Denial is Dangerous

By Carole Larkin

You may be past denial — Perhaps your sisters or brothers, mothers or fathers, cousins or friends (especially ones that don’t often see your loved one with dementia) are in denial. People in denial about a loved one with dementia often say to themselves things like:

Denial:

• I’ve always looked to Dad for strength and guidance. I don’t know how I can handle things without him. The thought that I have to take care of him as well as myself is too terrifying for words.
• He’s the parent, I’m the child. It’s never been any other way and I don’t know how to change it.
• If I ignore it, it will just go away.
• He had a really good day today; maybe it’s not really as bad as I though. I’ll just wait until his behavior and memory get worse.
• He’s just having a bad day. He’ll be better tomorrow.
• If I admit that he has dementia then that means that I’ll probably get it too and I can’t face that.
• He made me promise that I would never put him in a nursing home. That’s where I’ll have to put him if he has Alzheimer’s, so I won’t admit that he has it.

Underneath the denial:

• Fear about the future. That’s really the underlying emotion behind the denial.
• It’s human to deny what we find unpleasant or frightening. But when it prevents us from seeing facts and facing their implication then it will not help our loved one or ourselves.

Consequences:

• Using denial as a coping strategy will always fail eventually.
• Denial will prevent the family from taking the steps possible to “get ahead” of all the issues to follow — like starting medications that could prolong the patient at the highest levels possible for the longest time possible.
• Denial can prevent completion of legal forms allowing your loved one or your family to be in control of medical choices, property matters and inheritance issues.
• Denial will cause major lasting conflict within your family.
• Denial can cause unwanted outcomes.  For example, your loved one could need nursing home care due to delayed care that could prevent the progression to the situation where only skilled nursing can care for them.
• Denial causes stress to the caregiver — even to the point of a serious heart attack, stroke or other fatal event, leading to nursing home placement for your loved one anyway.

You can help your family member or friend in denial by:

• Telling them that it is OK to be fearful but that it does not help your loved one or the rest of the family.
• Help them to understand that fear is overruling logic.
• Explaining that denial or doing nothing is actually doing something; and that doing nothing is going to cause more pain to all involved.
• Helping them see that this is not about them and whether they will get the disease or not. Tell them that there is no relationship between helping your loved one and increasing the chances of getting the disease. It’s not contagious!
• Helping them see that it is not about them and the inconvenience to their daily life. This is about helping someone that they love have the best care possible.
• Letting them see that this is not about whether they like or dislike your loved one and that even if they don’t like the family member or friend, that helping is the right thing to do.
• Be kind, gentle and calm in approaching your family member or friend in denial. Anger will only cause them to dig their heels in deeper.
• Let your family member or friend in denial know that you will be there to support them through the time they are confronting their fear — they are not alone.
• If you see that you are not making a dent in their denial, drop the subject. You can return to it another time.

Carole Larkin  MA, CMC, CAEd, DCP, QDCS, EICS is an expert in Alzheimer’s and related Dementias care. She has a Master’s of Applied Gerontology from the University of North Texas, is a Certified Alzheimer’s Educator, is a Dementia Care Practitioner, is a Qualified Dementia Care Specialist, and an Excellence in Care Specialist at the Alzheimer’s Foundation of America, as well as a Certified Trainer/Facilitator of the groundbreaking dementia care training tool, the Virtual Dementia Tour Experience She is a Certified Geriatric Care Manager who specializes in helping families with Alzheimer’s and related dementias issues. She consults with families telephonically nationwide on problems related to the Dementias. Her company, ThirdAge Services LLC, is located in Dallas, TX, and her website is www.thirdageservices.com.