Talk to a family member about seeing their GP
Use the steps in this article to help you prepare for a conversation that might be difficult.
Talking with someone you think may experiencing changes which might be dementia is never easy. It’s even more difficult when the person with changes in behaviour and thinking does not recognise there is a problem, denies there is a problem, or doesn’t want any help despite having difficulties.
You might want the person to see their GP to get an assessment, but you might also worry about upsetting them or hurting your relationship with them.
Here are some tips for having this potentially difficult conversation.
1. Get family on the same page
Speak to other family members and make sure they will share the same message about needing to see the GP for an assessment. It will be easier to persuade the person if other family members are saying the same thing.
Talk about your concerns with other family members to see if they share your worries. You might need to educate other family members about the possible signs of dementia and benefits of seeing a GP for an assessment.
The Checklist for dementia symptoms and changes is a useful tool for discussing changes with other family members.
2. Identify the right person to have the conversation(s)
The right person is someone the person with changes trusts and will listen to.
The nominated person should approach the conversation from the perspective of wanting to help the person with changes and respecting their viewpoint and wishes.
For example: Ahn always had a very trusting relationship with her husband Hoc, but she knew he would not be open to discussing his memory problems with her. It was better for this conversation to be started by their son, Hieu. That way Ahn could continue to be her husband’s main ally and support.
3. Plan your approach(s)
- There will probably be more than just one conversation. There may be many conversations over a few months.
- Have the conversation in a quiet, familiar comfortable environment.
- Choose a time when the person is relaxed and open to interaction.
Possible ways of starting the conversation
- Open the discussion by talking about your concern for their well being. This will be more persuasive than pointing out mistakes which might make the person defensive.
“I’m worried because you seem to be having trouble with banking”
“I’m worried because you’ve missed a few appointments”
- You might talk about seeing the GP about a health issue the person themselves is concerned about. Suggesting a full health check-up may be more acceptable to the person than suggesting an assessment for problems with memory or everyday tasks.
- With the person’s permission, a family member can accompany the person to the GP. They could take the opportunity to subtly raise the issue with the GP. Here is more information about how to Ask a GP.
“You mentioned that you’re feeling tired and all the housework exhausting. I wonder if we should go and talk to your GP?”
- You could focus the conversation around getting treatments and services:
“There are medications that help with memory”
“Daphne’s GP gave her a referral for free bathroom rails and equipment”
- You might decide not to use the term “dementia” in these first few conversations. Wait for the doctor to give a diagnosis before using the term.
4. Be positive and supportive
- Use language carefully to show you want to support the person and you are on their side.
- Don’t insist you are right and don’t argue!
- Your body language is often more important than your words! Keep your posture relaxed, smile, make eye contact and use reassuring gestures.
- Offer to go with them to the GP. If the conversation goes poorly, change the subject or stop the conversation. You can learn from what went well or what went poorly, and change the way you approach the conversation next time.
- Try to talk about changes and difficulties, not dementia. Know that some conditions might ‘look like dementia’ (for example depression can mimic dementia) and an assessment by a GP is needed.
- Know there are treatments, rehabilitation and support services for dementia and that many people live positively with dementia.
- Read about the experiences of others as well as the benefits of getting an assessment and benefits of a diagnosis.
5. Be prepared to keep trying
- Key is listening to the person and adapting the conversation as you go.
- Remember, it is not the only chance and this may be the start of many conversations.
- If they do agree to an assessment, offer continuing support (such as making the appointment and going with them to see the GP).
If the person does not want to talk about their difficulties
For some people, dementia affects insight – their awareness and ability to recognise their own difficulties.
Other people will know they have difficulties but they, themselves will deny or minimise the difficulties because they are fearful about having dementia or losing their independence. Visit Forward with Dementia to learn more about when the person who won’t talk about changes or potential dementia.
Keep communication open. The LEAP approach helps people with poor insight to accept hep. LEAP stands for Listen, Empathise, Agree, Partner.
Listen: Understand the person’s point of view and reflect back to them your understanding. Listening does not involve giving advice, trying to find solutions or offering your opinion.
Empathise: Let the other person know you understand their thoughts and feelings. Acknowledge and reaffirm these thoughts and feelings, even if they are irrational.
Agree: It is important to reach agreement on the way forward. Ensure you work on aspects the other person sees as a problem. Highlight the benefits of seeing the doctor.
Partner: Find a goal that you can mutually work towards. The person needs to feel supported rather than someone else trying to ‘take over’. If they are already worried about losing their independence, forcing them against their will may make these feelings stronger.
Sarah’s story shows how she used the LEAP approach to help her brother.
I have been concerned about my brother for a couple of years now. His house is falling into disrepair, I know there are unpaid bills, and I am not sure what he is eating other than toast as he doesn’t seem to do any shopping or cook for himself.
I tried to talk with Gerald about how he was managing. I gently suggested we should get him to the GP who might be able to help with his anxiety and forgetfulness. Gerald got defensive and kept telling me he knew there was a problem but put it down to being stressed with repairs needed on his house.
Sarah describes how she listened and empathised with Gerald:
I tried the conversation again a couple of weeks later. I said I was worried about the state of the house. I just listened to Gerald’s complaints about being unable to find tradesmen who were honest or charged reasonable rates and how he could do a better job than a tradesman. I agreed with him that this situation was really very anxiety provoking. This time, Gerald didn’t get defensive. I think it was because I wasn’t trying to fix things. He appeared to know I understood how he was feeling.
Gerald was happy to acknowledge he was anxious – but nothing else. Because he was more relaxed with me, I felt this provided a ‘window of opportunity’ to suggest there were practical things I could help him with and also say the doctor could help with his anxiety.
Gerald eventually agreed that I could find a tradesman to help with the house repairs, but I would consult him every step of the way. With me emphasising the GP could help with his anxiety and he might feel a whole lot better. We agreed to make an appointment with the GP the next week. Gerald was happy for me to drive, and I said I would be happy to support him at the appointment. We wrote this down together as I knew I would need to repeat this conversation a couple of times to make sure Gerald remembered what we agreed.
LEAP is adapted from the work of Dr Xavier Amador.
