When They Tell the Doctor Things That Aren't True: Managing Appointments

"I'm doing just fine, I don't know why she's so worried." Medical appointments have their own version of therapeutic fibbing, and it's yours to navigate.

Why does this happen so often?

It's rarely deliberate deception — it usually comes from memory gaps, reduced self-awareness, or a natural instinct to present well in front of an authority figure.

Three things tend to be going on at once. First, memory: if a fall, a confused episode, or a bad week happened three weeks ago, it may simply not be available to recall in the exam room, especially under the mild pressure of being asked directly. Second, a condition called anosognosia — a genuine, neurologically based lack of awareness of one's own deficits — means some people with dementia aren't withholding information so much as they honestly don't perceive the problem the way you do. Third, there's a very human instinct to want to look capable in front of a doctor, the same instinct that makes most people say “fine” when asked how they're doing, just amplified by cognitive change and sometimes a fear of what an honest answer might lead to (a driving restriction, a move, a loss of independence).

How to make sure the doctor gets the full picture

The most reliable fix is keeping a written record between visits, so you're not relying on memory (yours or theirs) in the moment.

• Keep a simple running log — date, what happened, how long it lasted — for falls, confusion episodes, medication issues, or behavior changes between appointments.
• Bring the log with you, or send it to the office ahead of time through the patient portal if one exists, so the doctor has it before the conversation starts.
• Note patterns, not just incidents — “more confused most evenings this month” is often more clinically useful than a single dramatic story.
• If something concerning happened, be specific rather than general: “forgot the stove was on twice this month” carries more information than “she's been more forgetful.”

Getting a moment alone with the doctor

Most dementia-experienced doctors expect to hear a different story from the caregiver than from the patient, and have a system for it.

It's completely reasonable to ask for a few minutes separately — many offices are used to this and will find a way to make it happen, sometimes by having a nurse or medical assistant briefly separate you before the doctor comes in, sometimes by asking your loved one to step out for a vitals check. If that's not an option in the moment, a note handed to the front desk, or an email or portal message sent before the appointment, works nearly as well and avoids any awkwardness of trying to signal something silently in the room.

The goal isn't to contradict your loved one in front of them or make them feel exposed. It's to make sure the clinical picture the doctor is working from is complete, since decisions about medication, safety, and care planning depend on accurate information.

What to do in the moment, if a mismatch comes up live

Gently expanding rather than contradicting tends to preserve dignity while still getting the accurate information across.

If your loved one says “I've been doing great” and you know there was a fall last week, you don't have to flatly contradict them in the room. A softer approach: “That's good to hear the days have felt better. I did want to mention, doctor, there was a fall last Tuesday I wanted you to know about.” This adds information rather than framing your loved one as wrong or dishonest, which tends to avoid embarrassment or defensiveness in the moment, while still making sure the doctor has what they need.