Mom's GP who is an internal medicine Dr. has refused the kids requests for help with diagnosis. She believes the patient has to ask for help herself. So Mom has been in early stages for years, 2 1/2 of those I have been living with her, noticed right away there were problems.
We see the doctor on Thursday, what should we ask and what should we expect? From reading this forum I know the testing will be long, or perhaps referred to neurologist?
What have been your experiences with early medical steps and type of doctor we should be seeing.
13 Answers
Helpful Newest
First Oldest
First
After my dads GP brushed off dementia, it became very clear and he referred him to a neurologist in the same network. This doctor looked at MRI of brain and said there were indications of Alzheimers but no other incidents.
As we live in Minnesota, we eventually went down to Mayo Clinic and the neuro there said there had in fact been an "incident" in the brain based on the MRI. We asked if he meant a mini stroke, but he of course says doctors dont use that term, but the issue was clear, he had had some kind of event in the brain.
But get to a neuro.
ADVERTISEMENT
But, the thing is, a doctor isn't for life. You've got to be comfortable with them and trust them. They aren't always right either.
In my own experience, we waited too long to do this for my parents.
Finally, after a brief hospital visit, we went to the hospitalist (a doctor who works for the hospital). The hospitalist already knew of some of the problems, such as neglecting to take prescribed medicine.
Also I went to their regular doctor, to discuss situation without my parents there. This was allowed (ethically) because my parents had earlier signed HIPPA forms allowing me to discuss their cases. I also paid the doctor a "consult fee", for his time.
Drs don’t see the patient consistently enough to make a good determination of a patients mental state.
I would write a note to the doctor explaining Mom is in denial and the changes you have seen. Give it to the receptionist asking the doctor get it before the appt. The doctor can then ask Mom questions based on your note. If she doesn't do this, I would speak up, if u are again told Mom has to ask for help, I would tell her that you are seeking another doctor because she doesn't seem to understand Dementia. The person with Dementia doesn't realize they need help.
Even if you don’t have a medical POA, a similar letter, signed by all siblings, would be very hard to ignore.
When I finally got a referral out of him to take my husband to a dermatologist for a spot (not the area I was worried about) when the dermatologist walked in and took one look at my Husband he said...I am less concerned about the spot that you are here for, I would be worried about the Melanoma on the forehead! (what I had worried about for YEARS)
He also shrugged off my concern about the memory and finally after administering 2 MME (sort of worthless as far as I am concerned) I dragged a referral for a Neurologist out of him. And we got the "Alzheimer's" diagnosis but he never went further than that. (I to this day think he also had Vascular)
So...long story short...PUSH the doctor. Be realistic, does anyone with dementia admit they have dementia? (I should say do most people as there are some...)
If your doctor will not agree to testing find a Neurologist or a NeuroPsychologist that will see her. Unless of course you truly NEED a referral.
You have to become your own advocate and be an advocate for the one you are caring for.
I think the doctor is a "bubble off plumb" in her thinking that the patient has to ask for help. That is sort of like having to diagnose yourself before you have to go to the doctor.
When our family was suspecting my MIL of short-term memory loss, I accompanied her to her doc appointment that was made to check for a UTI. I was not her PoA. I had a pre-written note that I passed the nurse before the appointment which said the family is worried about her (and gave evidence of worrisome behavior) and requested the doc perform a cognitive exam, which she did. I also had MIL fill out a Medical Representative form so that their office would release MIL's medical info to me for consideration. They allowed me to sit behind her during her exam and if she didn't give accurate answers to their general non-cognitive exam questions I'd indicate by head movement yes or no or shrugged. I don't know why your mother's doc wouldn't do this. Usually docs are happy to accommodate this request.