How to Persuade a Person With Signs of Dementia to Get Professional Help Everyday Health MenuNewslettersSearch Alzheimer's Disease News How to Persuade a Person With Signs of Dementia to Get Professional HelpWhen our mother seemed to be developing dementia, my sister and I felt we should intervene, but we didn’t know what to do or when and how to do it. By Susan SoesbeFor My Health StoryJune 21, 2018Everyday Health BlogsFact-CheckedThe author’s mother (left) and with her father, being pinned with his "wings of gold," which designated him a naval aviator.Photos courtesy of Susan M. SoesbeA year after my father died, Mom moved to her childhood home in another state, where my sister, Sharon, and I visited her from time to time. We would compare notes after each visit about changes we’d observed. For many years, our mother seemed fine, though not exactly thriving. She no longer went to church, and she stopped taking walks. She had trouble navigating the internet — but then, so did we. Noticing the Signs Eventually, though, Sharon and I agreed that our mother was exhibiting signs of dementia, not just typical age-related changes. One time, Mom was convinced that her car had been stolen and was astonished to discover it in the garage. In the past, she had kept meticulous records, but now she was leaving mail in plastic grocery bags on her closet floor. Another time, Sharon discovered that our mother had purchased "financial products" from a company that kept more than half the deposits after she changed her mind about them. We worried that Mom was heading for a crisis: a car crash, losing all her money in a scam, falling and being unable to summon help (she couldn’t remember to wear an emergency alert button). Recognizing Their Significance We learned that cognitive decline is more than memory loss. It causes a diminishment of executive function: the ability to plan, solve problems, make appropriate decisions, and consider consequences. Our mother was confused and indecisive and had poor judgment. It was a crisis waiting to happen. Paradoxically, Mom was now incapable of seeking professional help or deciding to move to a new living situation. My friend Cindy Wright, who works with older adults, says that some people who clearly need help “disregard every attempt for assistance. This can lead to a crisis … and force a decision for help or movement to a care facility.” Cindy is minister of care and mature adults at Solana Beach Presbyterian Church in Solana Beach, California. Planning When to Intervene Sharon and I wanted to avoid being forced to make a quick decision due to a crisis situation. We agreed on the criterion that would indicate it was time to intervene: an event in which our mother’s failure to make and execute a sound decision would illustrate to her that she was putting others at risk by living on her own. We hoped that by highlighting for her the potential outcomes in this situation, we could motivate her to make a change before she lost the ability to decide at all. We weren’t even sure if that window was still open. We prayed that it was. Executing the Intervention Our opportunity arrived when Mom asked someone in a parking lot for help finding her car. After the man helped her locate it, she proceeded to back her car into his pickup truck. Years before she would have called for a police report and filed an insurance claim. This time she simply gave the man a check for the damages. When we learned about this episode, we pointed out to Mom how terrible she would have felt if instead of hitting a truck, she had backed her car over a child. Mom loved children, and I think this, on top of other things we pointed out to her, motivated her to take our advice to move to an assisted living facility near my sister. When I spoke with Cindy recently, she offered this rule of thumb: “Safety is a threshold for decision-making. Not just Mom’s safety, but others’. There’s no law against living in a pigsty or eating unhealthy or weird things. But when it goes beyond personal impact, someone needs to step in and take some action.” The Importance of Making Plans Before They re Needed Most of the time, the initial signs of dementia are only seen in hindsight. The fact that my mother, a cradle Baptist, stopped going to church, counts as withdrawal from social activities, one of the 10 early signs and symptoms of Alzheimer’s disease, according to the Alzheimer’s Association. In hindsight, the indications were obvious: the purchase of questionable financial instruments demonstrated decreased or poor judgment, the time she thought her car was stolen indicated challenges solving problems, the bags of mail on the closet floor showed difficulty completing familiar tasks. It’s hard to be prepared for dementia, or in Mom’s case, Alzheimer’s disease, the most common form of dementia. It creeps up on you. It comes and goes as portions of the brain function as usual while others go awry. It’s easy to write it off in its beginning stages as quirkiness or old age. Cindy says that older adults should “make plans before they need them and share those plans with family who may have to implement them some day.” My sister and I saw the writing on the wall, agreed to look for the next opportunity when Mom might be more open to our advice, and seized it. She was able to decide to trust us before she forgot who we were. Her horror of harming a child, combined with her trust in us, overcame her fear of moving. She allowed us to sort through her things, pack up the stuff she’d need in the new place, and move her to an assisted living facility near my sister. Mission accomplished — for the time being. 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