Wednesday, July 22, 2009 shebuddy asks

Q: A New Doctor

I recently moved my Mother to my house in a different state. It took a while to find a new doctor that takes medicare.

The first place I went to gave me a nurse, not a doctor. The nurse was one of those people who likes taking patients off most pills and use natural methods.

She starts asking my Mother why she was on Aricept. My Mom doesn't think she has much of a problem with her memory. Mom told her that her late husband thought she was crazy and told the doctor that she needed them. And they just gave her the pills without even talking to her.

The nurse then turns to me and ask questions about Moms memory. That angered me, because I couldn't say too much because I didn't want my mom thinking I'm another bad guy telling people she's "crazy". That's her term for losing ones memory.

I was wondering why a person in the medical field whom should know a little bit about dementia, would ask the caregiver personal questions about the patient right in front of her? Asking me if she forgets this or that. I don't need my mom not trusting me and thinking I'm against her by telling how forgetful she is.

I have looked for a real doctor since then, and I finally found one, but I can't get her in for 2 weeks. (I want a physical for her).

My question is: Should I try and meet with the doctor before hand to talk to him about my moms dementia before she sees him? I'd like to explain the reasons for the medication and why she's taking it before he starts questioning her one on one. Or should he actually know better than to put me in a spot in front of her?

Also, what kind of test is done to be sure it's early Alzheimers?

Teresa aka She Buddy

Answers (3)

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Carol Bradley Bursack

7/22/09 7:22am

I've been there! Sitting with the doctor while the elder is with you prevents you from communicating and they should know it. If you can get into the new doctor for a consultation, before you go with your mother that is ideal. If not, please write a letter ahead of time, explaining the situation and exactly what you see and why you are not able to totally communicate in front of her. The doctor should know this, but they don't always get it.

She'll need a good physical and yes, her medications need to be checked to be sure the side effects aren't the problem with her memory. Since she started Aricept because of memory problems that is likely not the cause, but something else she takes could be a problem. Other physical issues can cause memory problems, as well. The doctor should then test her with the Mini Mental exam, have an interview with you about what she was like before the memory problems, find out what she did throughout her life (employment, education, etc.), and perhaps refer her for a neurological exam if that is needed. A PET scan if often done to see where the brain problems are, as there are many types of dementia.

It's unfortunate that she views memory problems as being "crazy." That will only make the whole thing harder for you. My heart is with you.

Carol

Dorian Martin

7/22/09 5:20pm

Hi, Shebuddy,

My mom would react just like your mom will do. I agree with Carol's suggestions. I'd also suggest that you could call the physican's nurse prior to the appointment and visit with her. Depending on that office, that nurse may serve as a conduit for information between you and the doctor.

Also, what you're describing is why I think there needs to be a common electronic medical records system that has all this information from previous doctors and that is accessible to all medical professionals. I believe that if we had such a system, caregivers wouldn't be placed in the position that you, Carol and I have been in since the doctor or his representative can review the data prior to the appointment.

Take care and keep us posted!

Dorian

bstrawn

7/23/09 8:19am

I hope you find your mom a good neurologist if she hasn't already seen one. We were taking our mom to a psychiatrist and didn't get her in for a full neurological work up for an entire year, until my therapist suggested it. She said alzheimer's is a physical condition not a mental one even though it affects memory & behavior and the neurologist could rule out a multitude of other conditions such as strokes, etc. When we finally took her to the specialist it made a huge difference. She did an MRI and diagnosed white matter on the brain (a brain disease) as well as alzheimer's, which helped explain some of the behavior that didn't seem alzheimer's related.

In answer to your question, I called the new doctor's office and asked if I could fax in a summary of Mom's symptoms that before her appointment. I then typed an entire page of her symptoms and faxed it to the neurologist. During our visit the doctor referred to that page often and then asked Mom the questions directly. We didn't have to answer for her. She affirmed the meds that the psychiatrist was prescribing and recommended a new one for her anxiety & sundowners (seroquel). It really helped to get her in to the neurologist and she was able to diagnose the other condition that neither the psychiatrist nor her primary care physician did.

shebuddy

7/23/09 3:52pm

Thank you for the advice. Before my Father passed, he was doing everything. Bills, appointments, cooking, etc. So after he died I was left in the dark about their affairs, including her medical situation. I had found an appointment for her one time and called them to see what it was for. They said an ultra sound on her stomach because she has an abdominal aneurysm.

That first "nurse" I saw said she would send for her medical records, but they haven't called me back. It's been 2 weeks. Guess I better be persistent.

I think taking her to a Neurologist and getting re-evaluated is an excellent idea. I'm going to stop by the new doctor's office and see if I can talk to the nurse.

Thank you for the help.

Q: A New Doctor

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