English  •  中文

Home How to… Talk to someone about getting an assessment

Talk to someone about getting an assessment

Use the steps in this article to help you prepare for a conversation that might be difficult.

Woman encourages husband to get an assessment

Early assessment for cognitive changes and a timely diagnosis (if indicated) usually leads to better treatment options and support.

However, talking with someone you think may experiencing changes which might be dementia is never easy. It is important to express your concerns and support the person to get an assessment and treatment.

The following five steps can help you think through and plan your approach to a conversation with someone you care about.

1. Consider – should I be concerned? 

Everyone forgets things, but if you know someone is experiencing changes in ability, behaviour, personality, thinking or memory it might be dementia.

2. Anticipate potential reactions

Use your knowledge of that person to think through their potential reactions. Understanding how they may react can help you think about how you start your conversation.

How has this person reacted in the past to general conversations about their health or wellbeing? Their future? Or other sensitive topics like death or dying? Are they open to chatting about issues like this? Or do they get defensive or upset?

Consider if the person has expressed concerns about themselves. For example, have they mentioned:

Consider what may stop the person from going to the GP? (e.g., do they have a long-term/good relationship with a GP?)

3. Prepare for the conversation(s) and set the scene.

Consider who, what, where and when

Who is the best person (or people) to have the conversation? Consider existing relationships, and family dynamics. Some family members might be better placed to raise the issue, or might be able to raise the issue with less conflict.

What to talk about

You might approach the topic by talking about your concerns for their well being. This might be more persuasive than pointing out mistakes which might make the person defensive.

Here are some potential conversation openers:

You might talk about seeing the GP about a health issue that the person themselves is concerned about:

You might couch the conversation in terms of getting treatments and services:

You might decide not to use the term “dementia” in these first few conversations. Wait for the doctor to give a diagnosis before using the term dementia.

Where is the best place to chat? (e.g., familiar, quiet, comfortable, place is usually best).

When is the best time of day to have the conversation? Ensure the person is not hungry or at a time their favourite TV program is on. Maybe you’re listening for when the person expresses concerns themselves, and then build on that conversation.

4. Be positive and supportive

5. Be prepared to keep trying

If the person does not want to talk about their difficulties

For some people, dementia affects insight – their awareness and ability to recognise their own difficulties.

Other people will know they know they have difficulties but deny or minimise the difficulties because they are fearful about having dementia, or losing their independence. Visit Forward with Dementia to learn more about when the person who won’t talk about changes or potential dementia.

Keep communication open. The LEAP approach helps people with poor insight to accept hep. LEAP stands for Listen, Empathise, Agree, Partner.

Listen: Understand the person’s point of view and reflect back to them your understanding. Listening does not involve giving advice, trying to find solutions or offer your opinion.

Empathise: Let the other person know you really understand their thoughts and feelings. Acknowledge and reaffirm these thoughts and feelings, even if they are irrational.

Agree: It is important to reach agreement on the way forward. Ensure you work on aspects the other person sees as a problem. Highlight the benefits of seeing the doctor.

Partner: Find a goal that you can mutually work towards. The person needs to feel supported and, rather than that someone is trying to ‘take over’. If they are already worried about losing their independence, forcing them against their will may make these feelings stronger.

Sarah’s story shows how she used the LEAP approach to help her brother.

I have been concerned about my brother for a couple of years now.  His house is falling into disrepair, I know there are unpaid bills and I am not sure what he is eating other than toast as he doesn’t seem to do any shopping or cook for himself.

I tried to talk with Gerald about how he was managing. I gently suggested we should get him to the GP who might be able to help with his anxiety and forgetfulness.  Gerald got defensive and kept telling me he knew there was a problem but put it down to being stressed with repairs needed on his house.

Sarah describes how she listened and empathised with Gerald:

I tried the conversation again a couple of weeks later. I said I was worried about the state of the house. I just listened to Gerald’s complaints about being unable to find tradesmen who were honest or charged reasonable rates and how he could do a better job than a tradesman.  I agreed with him that this situation was really very anxiety provoking. This time, Gerald didn’t get defensive. I think it was because I wasn’t trying to fix things. He appeared to know I understood how he was feeling.

Gerald was happy to acknowledge he was anxious – but nothing else. Because he was more relaxed with me, I felt this provided a ‘window of opportunity’ to suggest there were practical things I could help him with and also say the doctor could help with his anxiety.

Gerald eventually agreed that I could find a tradesman to help with the house repairs, but I would consult him every step of the way. With me emphasising the GP could help with anxiety and he might feel a whole lot better, we agreed to make an appointment with the GP the next week. Gerald was happy for me to drive, and I said I would be happy to support him at the appointment. We wrote this down together as I knew I would need to repeat this conversation a couple of times to make sure Gerald remembered what we agreed. 

LEAP is adapted from the work of Dr Xavier Amador.

What’s next?

In this article, you’ve learned some ways to encourage someone to get an assessment. Try next: