angelarochon Asked August 2020

Should we continue doctor visits?

My husband has dementia (Alzheimer's) and no other conditions. I wonder should I keep making him go to the neurologist when the doctor does nothing that will really help the condition? My husband has no problem going to our general doctor for anything else that I think is wrong. We went for the annual wellness visit recently and it went well. The neurologist is expensive and quite a distance from our home.

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No, I wouldn't continue to go. Write a lovely thank you letter and tell the doctor you will revisit for any changes or needs in future.

Helpful Answer (9)

When my mom last went to the hospital, they thought she may have had a seizure and had the tests run. I work in Neurology, and I KNOW she did not have one. All the tests proved I was right. Then on discharge they wanted us to see the neurologist again.. why?? It was dehydration and CHF. I politely declined that apt. I told her regular Dr about this, he agreed I was on track. I see no need to go to Drs who only want the money. If you are happy with the regular Dr,, stay the course. My almost 90 YO mom does not need more apts.

Helpful Answer (9)

Same here; upon discharge from the hospital a year ago May, the neurologist cornered me to ask if I'd made an appointment! I was flabbergasted! I told her No, what for? She said so she could keep an eye on my mother's neuropathy for which there is NOTHING she can do! Including the dementia! So I should schlep my wheelchair bound mother downtown for an neurologist appointment for NOTHING? Nope, not gonna happen.

(9)

If neurologist is not prescribing medication or treatment, you could skip re-evaluations. Your primary doctor can always submit a new consult if new problems develop.

Helpful Answer (9)

This is the time of COVID-19. You should contact doctors by videocalls or phone calls. Not in person visits. Medicare and other health insurancesnow pay for video and telephonic calls. It saves everyone's time and energy.

Helpful Answer (9)

and sanity

(4)

Just tell them you'll need to check back about a new appointment and don't schedule one. Repeat business is good for a specialist especially if there's no changes.

Helpful Answer (9)

If the neurologist says there are no more therapies to try, I'd discontinue the visits. There is no purpose. I'd also ask the primary care MD if your spouse is at a "hospice" stage, where no further general medical therapies are going to make a difference to him.

My dad had congestive heart failure and kidney failure. He was very weak, and needed bathroom assistance all the time. His MD told us that there was nothing further that medicine had to offer. He was at the end of his life. So the MD arranged to have him put on Medicare hospice status (they had moved to AL at that time as well since he needed round the clock assistance with the ADLs.) Hospice provided regular nursing and social worker visits for comfort care only. He also signed a "do not resuscitate" order (never needed, fortunately.) He passed away peacefully beside mom in their AL apartment.

Helpful Answer (8)

I agree with the others. Given there really isn't anything any doctors can do for most dementia patients, other than perhaps Rx something if they are having real issues (anxiety, hallucinations, etc.), what is the point? I would just say that unless he has some additional neurological issue(s) that can't be addressed by his regular doctor it is too difficult to travel that far with him. Keep the door open, just in case something pops up later. Nothing really that can be done, other than treat symptoms if needed, but you might have need.

I just sent via the portal a question for mom's regular doc (we never saw any "specialist" for the dementia) regarding a refill for her BP meds. Currently this is all she takes, unless we have a UTI. Generally doctors will require you to be seen in order to do the refill, which is totally understandable. But like lealonnnie1, I find it rather difficult, esp with the virus, to get her there (won't stand or walk without serious support, which I can't do.) I can get transport and an aide to help, but it is better not to make trips outside the facility, esp since so far there have been NO cases! So, on the call back, the nurse asked if I could sit with her for a TeleHealth instead. Really? To do what? You can't listen to heart and lungs, you can't check weight and BP. She can't hear you and even if she could, she wouldn't understand much!!! (they tried to get me to do TH last month for my annual physical - same question: WHY? Oh, because you can get paid. Physical exam over my little phone, woo hoo, you'll do a great job with that!)

So no, I wouldn't continue taking him there.

Helpful Answer (8)

Oh I hear you!! Moms cardiologist wants a tele visit in 3 months,, see her in 6. What can he do over the phone as a cardiologist? No EKG, no weight ( she fibs) and no BS or BP. I'm going to cancel that puppy! Today she needed her Prolia shot at her regular Dr, much delayed due to COVID. I was going to ask when I called for arrival about them coming to the car,, they beat me to it! They came out, gave her the shot.. yippee skippey! I didn't have to get her out of the car and get her into the office.. she was so happy we went for a drive after!

