If your loved one is displaying possible signs and symptoms of dementia, it is understandable that you would want them to get a diagnosis and seek treatment as early as possible. However, having a conversation with your loved one about the memory lapses and moments of confusion they have been experiencing may be difficult. Often, someone experiencing these symptoms may feel defensive, worried or be in denial.
In a situation like this, what can you do to (1) convince your loved one to see a doctor and (2) care for your loved one who continues to exhibit symptoms of dementia, in the meantime?
This article highlights the steps you can take to reframe the conversation surrounding getting a diagnosis, as well as the services available in the community that you and your loved one can turn to for assistance until they agree to get a formal diagnosis.
Reframe the Conversation
Before having another conversation with your loved one, it is important to understand their concerns and the reasons they do not wish to get a diagnosis. Doing this will make them feel included in the conversation and give you a better idea to allay their concerns and assure them that seeking professional help is the best way forward.
Concern: Fear of doctors and hospitals
- Always use positive language and describe the benefits of health screening in an encouraging manner, rather than catastrophising or using fear to threaten them.
- You can offer to set up an appointment – but with the added reassurance that you do the screening together. It reduces the stress and anxiety of doing it alone.
- Finding a doctor that your loved one is comfortable with will also help.
- Alternatively, you may wish to let your loved one know that they need to go for regular check-up and mention that you have already made the appointment.
Concern: Afraid of losing their independence
- Your loved one, especially if they live alone, may be less likely to agree to a diagnostic assessment and more likely to perceive stigma associated with a diagnosis.
- They may associate having dementia with a loss of activities such as driving and the independence they have been accustomed to.
- They may be anxious and only think of worst-case scenarios.
- In such situations, it is important to assure your loved one that there are ways to cope with the changes that may come to maintain their independence for as long as possible.
- Driving, for instance, can represent independence and freedom for a person. You and your loved one can work together with your doctor to come up with a new driving arrangement that still allows them to drive independently, whilst ensuring their safety and that of others on the road. Find out more here.
- Additionally, in some circumstances, it is still possible for your loved one to continue living on their own (in the early stages of their dementia). Find out how here.
Concern : Thinks forgetfulness is a normal part of aging
- Previous studies have shown that a general lack of knowledge about dementia and its symptomology are strong barriers to receiving a diagnosis.1
- Specifically, an individual’s belief that symptoms of dementia, such as cognitive decline and lapses in their memory, is a normal ageing process may prevent them from seeking a diagnosis and getting more information on the condition.2
- It is important to intervene on your loved one’s perceptions about getting a formal dementia diagnosis and their misconceptions about dementia. It would also be useful to share the benefits of getting an early diagnosis with them.
Concern: Finances
- Mention that their MediSave helps to pay for at least a certain portion of selected outpatient treatments such as the management of chronic diseases and health screenings.
- Dementia falls under the 23 approved chronic conditions under the Chronic Disease Management Programme (CDMP).
- In fact, should your loved one indeed have dementia, it would make more financial sense to get a diagnosis because the eligibility criteria for certain financial schemes and subsidies often include being formally diagnosed, amongst other factors. This is to ensure these aids are provided to those who are in need of them.
- Find out more about the government financial schemes available for persons living with dementia as well as their caregivers here.
Read on for a step-by-step guide on how best to navigate this conversation with your loved one here.
How Can I Help My Loved One in the Meantime?
At Home
Should your loved one continue to show signs and symptoms of dementia, you may choose to care for them as if you are caring for a person living with dementia.
This includes designing a daily routine, ensuring that they are meaningfully engaged and educating yourself on the needs and realities of persons living with dementia.
Living with Dementia: Providing Care
Source: Agency for Integrated Care
Living with Dementia: Providing Care is a resource designed for caregivers like yourself to pick up tips on having effective communication with your loved one, how to design a daily routine with engaging activities, and managing dementia as it progresses by stages, etc. This in turn enables you to better cope with your caregiving journey, ensuring your loved one receives the best possible care.
Living with Dementia: Knowing Dementia
Source: Agency for Integrated Care
Living with Dementia: Knowing Dementia is a resource designed for the general public and caregivers like yourself to learn more about dementia, understand signs and symptoms, learn how to lower risks of getting dementia, on how to start early conversations, and how and when to seek diagnosis.
In the Community
Understandably, these responsibilities can be rather overwhelming. Fortunately, there are services in the community that can help you, especially in the beginning of your caregiving journey:
1. Community Outreach Teams (CREST)
CREST focuses on raising public awareness of mental health conditions and dementia, promotes early recognition of at-risk individuals, and provides emotional support to individuals and their caregivers.
How can CREST be of help to you?
1. Links individuals to relevant health and social care services when necessary.
2. Conducts meaningful activities to support the clients’ well-being and stimulate their cognitive functions.
Find service providers near you here.
2. Active Aging Centres (AAC)
An AAC is a drop-in social recreational centre that extends support to seniors (aged 60 and above) living nearby in the community.
How can AACs be of help to you?
- If your loved one is at least 60 years of age, they may drop by an AAC near their home and build strong social connections, take part in recreational activities, and contribute to the community as they wish.
- Provides and promotes a variety of activities such as karaoke, arts and craft, cooking, and exercise programmes.
- Provides social support to seniors through house visits and phone calls.
- Provide information on schemes, grants and support.
- Raise referrals to appropriate services.
Find an AAC near you here.
3. Family Service Centres (FSC)
Persuading your loved one to get a diagnosis and dealing with these changes can result in a stressful time for you and your loved one. It may also be the case that your relationship with your loved one and the rest of your family has been negatively impacted by these changes.
In situations like this, it may be good to seek out social workers and service professionals, who can help families de-escalate risks, meet their care needs, and achieve resilience through the challenges they may face.
How can FSCs be of help to you?
- Information and Referral (based on the assessed needs)
- Casework: Providing holistic case management and individual/family counselling. Caregivers of persons living with dementia face unique challenges. Offer a private and safe space for you to share your thoughts and challenges.
- Group Work: Bringing families together for purposeful group interactions to address their concerns and bring about positive change.
- Community Work: Tap on community resources to help families support and empower one another.
Find an FSC near you here.
4. Helplines
A helpline is a fast and convenient way to obtain information and advice. It can also be a source of emotional support when you are in distress.
- Dementia Helpline (Dementia Singapore)
Provides information and service linkages on dementia care.
Tel: 6377 0700 - SAGE Counselling Centre
Provides counselling to enhance the well-being of older persons and their caregivers, focusing on the psychological and social aspects of health.
Tel: 6354 1191 - Caregivers Alliance Limited Helpline
Provides emotional support for caregivers who are caring for persons living with dementia and living with mental health issues.
Tel: 6460 4400 - O’ Joy
Provides English, Mandarin or Malay counselling for caregivers experiencing stress from caring for older persons.
Tel: 6749 0190
Tell us how we can improve?
- Fowler, N. R., Frame, A., Perkins, A. J., Gao, S., Watson, D. P., Monahan, P., & Boustani, M. A. (2015). Traits of patients who screen positive for dementia and refuse diagnostic assessment. Alzheimer’s & dementia (Amsterdam, Netherlands), 1(2), 236–241. https://doi.org/10.1016/j.dadm.2015.01.002