I work with many adults who coordinate care for an aging loved one (for the sake of this blog post, we’ll say “parent,” though of course there are many people we may end up supporting in this way – siblings, grandparents, neighbors, friends, or even adult children). The day-to-day tasks of bathing, toileting, dressing, and managing meds can be overwhelming (a topic for another blog). There are different challenges to managing medical care: scheduling many appointments, transportation, time off work, writing down information from doctors, and following up on recommendations. When you’re juggling so much, it can be hard to communicate with your parent effectively.
ROADBLOCKS TO SEEKING COGNITIVE TESTING
As a psychologist who does neuropsych assessments, I’ve met many caregivers who aren’t sure how to talk to their parents about medical care and psych testing. A neuropsych evaluation for dementia or other concerns can be a sensitive topic for many reasons. These conversations are especially hard when your parent:
Has memory or other cognitive problems and doesn’t remember every incident
Doesn’t see the problem
DOES see the problem and feels defensive
Is afraid of what testing might find
Is resistant to having you manage their care in general
These barriers are common, but make things harder for everyone. If you’ve noticed a cognitive change and believe your parent should have neuropsych testing, here are some ideas about the best way to approach the conversation.
HOW TO TALK ABOUT A NEUROPSYCH Evaluation: THE BASICS
There are some basic communication skills that make any complex conversation easier:
Timing is everything. Bring the subject up when you have plenty of time to talk and won’t be rushed.
Location, location, location. Talk in private, in a space free from distractions, and where you can look at one another while you talk (while driving is never a good time for a serious talk).
Put yourself in their shoes. It’s frustrating when a problem is obvious to you and your parent seems to be in denial. Imagine how they may feel: afraid, sad, embarrassed, confused, angry…or all of these. When you start with empathy, you have a better foundation for a tough conversation. Try “I know this is hard to think about. I haven’t known how to talk with you about it because it’s scary, but I love you, and we can get through this together.”
HOW TO TALK ABOUT NEUROPSYCHological TESTING: THE NEXT LEVEL
Once you’ve got the basics, here are some strategies that have helped me to engage reluctant or angry testing patients over the years:
Be kind AND straightforward.
Sugarcoating doesn’t help. Do your best to keep a neutral tone, and keep your own feelings (anger, frustration, fear) in check. For example, “I know this may be hard to hear, but we need to talk about it. I’ve noticed you forget things lately. Yesterday when you had your hair appointment at 2, I reminded you three times to get dressed. Earlier, you turned on the burner and forgot, so the smoke alarm went off. Dr. Smith has noticed you repeat what you’ve already told him during appointments, and he said you need some testing to find out more about what’s going on. Neuropsych testing can give us some answers.”
Offer relief from shame.
Especially in the early stages of cognitive change, your parent may feel embarrassed or blame themselves, which will only get in the way of getting testing and support. Try, “It must be scary to forget things and feel like your thinking is slower, but this is not your fault. It’s nothing to be ashamed of.”
Show confident leadership.
Caring for your parent is a role reversal that can be very hard on everyone. Pursuing a neuropsych eval is one instance where you may need to decide what is in their best interest, even if they’re angry. You might say “I know you don’t want to do neuropsych testing, but you and I have both noticed changes in your memory and speech, and it is time to get some answers. I’ll make the appointment because I know it’s the right move. I hope you’ll agree, but either way, we have to move forward.”
If all else fails, say this. “I know you don’t see the problem. Think of it this way: if you do the neuropsych evaluation and something’s wrong, we’ll get help. If you do the testing and it turns out nothing’s wrong, then at least you’ll get me and Dr. Smith off your back about it!”
Once you have made the appointment, you can also enlist the help of your psychologist, who can further explain the value of testing and what to expect.
Begin Working WIth A Neuropsychologist in Los Angeles, CA
Talking to your loved one about a neuropsychological evaluation can be difficult, but the benefits are worth the conversation. As a Los Angeles Psychologist, I would be honored to help provide the insight to help you better understand what care your loved one may need. You can learn more about what you can expect from neuropsychological testing with Dr. Reger by doing the following:
Reach out for a free consultation.
Schedule neuropsychological testing with Dr. Reger.
Start receiving the support you deserve!
Other Therapy and Testing Services Offered in Los Angeles, CA
I understand you may need more support in addition to neuropsychological testing. This is why I’m happy to offer several types of assessments and services around Southern California. I also offer psychological evaluations for workers’ comp, preoperative assessments, individual therapy, and therapy for older adults. Visit my blog for more helpful information today!