Anonymous Doctor

People will go to great lengths to deny that their loved ones are demented. The other day, I asked a patient what year it is.

"1970."

"You sure?"

"Yep."

Checked his chart, no indication he'd ever been diagnosed with dementia. So I swung by his room when his wife was visiting. "How long has your husband been having trouble with his memory?"

"Oh, he doesn't have any trouble with his memory."

"He told me this morning that it was 1970."

"He just gets confused in the morning sometimes. But his memory is fine."

Not to oversimplify, but, you know, it's a binary thing. Either you have dementia or you don't. Non-demented people don't get confused at certain times of the day. Non-demented people remember the people they've met, and have a pretty good idea of what year it is. Non-demented people know if they've eaten breakfast yet.

The worse part is that it's not that his wife is lying to us-- she isn't. She's just in complete denial-- she genuinely believes that his memory is in working order. Which is a problem, because he tells her things about what's going on in the hospital that simply aren't true.

She had me paged this morning. "You know, I should report you and your entire team. My husband said he asked the nurse to help him to the bathroom, she said she would, and she never did."

I checked with the nurse. She said she helped him to the bathroom. Twice.

"And he said he's been here all day and hasn't gotten anything to eat."

Nope. Not true.

"And he never got his MRI."

"Well, I have his results."

"Then I guess you didn't even take the time to explain to him what kind of test he was getting, because he does not remember getting the MRI."

"He doesn't remember because he is unfortunately suffering from dementia."

"He is not. He takes care of himself just fine at home."

Just wait until he lights the house on fire, or leaves the house and can't find his way back. His primary doctor is a cardiologist. The cardiologist isn't necessarily going to diagnose dementia. People need primary care doctors. I called social work-- he can't be on his own when we release him, his wife needs to get help for him. But she won't, because she thinks he's fine.

Until he doesn't remember who she is, and then maybe she'll realize. Or maybe she won't.