Tips for Caregivers: Talking to Your Loved One about Getting a Neuropsych Evaluation

I work with many adults who coordinate care for an aging loved one (for the sake of this blog post, we’ll say “parent,” though of course there are many people we may end up supporting in this way – siblings, grandparents, neighbors, friends, or even adult children).  The day-to-day tasks of bathing, toileting, dressing, and managing meds can be overwhelming (a topic for another blog).  There are different challenges to managing medical care: scheduling many appointments, transportation, time off work, writing down information from doctors, and following up on recommendations.  When you’re juggling so much, it can be hard to communicate with your parent effectively.

ROADBLOCKS TO SEEKING COGNITIVE TESTING

As a psychologist who does neuropsych assessments, I’ve met many caregivers who aren’t sure how to talk to their parents about medical care and psych testing.  A neuropsych evaluation for dementia or other concerns can be a sensitive topic for many reasons.  These conversations are especially hard when your parent:

• Has memory or other cognitive problems and doesn’t remember every incident

• Doesn’t see the problem

• DOES see the problem and feels defensive 

• Is afraid of what testing might find

• Is resistant to having you manage their care in general

These barriers are common, but make things harder for everyone. If you’ve noticed a cognitive change and believe your parent should have neuropsych testing, here are some ideas about the best way to approach the conversation.

HOW TO TALK ABOUT A NEUROPSYCH Evaluation: THE BASICS

There are some basic communication skills that make any complex conversation easier:

• Timing is everything.  Bring the subject up when you have plenty of time to talk and won’t be rushed.  

• Location, location, location.  Talk in private, in a space free from distractions, and where you can look at one another while you talk (while driving is never a good time for a serious talk).

• Put yourself in their shoes.  It’s frustrating when a problem is obvious to you and your parent seems to be in denial. Imagine how they may feel: afraid, sad, embarrassed, confused, angry…or all of these.  When you start with empathy, you have a better foundation for a tough conversation.  Try “I know this is hard to think about.  I haven’t known how to talk with you about it because it’s scary, but I love you, and we can get through this together.”

HOW TO TALK ABOUT NEUROPSYCHological TESTING: THE NEXT LEVEL

Once you’ve got the basics, here are some strategies that have helped me to engage reluctant or angry testing patients over the years:

Be kind AND straightforward. 

Sugarcoating doesn’t help. Do your best to keep a neutral tone, and keep your own feelings (anger, frustration, fear) in check. For example, “I know this may be hard to hear, but we need to talk about it.  I’ve noticed you forget things lately.  Yesterday when you had your hair appointment at 2, I reminded you three times to get dressed. Earlier, you turned on the burner and forgot, so the smoke alarm went off. Dr. Smith has noticed you repeat what you’ve already told him during appointments, and he said you need some testing to find out more about what’s going on. Neuropsych testing can give us some answers.”

Offer relief from shame. 

Especially in the early stages of cognitive change, your parent may feel embarrassed or blame themselves, which will only get in the way of getting testing and support.  Try, “It must be scary to forget things and feel like your thinking is slower, but this is not your fault.  It’s nothing to be ashamed of.”

Show confident leadership. 

Caring for your parent is a role reversal that can be very hard on everyone. Pursuing a neuropsych eval is one instance where you may need to decide what is in their best interest, even if they’re angry.  You might say “I know you don’t want to do neuropsych testing, but you and I have both noticed changes in your memory and speech, and it is time to get some answers.  I’ll make the appointment because I know it’s the right move.  I hope you’ll agree, but either way, we have to move forward.”

If all else fails, say this.  “I know you don’t see the problem. Think of it this way: if you do the neuropsych evaluation and something’s wrong, we’ll get help.  If you do the testing and it turns out nothing’s wrong, then at least you’ll get me and Dr. Smith off your back about it!”

Once you have made the appointment, you can also enlist the help of your psychologist, who can further explain the value of testing and what to expect.

Begin Working WIth A Neuropsychologist in Los Angeles, CA

Talking to your loved one about a neuropsychological evaluation can be difficult, but the benefits are worth the conversation. As a Los Angeles Psychologist, I would be honored to help provide the insight to help you better understand what care your loved one may need. You can learn more about what you can expect from neuropsychological testing with Dr. Reger by doing the following:

1. Reach out for a free consultation.

2. Schedule neuropsychological testing with Dr. Reger.

3. Start receiving the support you deserve!

Other Therapy and Testing Services Offered in Los Angeles, CA

I understand you may need more support in addition to neuropsychological testing. This is why I’m happy to offer several types of assessments and services around Southern California. I also offer psychological evaluations for workers’ comp, preoperative assessments, individual therapy, and therapy for older adults. Visit my blog for more helpful information today!

