Dear Family Advisor

How Do I Convince My Dad to Get Tested for Dementia?

Last updated:

August 09, 2011
Senior Man With Adult Son In Garden

I think I'm seeing signs of Alzheimer's or cognitive impairment in my dad. He's having trouble with things he's always done well, like tracking the finances. He's also increasingly sensitive and crabby -- but since he's always been a bit this way, it's hard to tell if it's a personality change or just normal aging (he and Mom are in their late 80s).

I think he should see his doctor for some kind of cognitive workup, but I can just imagine his angry reaction if I said, "Dad, let's get you tested for dementia." On the other hand, if I go privately to his doctor and suggest that it's needed, I'd feel sneaky. Dad would have a right to be angry, and Mom would have to live with the consequences.

Should I just let it go? What's the best way to handle this?

Be, as you say, sneaky. Talk to your dad's doctor about a neurological screening. Let the doc be the bad guy, and never tell a soul that you were the one who got the ball rolling if you think it'll just cause trouble. Men, in particular, need to be strong and in control, and that's OK. Our fathers, brothers, and dads fight wars, protect us from bad guys, and provide for their families physically and financially -- it's only natural for them to want to hold onto their hero capes as long as they can.

Meanwhile, keep note of any physical or cognitive changes you see. You may have to eventually make a fuss either with your dad or the medical community, and you'll need "proof." Write it down if he has a fender bender, unexplained bruises, confusion about his finances, or anything else that gets dismissed but raises a red flag in your mind.

Keeping this kind of journal is important for other reasons, too. Life gets busy and crazy and we adult children want and need our parents to be all right. We want them to go on enjoying independence and good health, and we can easily make excuses for them and with them. Sometimes it takes strength to acknowledge our doubts.

What's more, even if your dad's doctor does give him a workup, don't assume the doc will see what you're seeing. Often our elders rally at an appointment and appear perfectly fine -- or they deny it, avoid it, and throw the doctor off the trail. Or the doctor may not agree with you for his own reasons. Even if this happens, stay vigilant. Family members often pick up on symptoms before the medical community does.

Meanwhile, focus on how you treat him now, before any big changes occur. Your dad is aging and changing, but he's still the patriarch of the family. He's still your hero, your good guy. Start reminding him how much you respect and admire his character, his wisdom, his humor, whatever it is that's at the core of who he is. Have him sit at the head of the table at family gatherings and shush others to listen to what he has to say. Ask him about history, about what he's witnessed. Not only does he deserve this status, but it also helps him and others begin to see him differently, in a place of honor that isn't based on what his physical body can or can't do.

Whether it's addressing the idea of neurological/cognitive testing or stepping up to speak to your dad about a financial issue, know that eventually you'll have to do something like this. Do it in love, and respect, and strength. Caregiving helps us finish growing up. Standing tall and speaking a truth that needs to be said for someone's well-being and safety is something every family member and caregiver has to learn to do. It isn't easy, but it's an integral part of being an adult and a loving family member.

Investing now in how you talk to your dad and how you treat him will determine, in part, how he'll listen to your counsel in the future. If dementia changes him, then you'll be able to do what you need to do. You know who he really is -- beyond any fear, paranoia, or confusion that may arise. That's just the smoke and mirrors of a nasty disease. Your dad is the man you've turned to a thousand times. I'm sure he's not perfect, but I hope he's a good man. I believe that when you approach him from that standpoint, when you stand in a place of quiet strength, then even the toughest decisions and the toughest conversations won't thwart you from doing what's right and what's best for all involved.