How can I get my mother to go for another Alzheimer's evaluation?

Nwood asked...

I took my mother in for an Alzheimer's evaluation over three years ago. At that time, the neurologist found nothing wrong. Now, my family is saying our mother is doing the same things again, and they want me to take her in again. The problem is getting her to go. She went the first time to prove to everyone that nothing was wrong, and she proved that. Now, I feel she will not go a second time. She has said she won't. How do you "force" someone to get another test? Help me, please.

Expert Answer

Lisa P. Gwyther, a social worker specializing in Alzheimer's services, is the author of The Alzheimer's Action Plan. An associate professor in the Duke University Medical Center Department of Psychiatry and Behavioral Sciences, she's also a past president of the Gerontological Society of America.

Your mother's clearest perception of herself, reinforced by the neurologist who found nothing wrong, is that of a functioning and competent adult. Alzheimer's evaluations produce memorable anxiety, and it is completely understandable that she refuses to repeat testing. Few people with significant changes in memory and thinking cavalierly agree to an evaluation. She probably doesn't understand that signs and symptoms of Alzheimer's develop subtly over years. There is no on/off switch. At this point, it's not about "forcing" another test, but more about knowing her well enough, as she is now, to get her to "yes."

First, make an appointment in advance with the same neurologist at a time you or a close family member can accompany her. Then make an off-handed suggestion to your mother about hopeful new approaches to early prevention or treatment of age-related memory problems. Some educated older people are persuaded by recent media features about healthy brain aging - for example, lifestyle approaches like exercise make a difference in overall function and memory.

Don't focus on her deficits, but rather on her retained skills and strengths and what can be gained by early treatment. Make it your issue rather than hers - you would rest easier knowing that she has the most up-to-date information about how to retain her memory, function and quality of life. You want to support her best care for herself.

Perhaps she has persistent health complaints about related issues - low energy, fatigue, just not feeling like herself? Then suggest an evaluation with the doctor who saw her when she was functioning so well.

If she currently trusts a relative, friend, her attorney or clergy person as someone who has all the right answers, ask this person to casually support your idea. Avoid ganging up on her or pushing her into a corner. Be casual, open-minded, but not too invested or persistent. If she reacts negatively, drop it and try again. If she still refuses, just tell her it's so hard to get an appointment with this doctor, that you scheduled an appointment far in advance just in case. If she reacts with anger, just say "I'm sorry - I mean well." Suggest you go with her and then go out to lunch or to some activity she really enjoys.

The Alzheimer's Action Plan has many bulleted suggestions about how to prepare for the evaluation and how to get the most out of your time with the doctor or evaluation team. You'll be surprised by the number of successful but quite different approaches families use to insure timely evaluation of changes in memory and thinking.