anereus Asked October 2017
Do I need to know what kind of dementia my Mom has?
Follow
Share
My Mom has mild to medium dementia - depending on the day. She is on Galantamine and Memantine which was prescribed by her primary care physician. Should I get a screening from a neurologist? Are different drugs prescribed for different kinds of dementia? Or should I just leave it alone?
This question has been closed for answers. Ask a New Question.
27 Answers
This question has been closed for answers. Ask a New Question.
Popular Questions
Related Questions
- My husband entered Memory Care and panics when I am not there. I spend 4 hours each day but he does not remember it. Any advice?
- What do they do in a geriatric psychiatric unit?
- What do I do when hallucinations only happen during the early morning hours like midnight until 7am?
- How can I get personalized caregiving advice?
Ask a Question
Would it be useful to know what kind of dementia your mother has? At this point it would be useful to science if she were enrolled in a study. It MIGHT be useful in coming up with a treatment plan or in understanding her symptoms. But we know so little about how to treat the various kinds of dementia that being able to differentiate among them may not be as valuable as we wish. This will change as research progresses, but right now even if you knew that mother had XYZ type dementia, there aren't likely to be any specific treatments for XYZ in any case.
There are very few biomarkers that allow for diagnoses of type of dementia in non-intrusive ways. Autopsy is often the only way of identifying what was going on in the brain. While that is very useful for research, it is of no practical value to the patient or family. (My husband donated his brain for this kind of research.)
Here is an important consideration: The different kinds of dementia have different symptoms and progress in different ways. Even within the same kind of dementia, individual cases vary a lot. So if the care center or day care program or hospital staff -- anyone who deals with a "dementia" patient expects all patients to match some predefined "typical" case, that will be a problem. But if they are better educated and flexible in their approach then the exact diagnosis isn't so important.
Case in point: A nursing home staff was sure a resident was being manipulative and "faking" symptoms, because they seemed to come and go. Something he could do in the morning he claimed he couldn't do in the afternoon. None of their other dementia patients had this much and this frequent variation. But that is a core identifying feature of Lewy Body Dementia (which is what he had). So in a way it would be good to identify what type of dementia people have. But for now it would be cheaper and more convenient to simply treat each person as a unique individual and deal with the symptoms they have, without regard to some supposed "typical" dementia pattern.
We never did know what kind of dementia our mother had. By observing the symptoms I would say it was not ALZ, and I'm definitely sure it wasn't LBD. It might have satisfied my curiosity to know, but I doubt it would have made any difference at all in my mother's care.
If it were easy to get a differentiated diagnosis, why not? But it is not easy, not inexpensive, not highly accurate. I don't think that putting my mother through more tests, interviews, etc. would have been worth the effort for her. As diagnostic techniques become refined, and as effective treatments become available, this will all change.
For now, the biggest benefit is probably for the caregiver.
Does it matter during the course of their lives?...maybe.
A person with Lewy Body Dementia can not take certain types of medications. But Lewy Body is usually in people with Parkinson's so if she does not have Parkinson's It probably doesn't matter.
Vascular Dementia on the other hand is different. The Dementia is worsened by small strokes. And at some point there may be a major stroke that you may have to deal with. Either the person (and caregiver) is lucky enough to not survive or unlucky enough that it is one that they do survive and are left with not just the result of more decline but more physical problems as well.
The "normal" decline of one with Alzheimer's is a slow and steady decline. (Like walking down a ramp)
The "normal" decline of someone with vascular dementia is sudden drops. (Like walking down stairs.)
My Husband never got an "accurate" diagnosis and I think he had both Alzheimer's and Vascular Dementia's. His decline was slow and steady like walking down a ramp with sudden steep declines just like he came to a landing on the ramp that forced him to take a step down to another ramp of decline.
Did not knowing make a difference? Not really. I would not have changed what I did and it would not have changed the ultimate outcome.
So the ultimate person to answer this is you and you knowing your Mom.
Can she withstand the testing?
Can she cooperate during the testing?
Will she have to be sedated during any of the testing and how will she react to the sedation?
Is she otherwise healthy?
Have you discussed the outcome of any testing and whatever it may uncover?
If she has Alzheimer's or other form of dementia and problems are discovered during any testing what will you do with the results? (example: during a full physical the doctor suggests a colonoscopy? would you elect to do it? If you do it and the results show cancer will you elect to treat or not?)
Do you/she have a P.O.L.S.T. (used to be a DNR) in place? A P.O.L.S.T. is more detailed than a DNR
All very tough discussions but these are conversations that are best had as early as possible or you will be left making the call.
And if you have siblings they need to be kept in the loop and be made aware of decisions that your Mom makes.
You probably could have saved Mom from a diagnosis that would have led to many medications, that (in some people's opinions), would have led to a more rapid deterioration. I think for you, and for your Mom, you did good, really good!
See All Answers