My mother's dementia continues to advance. My wife and I have durable power of attorney for my parents. We scheduled a meeting with the current doctor because we wanted to talk about her dementia. At a seminar about Alzheimer's we were instructed that the first thing to do was to get the patient diagnosed so they could be treated. When we talked to their current doctor about this he said, "Once she is diagnosed, then what's the plan?" We were speechless. We thought the doctor would help us determine the plan. He wouldn't even help with the diagnosis. He also cleared my mother for getting her driver's license and then was surprised because the DMV gave her a license! We really need to get her to a doctor that understands older people and can help us.
He is very noncommittal.
I was at least able to get a diagnosis of MCI.
Sometimes the squeaky wheel gets the grease!!
Stay on her Doctor for a referral.
As a side note, if Mom is still driving and you don't feel it's safe, you may need to get creative.
Look into "therapeutic fibbing ".
It may sound awful, but is very helpful.
God bless!!
Having your loved one examined for dementia is not cut and dried. There are different levels, stages of dementia - from mild cognitive impairment to severe. A competent geriatric doctor or neurologist should be able to help diagnose and stage your mom's mental abilities.
As for "creating a plan," there are several ways of going about this. Medical professionals, social workers, home health care agencies, and residential facilities can point you in the direction of resources and costs. Ultimately, you will need to decide on what is the best option - and plan of care - for your loved one.
Also, it's not the responsibility of any physician to "make a plan" for an elderly person with dementia. The family or POA needs to determine whether they want to try the medication, to care for the person at home, to place them in assisted living, etc.
BTW - if anyone feels that an elderly person is unsafe as a driver, all they need to do is to phone the DMV and report it. They will give a driving test to the person - and "pull" their license if they are deemed to be unsafe.
Otherwise, I would ask friends, neighbors, anyone you might know and who may have an elderly parent. And there’s always Google. I would specifically look for a doctor who specializes in geriatric care. I feel like I got very lucky with our first attempt. Good luck!
But I don't mean to be cynical: of course assessment is essential, and investigation (preferably leading to diagnosis) is in turn an essential part of that.
In defence of your mother's doctor, what I suspect he is trying to combat is expedient labelling. He is considering your mother's best interests. A label that will certainly restrict her freedom of action but will not in itself contribute to improving her quality of life is not in her best interests.
I would argue with both the seminar and, respectfully, with your mother's doctor.
The first thing to do is not "to get the patient diagnosed." The first thing is to investigate the patient's symptoms and determine their probable cause(s). Go looking for Alzheimer's and you are sure to find it. Go asking questions, and you are more likely to end up with a more accurate, more certain diagnosis which will lead to a much better care plan tailored to her individual needs.
The doctor needs to be more patient (adjective) and clearer in what he is communicating. Go back to him armed with a detailed, well-documented description of symptoms, incidents and concerns and ask him to start again.
she is now almost 91 and is back to how she was maybe 6 years ago.
I know this is all unchartered territory, but once she has the right doctor you will feel confident in the advice you are given. Good luck and God Bless.
Look for a geriatrician who has a social worker on staff. They can be invaluable.
Alternatively, sometimes eldercare attorneys have switched on staff who can help with planning.
Barb’s idea is a good one. Geriatricians are primary physicians for the elderly. Chances are though, that even that doctor will refer you to someone else, probably a neurologist. She needs testing and evaluation.
I'm sorry her doctor let you down. Seems to be the norm nowadays.
Call the local Area Agency on Aging; they may maintain a list of geriatrics doctors.
Call good local nursing homes and find out who their medical directors are. They are often geriatrics docs.
Independent and Assisted Living facilities often have geriatrician who have on-site office hours a few times a week.
In my journey with mom with dementia, the best advice and guidance we got was from geriatric psychiatrists; you might consider seeking out that specialty first.