Your loved one insists they’re fine. They can still drive. They can live alone. They can handle all their own finances.
But they can’t. And you know that.
So you look for a way to convince someone with dementia they need help. You explain. You show them the evidence. And it goes nowhere.
Careblazer, what I’m going to share here can make caregiving easier, improve your relationship with your loved one, and save you from so many arguments. But first, why convincing doesn’t work.
Why You Can’t Convince Them: Anosognosia
To you and me, and every human being without dementia, it looks like denial.
What’s really happening is often something called anosognosia, which means lack of awareness.
That matters, because it means there is no amount of arguing, correcting, reasoning or showing them evidence that will ever get them to change their mind.
Anosognosia isn’t the only reason someone pushes back, and I go through 5 reasons your loved one with dementia resists help.
What Not to Do: Arguing, Correcting and Showing Evidence
When they think they can do something and you say, “Actually, you can’t, here’s why.” Or “You have this diagnosis.” Or “You’re not safe.” Or “The doctor said no.” When you jump into all that reasoning and try to give them all the evidence, it backfires. It leads to more frustration.
I once had a patient who believed people were coming into his apartment at night, changing out all his cabinets, and leaving. He’d wake up in the morning and say, “Look at the cabinets. Somebody’s been in here changing all my cabinets.” His family started recording videos to show him nobody came in.
It didn’t matter. Because of the way the brain is working in dementia, evidence does not work.
What to Do Instead: Ask What You’re Trying to Accomplish
We think that if we can just get them to understand they need help, or that they have dementia, they’ll suddenly become more agreeable. That they’ll suddenly do what we want them to do.
It doesn’t work that way.
So instead, ask yourself this: what am I trying to accomplish by getting them to understand?
Why do I need them to believe this right now? Why am I working so hard to convince them of X, Y or Z?
Your answer to that question is what you solve for. Then use creative thinking to ask, “How do I just get them to do that?”
That’s the key. You don’t solve a difficult behavior by highlighting the person’s impairment, or by showing them everything they’re doing wrong.
Three Examples of Solving for the Real Goal
When They Won’t Go Into the House: “That’s Not My Home”
One of my members had spent the day running errands with her mom, who has dementia. They parked right outside the house. Time to go in.
And her mom said, “That’s not my home. I don’t want to go in there.”
Like so many amazing caregivers, she went back to how we’ve communicated our whole lives. “That’s where we live. That’s our home.” Her mom said no. So she opened the glove box and pulled out the registration and the insurance, with her mom’s name and the address of the house on them. “Look, you live here.” No. She took out her phone and showed pictures of her mom in the home. No, no, no.
So why did she need her mom to understand that was her home?
Because she needed her mom to go into the house. That’s what she solves for.
Once she saw that, the question changed. Not “How do I convince her?” but “How do I get her into the house?” They’d been out running errands all day. Maybe this is just one more. “Hey Mom, we have one last errand to make.”
You don’t even need her to understand it’s her home. If the goal is to get her out of the car and into the house, that’s the only question you need to answer.
When They Can’t Manage Their Finances Anymore
Your loved one may no longer be able to manage their finances on their own. That happens a lot.
So we’re not going to try to convince them they’re making mistakes, that they’re being scammed, that they’re making late payments. And honestly, think about what it would mean if you did convince them of all that. It would probably feel really awful for them to truly understand it.
Ask yourself why you want so badly for them to understand they need help with their finances. Because they actually do need help. That’s what you solve for: how do I help them manage their money, and how do I make sure it’s safe?
Now your brain gets creative:
- Could I set up automatic bill pay?
- Could I intercept the mail and take the bills out before they see them?
- Could I put their number on the Do Not Call Registry for scam calls?
- Could I program their phone so only known contacts get through?
All of a sudden you’re working toward really good solutions that don’t need them to admit how many problems they’re having. That’s so much more pleasant for everybody involved.
And hear me when I say this: it doesn’t mean they can’t have any control over their finances. You can find creative ways for them to still feel involved. Maybe they open a letter, one you wrote, that says, “All your bills are paid this month. Thank you for your payment.” Maybe they sit with you and check the bank account. Every person with dementia is different, and for some, that would get them riled up. The point is that you’re not trying to convince them they need help. You’re figuring out how to give them that help.
If scam calls and mail are part of the worry, I go through more ways to protect them in how to protect your loved one with dementia from scams.
When They Can’t Live Alone Safely
If you’re trying to get them to understand why they can’t live alone, ask yourself what you’re trying to accomplish.
Maybe it’s this: I’m trying to keep them safe. I’m trying to stop them from eating moldy food, from letting strangers into the house, from lying on the floor for 48 hours before anyone finds them.
That’s what you solve for. Then you can ask your brain, “What are some ways I can keep them safe?”
Why This Approach Works: Harder Up Front, Easier in the Long Run
This is going to take some deep, creative thinking on your part. There are hundreds of difficult behaviors you might face, and just as many creative ways to respond to your loved one’s specific behavior.
In the moment, it’s easier to respond the way you always have. “You can’t do that. This is why. You have dementia.” That’s the habit your brain has been running.
But it’s harder in the long run. It leads to an argument. It puts more strain on the relationship. And it makes it less likely they’ll want your help in the future.
This approach is harder up front, because it asks you to think about your situation, not a generic tip that could apply to anybody. What would work for your loved one, in your situation? But it’s way, way easier in the long run.
So you can take the easy route now: convince, argue, show all the evidence, and get more frustrated. Or you can take the hard route now. Ask yourself what you’re trying to accomplish, and how you can do it without convincing them. Then brainstorm, and don’t block out any idea that comes to mind.
The next time you feel that pull to make them understand why they need help, ask that question.
Believe in yourself, Careblazer. You can figure this out. There is a way that doesn’t involve all the arguing. It just won’t come from asking them to understand something their brain isn’t capable of understanding.
Some situations take more than one person’s brainstorming. Inside the Care Collective, we take real situations like the one with her mom in the car and work out creative ways to help, often without your loved one needing to know they’re being helped. You can learn more here.
