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.
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.
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.
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.
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.
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.
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.
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