Denial is not a strategy: Coming to terms with a challenging diagnosis
Originally published in Jewish News of Greater Phoenix, September 2025
We all want the people we love to be okay. We want to believe that the minor memory slips, the softening voice or the stiff walk are just “normal aging.” We tell ourselves not to overreact, that maybe they’re just tired or stressed or having a bad day. But sometimes, deep down, we know something has changed.
For many families, this moment of realization is the start of a long, emotional journey. When a loved one begins showing signs of cognitive or neurological decline, whether it’s dementia, Parkinson’s or another movement disorder, there’s an understandable urge to look away. Often, the person experiencing the symptoms does just that. They shrug off the diagnosis, resist treatment and insist they are fine. They say the doctors are wrong, or that the tests were unnecessary. They stop going to therapy, ignore dietary advice and pretend nothing has changed.
This isn’t stubbornness. It’s fear. It’s grief. And it’s a very human response to a life-altering reality.
But denial, while understandable, is not a strategy. And it does not protect anyone from what lies ahead.
In fact, it often makes the road more difficult for everyone.
The first signs are usually subtle. A family member who used to talk for an hour now rushes off the phone after a few minutes. They have lost weight but deny anything is wrong. Maybe they are wearing the same clothes multiple days in a row, avoiding their favorite activities or getting lost on familiar streets. They stop making appointments, or worse, don’t remember them at all.
And when the neurologist confirms what you feared, a diagnosis like Parkinson’s or early-stage dementia, the truth can feel overwhelming. But the real challenge begins when your loved one refuses to accept it.
I’ve seen this dynamic play out in families I know. Someone receives a clear diagnosis and is offered straightforward, practical steps to help, things like simple lifestyle adjustments, therapy or joining a support group. But instead of taking advantage of these tools, they retreat. They dismiss the recommendations, or even the diagnosis itself. And with that, a chance to slow decline and maintain independence begins to slip away.
This happens more than we talk about. And it leaves families torn between wanting to respect a loved one’s autonomy and needing to protect their safety.
So, what can you do?
Start with empathy. Understand that this isn’t just about memory loss or shaky hands, it’s about losing control. It’s about confronting mortality, identity and vulnerability. Acknowledge the fear. Sit in it with them. Don’t rush to fix or force it. Instead, create space for gentle conversation.
Use “I” language: “I have noticed some changes, and I am worried.” Offer to go with them to the doctor. Offer to listen without judgment. And most importantly, offer hope, not false hope, but realistic encouragement. Remind them that early intervention can make a meaningful difference.
One of the greatest barriers to care is the belief that nothing can be done. But that’s simply not true. With conditions like Parkinson’s and dementia, certain lifestyle changes, movement, nutrition and cognitive engagement, can slow progression. Medications can ease symptoms. Support systems can offer comfort and connection.
Local organizations, like the Banner Alzheimer’s Institute and Barrow Neurological Institute, are leading the way in memory and movement disorder care. They provide not only diagnosis and treatment, but education, counseling and comprehensive support for families.
Still, what if your loved one continues to resist?
Bring in allies. Sometimes a longtime doctor, friend, clergy member or even another family member can be the voice that cuts through. Frame care as empowerment: “This isn’t about giving up, it’s about staying strong for as long as possible.” Share stories of others managing their illness with courage and success. Celebrate small steps. Encourage consistency. And stay connected.
In parallel, it’s vital to begin planning. Even after receiving a diagnosis of dementia or Parkinson’s, advanced planning is not only possible but strongly recommended, especially in the early stages while the person still has the capacity to make informed decisions. However, it’s even more effective to start before any diagnosis is made, if your partner or family member can be convinced to do so. Once a diagnosis is on the record, the window for legally sound decision-making can begin to close quickly, and in some cases, it may become impossible to execute essential documents like powers of attorney or create or revise a will. That’s why it’s so important to have these conversations proactively, before there’s an emergency or a clear medical crisis.
Work with a trusted elder law attorney or financial advisor to ensure all necessary legal documents are in place: medical and financial powers of attorney, living wills and estate plans. This helps avoid confusion, disputes and legal obstacles down the line. It’s about giving your loved one the dignity of making their own choices while they still can. Don’t wait for a crisis. Once cognitive decline accelerates, it may be too late to make decisions or legally authorize changes.
Frame these conversations as a gift: “Let’s make sure your wishes are honored. Let’s take care of this now, while you are still able to be fully involved.” Remind them that this isn’t about losing independence, it is about preserving dignity.
Families navigating these diagnoses are often surprised to discover how resilient their loved ones can be once the initial fear subsides. Many people who initially resist treatment eventually embrace it. But it takes time. It takes consistency. And it takes love without judgment.
If you’re on this path right now, remember you are not alone. Many families have stood where you are, navigating the same mix of confusion, fear, grief and hope. There isn’t a perfect script, or a single right way forward. But there is support. There are resources. And there is still so much life to be lived.
Lean on your community. Reach out to experts. And most importantly, keep showing up. Every gentle conversation, every shared appointment, every effort to stay connected, it all matters.
We cannot change the diagnosis. But we can change the journey.
Let’s walk it with compassion, intention and the quiet strength that comes from truly showing up for the people we love.
By Bob Roth
Bob Roth shines as a stellar advocate for caregiving. He has served on the board of Duet, and has received many community awards in recognition of his work. He hosts the weekly radio show and podcast, Health Futures – Taking Stock in You. Over 30 years ago, he co-founded Cypress Homecare Solutions after caring for his mother, which sparked a lifelong mission to provide compassionate in-home care. You can view his Duet webinar, Tips for Hiring a Caregiver. We are pleased to showcase Bob Roth’s monthly columns, originally published in Jewish News of Greater Phoenix: jewishaz.com/specialsections
