Can I ask Mom's primary doctor how much experience he has had with Dementia patients?

Thanks Jeanne - I think it's probably a case of the different systems kicking in: in the UK all referrals to specialists (unless you go outside the NHS, which is a daft thing to do if there's actually anything really wrong with you) have to be made by your general practitioner. So mother's geriatrician (I agree - terrifyingly young!), cardiologist, psychiatrist (older mental health services), ophthalmologist and orthopods are all accessed through him, as well as community support services like OT and PT. But in most general practices the partners will pick a specialty, so you look out for who's got DCH (child health) DOG ("ladies' troubles"!) etc. etc. after their MB BS MRCGP… phew. Like we didn't have enough acronyms to wade through!

I'm told, too, that because of governmental tinkering with pay structures there's a growing trend for acute specialists to take up positions in general practice - so your friendly family doctor may turn out to have been a top neurosurgeon in a past life, but discovered that he got better pay, improved conditions and more respect in general practice.

I had a look at the GP college's website last night, out of curiosity about what CPD training they can get. I was surprised that there wasn't an Alzheimer's diploma, though I think it's probably only a matter of time: there is already one for Mental Health in Older Age. They can even do courses in gambling addiction! Makes me wonder, again, how many pick their own problems - physician, heal thyself...

There are great doctors who also do the "rounds" at rehabs/ nursing homes. Many do specialize in gerontology as well. The nursing staff will know who the "good" ones are. You can ask the "charge nurse" and you will usually be lead in the right direction. The staff know who the bad ones are! Wow! For a doctor to spend an hour for an office visit thats amazing! Yes you can ask what his experience in dementia is. Two relatives, 2 nurses and 1 doctor, have told me their time learning about dementia was very limited. This is why people specialize in areas they are intersted in.

Mostly with Mother's primary doc she zones out when he starts talking and doesn't remember a word he said. The last 2 times we saw him he never checked her vitals, meds or asked her how she was doing. Just went into his speech about him and his other clients. All I want to know is how is my Mother doing and we got blah,blah, blah very discouraging to say the least.
I started a list of question to ask and told my Mother I had questions for him that she wasn't going to like and left it at that. She might remember I have questions and if she does I don't want her to be surprised by them.

CM, a geriatrician is like a pediatrician. When my children were children their primary care provider was a pediatrician. That doctor coordinated all their visits with specialists (pediatric cardiologist, for example), oversaw all their meds, received reports from all other providers, etc.

A geriatrician played exactly the same role for my husband. As his primary care provider she got reports from the dementia specialty clinic, sleep psychiatrist, and the cardiologist. She knew what they were prescribing and was careful to consider drug interactions. She was very familiar with the type of dementia he had but was happy to let the specialty clinic set the treatment plan for that.

I agree with you about having a single doctor in the center of the network. For children, that should be a pediatrician. For elders, especially elders with complicated health issues, that should be a geriatrician, in my opinion. My own primary care provider is an internist, but I am wondering about when to switch to a geriatrician myself.

My father and now my mother saw/see a geriatrician. I was surprised at how young my father's doctor was when I met him in the hospital. He asked why I was surprised. I said because you understand Dad's issues so well, I guess I figured you must be older. He laughed. That was his specialty, and that is what he focused his study on.

I think it makes a world of difference to have a doctor who has specifically studied the issues of the age group you are part of.

Jeanne, don't you also have specialist diplomas for primary care doctors, though? I like my mother's GP co-ordinating everything because he knows her really well and is himself really well known to all the specialists - I see him as the spider at the centre of the web (though I wouldn't tell him that, don't think he'd be flattered!). It's also reassuring to have all her prescription meds regularly reviewed by one person who knows about all of them. The only trouble is when he goes on leave, like this week grrrrrrr...

What you may be seeing is the MD getting the patient to open up by saying "Oh I have that too". It works, it relaxes them, it establishes empathy and gains the patient's confidence. When the MD does this, I take a seat off to the side, out of mom's range of vision, and let him draw her out, and stay quiet. If she tells him a big fat lie, I just shake my head "no" and this cues him to ask a few more questions. It's a sneaky way to deal with her, but she is very clever about telling him she is fine when we both know she is not.

The fancy-shmancy subject heading CM is looking for is Geriatrics. I feel it is best to have a geriatrician (similar to a pediatrician, at the other end of the age spectrum) as the primary care doctor, and a dementia specialist as well. The dementia specialist may be a geriatric psychiatrist or a behavioral neurologist. Ask about their experience with dementia.

Too right you can. Perfectly fair question.

But what answer are you expecting? And what will you do with the answer?

Many primary care doctors have specialist qualifications for general practitioners in, for example, Obs & Gyny or Paediatrics. I don't know what the equivalent for Elder Care, or Older People's Medicine, or whatever other fancy-shmancy subject heading they give it, would be, or what extra letters you want to be looking for after his title and name; but I'll be if you do your homework you can find out. Then find out if there are any primary care doctors in your area who fit the bill. Then look THEM up and see if any of them looks like the kind of Dr Kildare your mother would take to.

You could also go to the Alzheimer's Society and see if they have advice for choosing your primary care physician.

If you can identify any of the other patients Dr Shmooze is talking about you can probably get him struck off. I agree it is extremely irritating when a doctor's main preoccupation appears to be his own health and lifestyle!

If she loves the doctors, the best thing you may be able to do is add one more doctor that YOU trust in, to help with her diagnoses... As far as other types of doctors that know a lot about dementia and AL, I would have to say the geriatric doctors would be the best bet.... because dementia hits when you get older and into the geriatric stages, usually....