What to Do Once you Have A Diagnosis After Adult ADHD Testing Pt. 3

I discussed symptoms of ADHD in adults in the first of this series, then in part two, I talked about when to seek neuropsychological testing for ADHD. If you get a diagnosis of ADHD in adulthood, you will probably experience emotions ranging from shock to fear or sadness. But you may also experience relief in finally having a diagnosis to make sense of symptoms you’ve been coping with for decades. Here are some tips to help you navigate after being diagnosed with ADHD as an adult.

LEARN EVERYTHING YOU CAN ABOUT ADHD

It may sound cliché, but knowledge is power. Undetected ADHD symptoms can wreak havoc on your life and may have done so for a very long time. During that time, you may have gotten into unhealthy habits, like using caffeine or other substances excessively, poor sleep hygiene, undermining yourself in relationships, or underperforming or being chronically stressed at work. I highly recommend first learning a lot about ADHD, so you can begin to understand the breadth of the impact, and perhaps increase your self-compassion.

• Read Taking Charge of Adult ADHD by Dr. Russell Barkley, or any other well-researched book on ADHD by a psychologist or other clinician or scientist who studies ADHD. This is really helpful for understanding the basics of executive function and the causes and supports for ADHD in adults. (You might consider an audiobook if sitting to read is difficult. That way you can clean, exercise, or whatever else while you learn).

• Listen to podcasts! There are plenty of great podcasts by ADHD experts out there, and these are in naturally bite-sized pieces. A few I like, with different perspectives, but generally focused on adults with ADHD:

  • “The ADHD-Friendly Lifestyle” with Moira Maybin

  • “Faster than Normal” with Peter Shankman

  • “Adulting with ADHD” with Sara Snyder

  • “Translating ADHD” with Cameron Gott and Shelly Collins

SHARE WITH THE PEOPLE IN YOUR LIFE

If you have been diagnosed after getting adult ADHD testing, you have probably noticed that ADHD impacts your relationships. Undiagnosed ADHD can be frustrating, both for people with symptoms and for others close to them. You may have experienced the interpersonal impact of things like

• Chronic lateness

• Forgetting important tasks or milestones

• Difficulty following through with promises

• Difficulty paying attention in conversation

• Lack of motivation to do undesirable tasks

These types of symptoms wear on relationships over time, and there can be great relief and forgiveness (of the self and each other) once you have a diagnosis and understand ADHD. Although you may feel ashamed or afraid of sharing because of mental health stigma, there is power in naming what’s happening. It is also important to allow your loved ones and friends to understand and support you as you learn how to navigate ADHD more effectively. Neurodiversity is discussed more and more openly in the mainstream, and you might be surprised that others you know have or have been impacted by ADHD themselves.

CONNECT WITH OTHER ADULTS WITH ADHD

Once you know what you’re dealing with, you can begin to connect with others in the ADHD community. Talking to and learning from others with shared experiences can be very healing, and it can also teach you some strategies for approaching ADHD. Who knows, you may also have a thing or two to teach other people! Here are a few places to start for local and virtual support groups and other connections:

• Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD)

• Attention Deficit Disorder Association (ADDA)

• Kaleidoscope Society (resources for women and nonbinary folks with ADHD)

Get Answers Through an ADHD Assessment with A Psychologist in Los Angeles, CA

If you have identified with some, or all, of the ADHD symptoms, talked about in this blog series you can get answers and accommodations through adult ADHD testing. With a diagnosis from a Los Angeles Psychologist, you can gain access to treatments that will improve your quality of day-to-day life and relationships.

Find out more about what you can expect from adult ADHD assessments with Dr. Reger by doing the following:

1. Reach out for a free consultation.

2. Schedule your adult ADHD testing with Dr. Reger.

3. Start your journey towards improved mental health, accommodations, and resources.

OTHER THERAPY & PSYCHOLOGICAL TESTING SERVICES IN LOS ANGELES, CA

Dr. Reger offers several types of neuropsychological assessments around Southern California. She also offers psychological evaluations for workers’ comp and preoperative assessments. Additionally, offers individual therapy and therapy for older adults.

Adult ADHD Testing, Part 2: When to Seek Psychological Testing for Adult ADHD & What to Expect

In the first post of this series, I shared some common symptoms of adult ADHD. Some symptoms (like restlessness) can look the same in adults and kids. However, some symptoms (like difficulty prioritizing tasks) can be difficult to spot in adults. Unfortunately, I’ve heard adults blame themselves, and call themselves “lazy,” “thoughtless” or other harsh labels, when they are really suffering from undiagnosed ADHD.

