It’s not denial

I knew when to stop talking about dementia with Diane. It was when she denied having it.

In medicine the word “deny” is said without judgment. A report from a recent doctor’s visit includes this sentence: “Pt denies pain, fever, chills, runny nose, cough, depression/anxiety, headaches, vision changes, chest pain, dizziness, SOB,” and on and on. I was experiencing no symptoms because I was there for a routine checkup. But if I was sick the language would be vital to getting at a diagnosis.

With the dementia patient, though, we know the diagnosis and we know how it ends. The fact that you and the patient used to talk endlessly about your health and what foods to eat and what to put in your smoothie doesn’t matter any more. What matters is that their days are peaceful and pleasant.

By the time Diane started denying her diagnosis, someone in my support group had introduced me to anosognosia, a condition that the Mayo Clinic defines as “the inability, in a neurologic sense, to be aware of impairment.” It worked for me.