How can I get my mother to accept her Alzheimer's diagnosis?

1 answer | Last updated: Sep 14, 2017
Karide asked...

Hi - my mother is suffering from Early/Moderate Alzheimers which has been progressing for the past 2 years. I've been reading the posts to get advice on certain topics. One issue that creates the most challenges is her COMPLETE denial of her condition. Lately, the denial has turned into more defensive behaviour and anger. This makes it very difficult to remind her to perform certain tasks - including taking medication and bathing. Even until a couple of months ago, she would take a shower when asked (I only try once a week now) and now she is refusing to take medication. This is always met with the response - 'I don't need any help; what do you think - I'm an idiot...I do everything on my own'.
FYI, I have just placed a 24hr live in caregiver in my mother's house (she lives abroad, alone, and I am an only child), but she says my mother's moods are vert erratic.

Expert Answers

Joanne Koenig Coste is a nationally recognized expert on Alzheimer's care and an outspoken advocate for patient and family care. She is the author of Learning to Speak Alzheimer's. Also, she currently is in private practice as an Alzheimer's family therapist. Ms. Koenig Coste also serves as President of Alzheimer Consulting Associates, implementing state-of-the-art Alzheimer care throughout the United States.

I responded to an almost identical query in this column last month and am 'borrowing' some of that answer in reponse to your very familiar question. You sound like a wonderful daughter trying to do all the right things to make this experience as positive as possible. The problem is - it is not always possible! The denial of her diagnosis certainly compounds things for both of you. It is not unusual for a person with Alzheimer's disease (AD), who has always been in control, to adopt denial as a way of coping with the loss of control. This disease tends to make the AD-person feel out of touch and not needed by others. They are aware that independency is slowly eroding and try to exert control over almost anything. No matter how little sense it may make to us, the refusal to take a shower or medication is a chance to make a decision and exert control. As long as she does not admit that she is no longer functioning as she once did, then she doesn't have to change the way of life she has lived for many years. She convinces herself she has control over things she knows she is losing control over in order to remain powerful in a world that is leaving her powerless. Denial of an illness that is taking away one's humanness is rather common with memory-impaired folk. Unfortunately denial leads to delay. To delay facing the diagnosis leads to great frustration both for the AD person and for those around her. It also puts off appropriate and solid medical attention such as AD-specific medications that might make her more 'pleasant' and it makes social interventions considerably more difficult. Try to think of her behavior as defensive rather than offensive; she is attempting to defend herself against a world that is becoming increasingly less familiar with each passing day and since there seems to not be any active dialog with her about the diagnosis, she acts out to get across the message that she is feeling both fearful and isolated. Assure her, at these difficult times, by holding her and reassuring her that someone will always be with her. It appears she no longer is functioning independently with her daily routine; try to eliminate questions related to daily care and grooming and replace it with a direct statement. e.g., "here are your pills", or "your shower is ready". Be sure the live-in help understand her disease by providing them with appropriate written materials. Make sure you are taking good care of yourself as you attempt to take care of your AD-person from a very long distance.