If you read the first part of this series and noticed some of those symptoms in yourself (or perhaps a partner), you may wonder whether you have ADHD. There are many people who have “self-diagnosed” ADHD and other mental health disorders, but there are benefits to being assessed and diagnosed by a psychological evaluator.

SIGNS YOU MAY WANT TO SEEK AN ADULT ADHD EVALUATION

If you suspect ADHD and have never been assessed or diagnosed, it is worth considering when:

• You notice lifelong “personal traits” that sound like adult ADHD symptoms. For example, being a daydreamer, being called “flaky,” and others. Check out part 1 for more examples.

• These symptoms interfere with your personal relationships--with your partner, family, friends, or colleagues

• ADHD-like symptoms interfere with your work, or lead to difficulty holding a job. This can look like being chronically behind on deadlines, always late to work, or taking on too much and not being able to follow through.

• The symptoms cause problems with your education. You might find yourself unable to focus during tests. Or you find it impossible to self-start for online classes that are mostly independent work.

• You find yourself often having to apologize to others for “dropping the ball” in some way – losing an important document, forgetting to pick up a child from practice, missing a deadline, or not hearing what someone says because you got distracted. Feeling like you are constantly letting others down unintentionally can be a sign of ADHD

• These problems have been part of your life for a long time, even dating back to childhood. For example, you might have always been in trouble for talking out of turn, getting out of your seat, distracting others, or daydreaming.

• You drink a lot of caffeine or use other substances to help manage your ADHD symptoms.

WHAT TO EXPECT FROM Adult ADHD Testing

If you have recognized some untreated symptoms in yourself, and want to move forward with psychological testing for ADHD in Los Angeles, there are a few things to know.

Getting Adult ADHD Testing is Important for accommodations

Adult ADHD testing can be done by a psychologist or neuropsychologist who is trained in evaluating ADHD. An ADHD diagnosis can be made by any psychologist or psychiatrist licensed to diagnose, but without an adult ADHD assessment, you won’t have insight into your brain strengths and vulnerabilities or learning style. A diagnosis without assessment also won’t help you get accommodations in school or the workplace. Disability and resource offices want to see a psychological report to support accommodations. These are the same reasons I recommend against “self-diagnosis,” in addition to the fact that it may not be accurate.

Looking at the big picture not just ADHD

Sometimes I get requests to “just test for ADHD,” but this is not good practice for a few reasons. Adult ADHD testing performed by a trained psychological evaluator will look at many areas of brain function, not just attention. This is because we need to rule out other explanations for your symptoms, and also, because ADHD often occurs along with other learning or mood problems. It’s important to get the full picture. This way, we don’t miss anything important, and you get the best treatment.

Be Prepared for the Day of Testing

Expect that you will have a long day of paper-and-pencil or computer/tablet adult ADHD testing. Come prepared with a good night’s rest, breakfast beforehand, snacks, water, glasses, hearing aids, and anything else you need to focus and do your best on testing.

Waiting for results from the adult ADHD testing

After testing, it can take a few weeks for your psychologist to write a report. In a feedback session, your doctor will explain the results, as well as explain a diagnosis (if you have one), and any recommendations. These recommendations can improve your quality of life, and might include anything from strategies for managing forgetfulness, to support in college, like extra time for tests. These recommendations are personal and should be taken seriously as they can truly make a difference.

Keep Ahold of the Report

You should keep that report; you may need it in the future. For example, if you ask for disability accommodations at work or school, or if you have neuropsychological testing in the future and want a baseline to look back at. Keep it safe, make copies, or save it digitally, and don’t give your only copy to HR or the disability office at school!

Get Adult ADHD Testing in Los Angeles, CA

Psychological testing for ADHD is a great way to test your cognitive functioning and identify any potential issues with attention, impulsivity, and hyperactivity. With proper diagnosis and treatment, individuals with ADHD can improve their quality of life and better manage their symptoms. If you're located in Los Angeles, CA, don't wait any longer to schedule an appointment with a qualified neuropsychologist. Take the first step towards getting the support and resources you need to thrive.

1. Reach out for a free consultation.

2. Schedule your adult ADHD testing with Dr. Reger.

3. Start your journey towards improved mental health, accommodations, and resources.

Other Testing & Mental Health Services Offered in Los Angeles, CA

Dr. Reger offers several types of neuropsychological assessments at her Redondo Beach practice and in many locations around Southern California. That is in addition to psychological evaluations for workers’ comp and preoperative assessments. Additionally, as a Psychologist in Los Angeles, she offers counseling for older adults.

Adult ADHD Assessments, Part 1: What is Adult ADHD?

