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Long story short due to my mom's memory loss I wanted her to be evaluated so I would know how more to help and protect her we went in to hear her report. After ruling out the physical they gave her a cognitive test for Dementia/Alzheimer's. The neurologist said she has Alzheimer's. I asked him what stage and he said he doesn't believe in stages because there is no accurate way of really knowing that I have to use my judgment as to what we need to do etc…..I proceeded to ask him then any advice on day to day living etc….. again a judgment call on my part. He did prescribe Aricept for her( 5mg moving to 10 mg). He stated she has significant issues with present memory but seemed vague with his diagnoses to what stage she is in so I can find help. I feel the stage he gives me would help me determine what I need to do with her in keeping her safe. If you can tell me what questions to ask so I can call his nurse and ask them or change doctors.

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I don't think it's odd the doctor would not provide a stage of her dementia, because most patients have several symptoms from several stages. It' rare to have all the characteristics of only one stage.

I would suggest that you read the 7 stages of Alzheimers and be familiar with them. You will see the things your mom does that is on the list. Gradually, you will see other things. You will know to expect that your mom may lose the ability to recognize many faces or sometimes falsely accuse someone of stealing from her. You won't be shocked if your mom has forgotten how to put on gloves or has sleep disturbances. The symptoms vary from day to day as well.

I read the 7 stages at least twice per month to review where my cousin is. She has Mixed Dementia, (vascular and Alzheimers) and see how she has progressed to have all the symptoms of Stage 6. She's not yet at Stage 7, which is the final stage. I'm grateful, she still communicates really well. She could stay at this stage for years. The doctors can't predict this.

I am surprised that a primary Doctor said it was Alzheimers. I was informed that a Neurologist was required, which is where we went for a full exam, MRI and Neruopsychological evaluation. Maybe that's what you want. That 4 hour exam is very comprehensive and may give you answers about your mom's abilities at this time. I'm sure a neurologist could arrange it for her. I will say that if your mom is already very deep in dementia, it could needlessly stress her. That's why some family members don't proceed with it.
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Donna, a geriatrician is an internist who specializes in the care of the elderly.
Questions? What is your approach to treating people of my mom's age?
How would you determine what meds she needs, and which she can do without? How do you approach the need for diagnostic tests? How often do you want to see her? What sorts of issues should prompt us to call you? Do you want to be alerted to changes in mental status? How shall we contact you in an emergency or non emergency situation?

I've worked with two truly wonderful geriatrician in the past two years. The difference between their approach and my mom's previous internist was vast. Both geriatrics docs gave us their cell numbers and their email addresses. Both took mom off extraneous meds. Both discouraged extensive testing (mammos, bone marrow biopsies, colonoscopies) . If you're not going to do the treatment, don't do the test. Both alerted us to the fact that a sudden change in mental status could be an emergency and should be treated as such. It's a very different way of practising medicine, and worth looking into.
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Donna, there are tips to follow: Do not answer for the patient. Sit off to the side and let the MD and patient be face to face. Let them talk without interjecting. I stand or sit behind mom, and if she tells the MD a fib, I silently shake my head "No". That's his cue to dig deeper. When he is done, he will ask me if I have any questions. We go over meds and lab tests, and I report any changes or problems I have observed. If I want her to have an MRI, I will ask him "do you think an MRI would help?" That leaves them in control of the decision.
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I am looking for an internal medicine physician who will actually care for the patient. I needed appropriate questions to ask the 2 doctors she has appointments with to better help us to decide which of the two would be better for her.
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Are you looking for a physician to oversee you mom's general health? I would go to one who specializes in geriatrics. By Googling "geriatrics Virginia Beach", I came upon the Health grades site, which lists several geriatrics doctors in your area. I would then choose based on their hospital affiliation, although that seems less important these days, in this era of "hospitalists".

Good doctors treat their patients (especially those with dementia) as though they are present and involved in their own treatment. I'm always amazed at how much more alert and engaged my mom is when a doctor talks to "us", and not just to me. In addition, I found that an additional physician, a geriatric psychiatrist, can be an invaluable member of the team. My mom's cognitive losses have caused terrible anxiety and depression; getting the right meds for those symptoms has been a boon to her quality of life.
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I need to change my mother's primary care doctor and have two appointments with two different doctors. My mom does have the beginning of Alzheimers. The doctor and her office she has now is uncaring, looks down on the elderly, even though most of their patients are the elderly and they do not look likely about someone advocating for her. Could you give me questions to ask the doctors to better help us decide which doctor would be best for her.
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I need to change my mother's primary care doctor and have two appointments with two different doctors. My mom does have the beginning of Alzheimers. The doctor and her office she has now is uncaring, looks down on the elderly, even though most of their patients are the elderly and they do not look likely about someone advocating for her. Could you give me questions to ask the doctors to better help us decide which doctor would be best for her.
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I feel your neurologist may be good at diagnosis, but he could communicate better. You could get some help by going to the Alzheimer's Association Web site (www.alz.org). They list behavior and stages. Also, I'd call your local Alzheimer's group for some training and support. You also may want her records sent to a different doctor who may be able to communicate better. But first check with the Alz. association in your community.

You are so caring he should be listening to you, but some doctors just don't have that ability. Also, our system limits time for them. Sad, but true.
The Alz. folks can guide you.
Take care,
Carol
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