A friend, age 79, had a bad fall and concussion last year. She has become very forgetful, even forgetting the fall. She is stubborn and I think frightened that she has Alzheimer’s and refuses to see a neurologist. Family has tried to convince her to see a doctor. Any suggestions? I always thought I wouldn’t want to be told I had an incurable disease but now there are some medications that can at least delay progression if caught early. What do you think could move her?
There may have been a hematoma pressing on a vital center.
In recent falls this is handled emergently with drilling of a burr hole to release the bleed.
I would move her by telling her that there may have been a small brain bleed under there pressuring the brain and she should have a scan to ascertain this. Explain the sudden changes you saw after this fall and tell her there is a chance a scan can show an area pressured in her brain.
In all truth, what damage was done from a year ago in time is too late to address now. Any bleed will have done what damage it did do. But a scan would be useful in differentiating reason for her changes.
ALZ is not caused by a concussion. Even though its under the Dementia umbrella, it effects the brain differently. Usually inherited.
Due to your friend's advanced age, it may not be possible to determine what's actually going on with her, but a scan may reveal she had a brain bleed from the fall, or maybe she had an unrelated stroke at some point, or she has a form of dementia.
It's possible that your friend may be willing to go to a doctor if you go with her, since you may be less intimidating than her family. But you should work with your friend's family (discretely) to see if they want you to help in this regard, and to also communicate any outcomes of an appointment. You would definitely need to go into the exam room with her, and be present when anything discussion is had between her and her doctor. Make sure your friends knows that "if it was me, I'd want to know for the following reasons..."
There's a strategy called a "therapeutic fib", where we tell our LO a harmless lie in order to incentivize them to do something that's in their best interest. Hence the suggestion by Grandma1954 to use the Medicare Annual Exam as a motivator (implying that the exam is both "required" and free).
I wish you all the best as you help her navigate this situation!
If she has not had a follow up after the concussion that should be done.
I would approach it as a "concussion" follow up. Nothing more.
Since we are now starting to get all the information about insurance and "open enrollment" is soon I would also suggest that she have the "Medicare Annual exam"
Now that I have said all that...
This is a friend.
You are not a relative.
I am assuming you are not POA or Guardian
Say your piece then let it go.
To see a doctor or not is her decision
Let her know that you support her
Let her know that you will be there for her if she needs it.
Let her know that you are going to let the matter drop, that you are not going to hound her any more.
You can't do more than that.
(but if you are out together and she gets dizzy or shows signs of confusion you are within your right to tell her that you feel that she should go to the emergency room)
So encourage her to get a follow-up visit about the concussion. People go to cardiologists for their heart, ophthalmologists for their eyes, and pulmonologists when their lungs aren't working right; so why not see a brain specialist about a hurt brain?