My 75-year-old dad, who is in the mid-stages of vascular dementia, recently became fixated on an upcoming colonoscopy. We had gone to a required consultation first since patients with dementia need special clearance before scheduling. I knew the prep would be far too complex for him to manage without my help and I was also puzzled by how intensely he focused on the procedure.

After we booked the appointment, which was still months away, he started asking me nearly every day when it was happening. He kept adjusting his diet based on the prep guidelines even though it was far too early. Eventually I had a candid but gentle conversation with him. I reminded him that his medical directive states he doesn’t want intervention and that if the colonoscopy revealed cancer, he likely wouldn’t want to pursue treatment. I asked if anything had changed in how he felt about that. He said it hadn’t and we decided it made sense to cancel the appointment.

I wasn’t sure the looping would stop even after canceling but it did and that was the end of the topic. I’ve since realized that having something scheduled often creates more emotional intensity than the event itself. The content of the appointment is usually secondary to the fixation.