Do you know a person with dementia or memory problems who is refusing offers of help? Here are a few ways to support someone who may be in denial or lack insight about their situation.

It is common for someone living with dementia to not acknowledge that they are experiencing issues with their memory or other aspects of cognition, such as having difficulty holding conversations or carrying out daily living tasks. This could be due to denial or lack of insight. 

Denial is when a person doesn’t acknowledge certain facts or events, even when they may seem obvious to those around them. It is a psychological reaction that enables a person to cope with a difficult situation that may otherwise make them feel afraid, depressed, ashamed or worried. 

Similar to denial, lack of insight is when a person with dementia is unable to recognise changes in their behaviour and emotions.  This is caused by physical changes in the person’s brain. When a person continues not to acknowledge the difficulties they are having, this can cause further problems later on. For example:

• they may refuse to accept help 
• there could be delays in starting, stopping or continuing to take medication
• they may continue to drive despite it not being safe for them to do so.

Offering help to someone with memory problems who is experiencing denial or lack of insight

Someone living with memory issues may deny or not realise that they’re experiencing problems. This can be frustrating, especially if you’ve been encouraging them to visit their GP for a memory test.

For some people, they may have some awareness of their cognitive issues and may be feeling uneasy or anxious about this. They may also be fearful about the future. They may feel – or think that other people may feel – a stigma about having a diagnosis of dementia.

Here are some ideas to consider when talking to someone about your concerns. 

• Broach the topic gently. It may help to remind them that memory issues don’t always point towards dementia.
• Be kind and supportive during the conversation. Listen to their reasons and any fears they raise.
• Let them know that you’re worried about them. Give examples of issues like missing appointments, misplacing items, forgetting names.
• Break down the larger issue into smaller ones. Pick one to focus on, such as, ‘I’ve noticed you’ve been forgetting names of friends. Maybe the GP will be able to help.’
• Keep a diary of events. This will help you show someone you’re worried about that you have ‘evidence’ for your worries. The diary will also support you both if you see a doctor as they may want to see a record of issues.
• Turn the focus towards getting support for their friends and family. For example, ‘If you visit the GP, we might be able to get extra help that would give me a break...’

Offering help to someone with a diagnosis of dementia who doesn't acknowledge it

Receiving a dementia diagnosis can be a daunting experience. The person who has been diagnosed may feel a range of emotions, from sadness to disbelief to denial. When you talk to someone about their diagnosis and how they’re feeling, try to stay calm. This may help calm them down, too.

Giving the person time and space to think about their diagnosis and how they feel about it is a good way of approaching the situation.

If they continue to not acknowledge their diagnosis, you might start to feel frustrated or unable to help. There are a few things you can do to support someone who is in denial about their dementia diagnosis or refusing to accept help.

• Think about ways to support them without giving dementia as the reason. For example, introduce new technology or memory aids by letting them know how they can help with daily tasks.
• Find out more about local support groups and therapies. Attending these may help the person come to terms with their diagnosis. Talking and art therapies are popular choices.
• Try to think about what might motivate the person to accept help. Think about other times where you needed to persuade them of something, and try to adapt what worked then to this situation. 
• Try to stay calm when talking about your concerns. Getting angry or upset can make conversations uncomfortable for everyone involved. The person you’re worried about may be more hesitant to talk to you in the future.

It's important to try talking to the person you're worried about and to encourage them to see a doctor themselves. Where this doesn’t work, you might consider speaking to the person’s doctor yourself. If doing so, it is best to get the person’s consent, or at least inform them that you are going to speak to their doctor. It will then be for the doctor to decide whether they disclose the information to the person.