The question: My parents are aging and showing signs of slowing down mentally. I'm concerned about Alzheimer's some time down the road, but they don't even notice it. They say I'm overreacting. How can I get them to acknowledge that they may need help sooner rather than later?
The answer: Having a discussion with a parent about age-related changes can be one of the most difficult conversations you may have. A myriad of factors are probably converging to make this hard: your desire to be respectful and kind toward your parents; the challenge in having them recognize and accept changes that may truly be subtle and unbeknownst to them; pride on your parents' part; and, possibly some sadness and worry about the changes you are witnessing.
Your attempts to have a conversation about the changes with your parents have been met with some resistance, which is not an unexpected parental response. There are reasons for this: there may be changes that you are noticing that your parents are either (a) unwilling to see or (b) truly don't recognize; or, you are in fact overreacting. The best first step is to get a professional opinion on whether the concerns you have are warranted.
I suggest making a detailed list of the changes you are observing. Be as specific and comprehensive as possible, and articulate it in writing. Be objective in your descriptions: ("last week, mom asked me five times when I am next coming over, even though virtually every week I go over on Sundays") – rather than making judgments or assumptions ("mom is losing her memory"). Then, make an appointment with your family doctor to obtain an opinion on whether there is cause for concern.
Assuming there are red flags, the next step would be to gently start more dialogue with your parents while keeping in mind you may need to have multiple conversations. Approach your discussions from a position of care and concern, don't blame or point the finger, and be mindful of not conveying any frustration you may be experiencing. Be specific in expressing the concerns you have, staying away from judgmental or labelling language. It is important to let your parents know that although these are difficult conversations to have, you are motivated by love and concern for them.
Be sure you take the time to allow them to express their feelings and perspective as well. Let your parents have control in the conversation by asking them what they think would be good next steps ("what can I do to help?"; "what are you most comfortable with doing?"). Recognize that they may be frustrated, sad, or angry about changes that they are noticing but finding hard to accept as they transition to another stage in their life – from that of caretaker to possible dependent.
You may also find it helpful to enlist the support of another relative or family friend whom they trust. If you continue to be met with resistance, I would suggest making an appointment with your parents' family doctor to communicate your concerns. The doctor cannot, without your parents' permission, release any information to you, but you are able to share information with the doctor that may be helpful for planning purposes.
Dr. Joti Samra, R.Psych., is a clinical psychologist and organizational & media consultant. She is the host of OWN: Oprah Winfrey Network's Million Dollar Neighbourhood and is the psychological consultant to CITY-TV's The Bachelor Canada. Her website is www.drjotisamra.com and she can be followed @drjotisamra .
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