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Published May 26, 2012, 11:30 PM

Bursack: Grandmother hides symptoms from the doctor

I love my grandmother dearly, but she’s becoming increasingly forgetful and confused. She also hallucinates at night, “seeing” intruders leaving the house and birds flying to the ceiling.

By: Carol Bradley Bursack, INFORUM

Dear Carol: I love my grandmother dearly, but she’s becoming increasingly forgetful and confused. She also hallucinates at night, “seeing” intruders leaving the house and birds flying to the ceiling. She’s even called the police a couple of times.

When I take her to the doctor, she presents herself as doing well and denies the examples I give of her confusion and hallucinations. The doctor seems to believe her.

She needs help around the house and the family is doing that, but her mental state is too much to handle. I know she can afford assisted living for quite awhile, but she says she doesn’t want to go to an “old people’s home.” What can we do? – Katrina

Dear Katrina: It’s common for people to cover up their cognitive problems during a general examination. Most people instinctively fear change. Illness generally means their lives are changing, so staying in the familiar situation, even when it’s negative, seems easier than getting the right help.

However, I’d expect a doctor to be concerned by the events you describe despite your grandmother’s protests. It is possible that this doctor doesn’t know how to address the issue or doesn’t have the time.

Your grandmother probably should be tested for infections and medication interactions that can cause dementia-like symptoms, as well as for different types of dementia. A geriatrician would be an ideal choice for baseline testing, with a neurologist for dementia testing if needed.

I’d suggest that you make an appointment with a different doctor. Meanwhile, write down the episodes you describe and their frequency. Also, take note of the seriousness of memory lapses and any police calls. Mail your observations to the doctor in advance of the appointment.

You’ll likely have a problem getting your grandmother to see a neurologist for the behavior you describe. Seeing a geriatrician for medication issues or possible infection may be more acceptable to her. Once your grandmother is in the hands of the right doctor she may feel relieved enough to follow up on referrals and tests.

Since these episodes happen primarily at night, I’m wondering, also, if loneliness and fear, with or without dementia present, is a contributing factor. Many people, once they’ve adjusted to the change, feel safer in a group environment like assisted living.

I can’t emphasis enough the value of socialization for elders. Isolation can contribute to all kinds of problems. Even consistent attention from adult children and grandchildren can’t replace the feeling of living in a safe environment. She may complain about moving to a facility at first, but I expect she’ll eventually learn to like the companionship and the feeling of safety. Please look into changing doctors and continue to consider moving her into a more social environment.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com.

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