Families in denial.
This puts the older person at great risk .
Families in denial about the decline in health of their elderly parents is very common but a worrying problem.
I see this so much in my medical practice.
Denial about dementia is the commonest form of denial.
Blaming “old age” and “ageing” for cognitive and functional decline is just plain wrong and not science, yet most families do it and believe it!
Denial of dementia and cognitive decline in elderly parents just denies them an early diagnosis and proper medical care.
Denial increases the risk of a medical crisis and preventable public hospital emergency department presentation.
Some of the typical denial behaviours from families include-
The patient’s son or daughter are commonly very defensive and protective of their loved one during memory and cognitive testing by the Doctor. Therefore, they try to answer the questions for the patient.
Commonly sons or daughters will really compensate heavily for their elderly parents’ deteriorating cognitive function. They will say things like-
· “you have come on too strong” when I have asked the person where they live or
· “she wasn’t prepared for that” when I asked the person what year it was or
· “she has had a busy day and is tired” when I have asked for their formal home address which they can’t remember where they live.
· "Mum is always worse and more confused in the afternoon”.
The son and daughter will also make a patronising or condescending comment such as-
· “I couldn’t answer that question myself” which is who the Prime Minister is or what year it is, to try and placate and reassure their elderly relative and to emphasise in their mind that it is okay to be forgetful when you are old, which it is NOT!!
You’ve got to be kidding me! These relatives are highly functioning younger people operating businesses, driving cars, using computers, tablets and performing complex tasks on mobile phones, but they are not being honest when they say they don’t know what year it is and who the Prime Minister is.
The human brain has more than a trillion nerve connections!
So with so much brain power and memory reserve, there must be an almighty hit on brain function when someone starts forgetting simple things even with early mild Alzheimer’s dementia. Even “mild” Alzheimer’s dementia means that there is quite significant underlying brain disease to cause just mild memory impairment.
Families refusing an elderly confused relative to get appropriate pain relief for severe distressing pain is a common serious form of denial.
This is basically elder abuse and elder neglect. Why would anyone not want to give pain relief when needed to a frail older person in distress. This is cruel and unjust. These family members are in serious denial about the person’s dementia, have a paranoid fear of “losing” their relative and inappropriate fear of low dose narcotic analgesia such as drug addition which is ridiculous. These family members tend to obstruct medical care, intimidate and threaten legal action and formal complaints against Doctors and Nursing Staff in hospitals and nursing homes to maintain “control” over their relative. They use their status as the Legal Enduring Guardian to maintain control and power. However an Enduring Guardian must always act in the best interest of the patient. A Doctor has a legal, moral and ethical duty of care to treat severe pain in a confused older person. Pain management is a basic human right to ensure pain is controlled and improve quality of life. A new legal application for appointing a new independent Public Guardian can be sort where the existing Enduring Guardian is not acting in the best interest of the patient.
For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.