Because it is neurodevelopmental (meaning it usually begins at a young age), Attention Deficit/Hyperactivity Disorder (ADHD) is a diagnosis often associated with children. We tend to think of a child with difficulty quietly paying attention in class. But ADHD is a lifelong neurodevelopmental disorder that can affect people of any age, and across the lifespan. In fact, there are many adults and older adults struggling with symptoms that have impacted them since childhood and have no idea that what they’re dealing with may be ADHD. It is only recently that it has become common for children to be assessed for ADHD if they show symptoms, so there are still many adults unknowingly dealing with the confusing and frustrating symptoms of ADHD.

In this three part blog series, I will share insights about adult ADHD. We’ll start with understanding ADHD in adults, then talk about what to expect from adult ADHD assessments, and then what to do after a diagnosis of ADHD in adulthood.

WHAT ADULT ADHD LOOKS LIKE

It’s estimated that 4.4% of adults in the US have ADHD. When ADHD is not treated, it can lead to other problems, like depression and anxiety. Here are some adult ADHD symptoms to look out for:

• Lack of attention to detail

• Difficulty following through on tasks

• Difficulty prioritizing

• Frequently losing things

• Difficulty organizing

• Forgetfulness

• Restlessness

• Frequent lateness/problems with time management

• Problems listening

• Procrastination

• Interrupting/Impulsive talking

• Difficulty engaging in rest or quiet activities

• Being high energy/always on the go

If you struggle with several of these symptoms, you might be facing adult ADHD. Often, adults with ADHD find ways to compensate for their symptoms, or even use these attributes to their advantage. For example, if you are always on the go and restless, this can mean you multitask and get a lot done. But, it can also mean you miss details, leave things partially finished, or forget to close the loop on the things you do. If you suspect you may have undiagnosed ADHD, it is never too late to seek out adult ADHD assessments.

FACTORS THAT WORSEN ADHD SYMPTOMS IN ADULTS

ADHD symptoms may be better or worse depending on a lot of life factors. For example, many women who have ADHD notice that their ADHD symptoms get much worse when they go through menopause. This is because hormones impact the function of brain areas important in attention and self-regulation. Here are a few other risk factors for adults with ADHD:

• Stress

• Malnutrition/poor diet

• Overstimulation

• Environmental distractions (sounds, temperature, visual distractions)

• Fatigue or sleep deprivation

• Lack of interest

You might have noticed from this list that ADHD symptoms tend to worsen when people are not practicing good self-care (e.g., sleep hygiene, balanced eating, creating a calm environment). ADHD is also worse when you have to work on tasks that you don’t enjoy, or don’t naturally interest you. Ironically, people with ADHD can often hyperfocus on tasks or activities they really enjoy. This can be very effective at times, but a lot of life tasks involve both fun and not-so-fun parts, so ADHD can interfere with getting the whole task done. For example, you may love to cook a new recipe, but hate to clean up and do dishes. So you can enthusiastically focus and make a great dish, but end up with a messy kitchen that stresses you out for days.

FACTORS THAT CAN HELP WITH ADHD SYMPTOMS

There are also things that help folks with ADHD manage their symptoms. Here are a few things that can improve symptoms:

• Using external organization tools (calendars, reminder alerts on the phone, timers, planners, partners or friends who help you stay on track)

• Seeking adult ADHD assessments with a neuropsychologist to understand your diagnosis as well as cognitive strengths and vulnerabilities.

• Saying no to unwanted/unnecessary activities

• Speaking to your doctor about your symptoms

• Getting enough sleep by practicing good sleep hygiene

• Avoiding caffeine and other substances

• Discussing your symptoms and diagnosis with your partner, family, friends, and possibly even at work, so people can understand some of the more frustrating symptoms that may impact your relationships and work

• If you have already had neuropsychological testing, you might seek cognitive rehabilitation or psychotherapy for ADHD

In the next blog, I talk about finding a psychological evaluator if you want to seek neuropsychological testing to confirm or rule out adult ADHD. I also discuss what to expect from the process of adult ADHD assessments.

Through Adult ADHD Assessments in Los Angeles you can find out if you have ADHD

Do you recognize some, or all, of the symptoms listed above? If you do Dr. Reger provides neuropsychological testing that can help determine if you have ADHD. If you are ready to speak with a neuropsychologist in Los Angeles then follow these steps:

1. Reach out with any questions that you have.

2. Schedule your appointment for Adult ADHD assessments

3. Get answers so you can learn what will help make life easier.

Other Assessment & Counseling Services Offered by dr. reger in Los Angeles, CA

Dr. Reger offers several types of neuropsychological assessments at her Redondo Beach practice and in many locations around Southern California. She also offers psychological evaluations for workers’ comp and preoperative assessments. Additionally, as a Psychologist in Los Angeles, she offers counseling for older adults.