-in-law get services lined up and make plans since 2004 - including Adult Day Care, Respite, In-Home Health Care, finding information about Assisted Living, Memory Units, Veterans Benefits, Veteran's Aid & Attendance, Durable Power of Attorney, etc. He just flat out refused denying he needed the help - even after falling and breaking his right elbow in February 2011. He would not follow doctor's orders. I think APA got tired of dealing with my father-in-law because he was so persistant. With a heavy heart, I am just trying to take it one day at a time.


over 5 years ago, said...

what about talking to the person in denial...for instance...mother who insists she doesn't forget anything and is NEVER wrong...trying to convince her something is amiss...and she feels threatened when I try to explain she gets confused...lately with trips to 2 banks to prove they didn't steel $50,000 from her...she didn't admit she was wrong just said....why did I think that?...