How to tell a parent that they have dementia, but they are in denial and won’t accept that they have a memory issue?

I talked with my MIL, I told her if she got sick or hurt she couldn’t live by herself. We talked over options. She would not live with family. Ok, then you will move to a home. No way. I said this to her over and over. One night she fell twice. The first time the ambulance came she said she was fine, refused to be checked out. Fell again in the am. Went to hospital, ended up in rehab. After a month, we moved her into AL. She has been there a year. She hates me, the siblings hate me, but nobody took care of her. She doesn’t like it, but accepts it. She is 94 with bad arthritis. Can’t walk or use her arms and hands very well. 3 brothers have come around to accept it. One sister is so angry with me, she cusses when she sees me, but she doesn’t visit or care for her mom. We all live locally. I know I did right. I tend to her needs and sometimes she is so sweet to me, other times angry. Oh well, I know she is safe. You need to do what’s right.

https://www.agingcare.com/articles/anosognosia-dementia-patients-cant-recognize-impairment-210090.htm

Anosognosia is quite common with dementia, my mother never believed she was impaired and I didn't push it. What for? Its not "denial" the elder experiences but the inability to recognize the facts.

Stop insisting she grasp the situation and let her live her life in peace, that's my suggestion. Even if she was able to grasp she has dementia, it wont change a single thing.

Best of luck.

Many people with dementia (or stroke sufferers) experience anosognosia, which is the inability (not the refusal) to accept their diagnosis. The part of the brain that can understand and remember what's happening, and why, does not work so they cannot be made aware of their condition, no matter how many times we tell them. So it's best to let it go and stop trying to force them to accept the diagnosis. Instead, enter your mom's reality and work with her limited abilities. If she can't remember something you told her, just tell her again. In her mind she never heard it, and telling her she has dementia isn't going to make her remember the things you tell her. And she won't remember that she has dementia so it will be pointless. If she is having trouble getting things done and caring for herself, help her with that without telling her why you think she needs help. Just assist her. It will be so much kinder and easier for you both.

My mom had anosognosia along with her dementia, and every time we tried to force her to accept her diagnosis she got agitated and defensive and so upset. I wish we hadn't done that to her. It was frustrating for all of us. And now looking back, it was cruel of me to keep telling her she had dementia - what a scary thing for her to keep hearing over and over.

My Mom is in complete denial about having dementia. When she was diagnosed with Lewy Body Dementia, by a neurologist she had worked with as a nurse and liked and respected, he explained to her what was going on and she seemed to understand and accept it. All the women in her family had some form of dementia, and all the men had Parkinson's, and she had always been terrified of getting it. Shortly after her diagnosis, she would ask questions such as why she was taking new medications or why we were doing certain things or why certain things were happening. We would try to explain to her that she has LBD. She would become completely distraught and insist that she doesn't have dementia. She would say things like, "my sisters have dementia and I am not like them" and "I am so lucky that I don't have dementia." Very true that she's not like her sisters. When we would tell her, "Well, Mom, you have Lewy Body, " her response was, "Yes, but that doesn't mean anything." She seemed OK with hearing Lewy Body, as long as we left off the dementia. I then realized she's right, it doesn't mean anything. It doesn't change how we feel about her or how we care for and take care of her. I decided there was really no reason to try to convince her she has dementia. I mean, to what end? All it does is upset her. We work closely with her doctor to make sure she is getting the treatment and care she needs. When there are issues that need addressed, such as hygiene or excercise, we alert her doctor ahead of her appointment so he can address it with her. She responds better when issues are addressed by him. He has such a gentle and beautiful way of interacting with her. So, for us, her accepting that she has dementia really has no purpose. Now when she says, "I am so lucky I don't have dementia like my sisters," we just tell her, "Yes, you are."

Are you her POA?
If not, you likely have a very small window of time for her to make you POA.
And if her dementia is severe enough she won't appoint you at this time, anyway. Paranoia sets in pretty fast.

To your question now, you really CANNOT convince someone with dementia of ANYTHING whatsoever. In fact denial is a very strong and almost certain reaction to early dementia. And if she has dementia your Mom can no longer be rational, cannot understand the importance of all you say, and won't believe you.
That's part of the disease.

You can present Mom with some easy testing that you can pull of the internet. For instance, have her draw a clock face with the numbers and set the clock for 11:15. Spell Forum backwards. Etc. Simple memory test questions. Tell her it is a game and if she can do these things she wins and you will let her alone a while.

The important thing here is to have MPOA (so you can speak with her MD) a general POA so you can act for Mom's protection. As I said, once diagnosed and judged incompetent Mom can no longer confer POA.

I would, if this is serious enough, and if you believe that Mom is becoming a danger to herself in being alone, report her to APS and tell them what you have told us. They can visit Mom and speak with her, and if they feel she is in danger alone they can help you to act for her best interests. They can also help you get temporary guardianship in order to get testing started.