(2)

I've had great results with TH visits, I have a BP device, a scale, and a pulse oximeter, so I can enter the info myself and get to talk to my doc. He can prescribe/refill meds, listen to the slight cough I was worried about and make note of my appearance. I wouldn't discount the helpfulness of a Facetime or webcam TH appt for most people. You can turn up the volume on your speaker to hear clearly.
If nothing is done but a "follow-up" with the neurologist and there's no new meds can be tried, or therapies, then perhaps just a every other year check in is good enough.

Helpful Answer (6)

Question to others:

How many of you have a BP device, working scale, pulse oximeter? I don't have any of these (the scale most of the time, fresh batteries or not, doesn't work and it isn't that old - it's been a pig since it was new and I can't be buying more all the time.) Even my thermometers are questionable!

I don't currently take any medications, so they can't "refill" anything for me.

I don't have nor do I want a Face-anything.

Never used the camera on the laptop, don't even know if it works and have no plans to check it.

For me, checkups are a yearly thing. I haven't been sick in decades. If I can't be there and have them do what they do during a physical exam, then I consider it POINTLESS. (BTW, they can't listen to your heart or lungs over the video! Seems that would be especially important for someone with BP issues!!!)

For my mother, yup, BP meds, but:
1) she's in a facility (MC)
2) so far they've had NO cases and we want to keep it that way
3) she has little or no hearing, so turning up the vol will do nothing for her
4) I can't be there with her, as they requested. Not allowed.
5) She wouldn't understand any of it even if she could hear, she has dementia.
6) As noted above, if they can't do the actual checking, what's the point?

I'm not even sure they have any way to do video chats in the MC unit. They probably would defer to us in normal times, but since I'm not allowed and have no "capability"...

If someone wants to get a visit this way, have at it. I'm not suggesting what anyone else should do. For OP, no that would be a pointless visit. Others, whatever makes you comfortable. I'm just pointing out that TH is limited in what it can be used for. If there is something "concrete" the doctor can see or hear and perhaps evaluate, great. For many this isn't the case. I don't think my insurance has a co-pay for yearly exams, but even so, WHAT is the point for me or my mother and many others in the same boat?

(0)

Nope, I would not. I do not take my Mom for follow up neurologist appts. If something new presents, you can make an appt.

Helpful Answer (5)

When I took over managing my mothers doctor appointments, I knew I was potentially entering a bottomless rabbit hole. My mother was a Hypochondriac for as long as I could remember. If she wasn’t going to at least one doctor appointment a week - she wasn’t happy. I use to joke that the medical campus where most of her doctors had offices - should have given her a dedicated parking spot with her name on it. As moms dementia intensified her very favorite pass time was to mill through - reading and re-reading - the “visit summaries” they gave her at the end of each appointment.

So yeah - I knew I was in for a significant struggle in managing her many, many doctors and specialist.

Still, when I discovered my mom was seeing an OB/GYN every three months for a vaginal ring change-out - I thought my head was gonna explode. I mean, my mom was in her mid 80’s and she was on Homone Replacement Therapy. Seriously?

That was the first of what became many specialist visits that got crossed off the list. By the time my mother was put on Hospice care her prescriptions had been reduced to only what she needed in terms of her now occasional behavior meltdowns - an Ativan here or there. And, you know what? Absolutely nothing change or worsened beyond the natural progress of her dementia.

Ive got nothing against doctors in general but the “lather-rinse-repeat” of follow-up visits can get out of hand. And, too often they are completely pointless when a person hits advanced old age. Well, pointless beyond financing the medical machine.

Helpful Answer (4)

Funny, your mention of OB-Gyn reminded me... Mom was still well before any dementia, but continued to get a checkup every year (if not more often) despite the fact that she had a complete hysterectomy YEARS before! At some point, another doctor asked why she was even going there? I understood the hormone pills, to a point, since she lost that with the surgery, but at some point that shouldn't be needed anymore! She didn't develop enough signs of dementia until she was about 91. Meanwhile.. suck down those dollars docs!

(1)

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