I hope that what you are seeing is common forgetfulness (I am 80; I know about THAT) and perhaps some anxiety, which increases as we age; it can manifest with forgetfulness, and according to AARP is one of the most unaddressed problems currently common to seniors.

Good luck. Hope you'll update us as you go along.

Not all doctors cooperate when you ask for your relative to be tested. My spouse’s doctor would never do so and didn’t think people should “self diagnose.” I wen t through this for two years and that doctor was in geriatrics. I finally went through my own doctor who gave me the name of a neurologist who would see him without a referral from his physician.
of course, AD was confirmed. As in every profession, there are great, adequate, and questionable physicians. Get your POA and MPOA asap if you don’t have them and a backup in case something happens to you. Make any necessary changes in those areas very soon. Best wishes to you!

Write her doctor a note before the appointment and tell the doctor the same things you’ve told us. In the note, request doctor to inform her that she needs testing or that memory problems have been detected.

if you are present when she’s with doctor, sit behind mom where you can communicate silently with doctor by slightly nodding your head yes or no. That way if she’s lying, doctor will know.

if you’re not present at this appointment, at least doctor will know her issues and can get the ball rolling. And you should communicate again with doctor in a follow up call or note. Without her permission, doctor probably won’t talk to you, but your input is usually welcome.

Good luck!

Frankly, you'll get more accomplished by not insisting there's an issue or trying to reason with her. Get her to the doctor for an appointment by telling her it's required by new medicare laws.
If she has dementia she may have anosognosia, which is the inability to recognize that her memory is poor. Without a working memory she can't 'keep' new information-her mental calendar and information filing systems are down. So while she may have lost her keys and searched for them for hours yesterday, she won't retain any memory of that, and she'll think your're wrong if you tell her about it. I found this very helpful:
https://www.alzconnected.org/uploadedFiles/understanding-the-dementia-experience.pdf
These Videos and documents are helpful:
https://www.youtube.com/watch?v=pqmqC-702Yg

https://static1.squarespace.com/static/6372d16ea4e02c7ce64425b7/t/63f7b80d80d8aa3e3aa4a47d/1677178894184/DBAT.pdf

https://www.youtube.com/watch?v=awBm4S9NwJ0

https://www.youtube.com/watch?v=6cZTgG6kDjs

As well as posting here, the Alzheimer's caregiver forums are also very helpful :
https://www.alzconnected.org/discussion.aspx?g=topics&f=151

Why do you feel the need to tell her she has dementia? If she is “there”already, she may not be able to grasp, remember, understand, or easily cope with this. Treat her as gently as you can, while making your priority her safety (first) and her happiness second. Her ability to understand the full gravity of her unfixable personal situation need not be a goal.

I know that it is terrifying to realize that you are now caring for someone who may never quite understand everything the way she once did, All the explaining in the world will bring you both down.

Instead, move forward with a solution. if you need help, get help. If you must put her in a nursing home because that is your only workable solution, there is no need to make her feel incapable along the way.

Try “Janie is coming over for a spa treatment” instead of “Janie is supervising you in the shower because you have dementia.”

Try “a chauffeur will drop you off at the dermatologist so you don’t have to walk so far” instead of “you can’t drive anymore because you will get lost.”

Make her feel cherished and important. Watch her face for happiness and duplicate the conditions. Play her favorite songs, even if she can’t remember the lyrics because something inside her might feel a little happier. When you notice her face showing frustration, redirect.

This is a challenging and painful time. For you certainly, but also for her. Ease her sorrows as best you can. There will be plenty of happy moments and little miracles along the way. Don’t get so bogged down that you miss them.

When you need a good hard cry, know that many of us have been there. Love every day while she is still with you because it simply cannot and will not last forever. With dementia, you will find yourself longing for the past. Try your best to enjoy today, everyday, as it will inevitably be tomorrow’s past.

You don't tell her. Let her doctor tell her.
If you have access to her patient portal send a note to the medical staff so they can inform the doctor. He/she can then be prepared for her next visit.
If she does not have a visit soon I would request one. (use any excuse that mom will take to get her in before her appointment)
There is a very good chance that she will not believe the doctor. This also is a symptom that some with dementia have. What is important that the doctor make her and you fully aware that she can no longer live alone. You have to make it clear that she can not live with you (if that is the case and from what you have written I am guessing that is true) So that leaves mom 2 options.
Moving to Memory Care (you can call it assisted living if you want but she should be in MC not AL.)
or
Mom has caregivers that are there when you are not there for her. (and yes this probably means 24 hours a day. You never know what might happen at night she may wander or get up to use the stove, washer, take a shower and not turn off the stove, forget how to use an appliance)