As I've done some research, I feel like my mom is showing early signs of dementia. I would like to be able to speak to one of her doctors, perhaps her psychiatrist, and tell him my concerns and ask if he can screen her for a diagnosis. Of course, I'm not sure what's going on and I don't know what kinds of medications she takes so it could be something as simple as that. But it's clear to myself and my father that something is happening. I'm not sure how to go about this. I would prefer to have a private conversation with this doctor and have him evaluate her. Her reaction of my getting involved could get especially testy and angry so I would like to avoid just telling her I think something is going on and that she needs to be checked. She sometimes includes me on her HIPPA forms as a point of contact but after a doctor's visit today, I'm not sure she always realizes she's putting my name on a HIPPA form as opposed to putting me down as an emergency contact. My father would prefer that I speak to any doctors. I think he feels like I can better convey what we see and some of the interactions I've personally had with her. I'm not sure what to do. I have read that not being on the HIPPA form doesn't prevent me from calling her physician and stating my concerns but I don't want him to turn around and tell her I called. I don't want to sneak around but I have to consider the effect my participation will have on our relationship if I don't step carefully. As both my parents age, I will be the only one in the position to help them. Could someone give me some advice?
Whenever I took my parents to see their geriatric doctor and I was in the exam room, the doctor would ask my Mom or Dad a question... when my parent would answer, the doctor would glace at me and if she saw me motioning "no" then she would question my parent further.
Hopefully you are your parent's Medical Power of Attorney. If no one has been appointed, then get Mom and Dad to an Elder Law Attorney, ASAP before it becomes too late for your parents to understand a legal document. Take your parents when Mom is more clear minded, like in the mornings. And make sure other legal documents are up-to-date, too. And while there, get your own POA, Will, Medical Directive, etc. made.
The situation is by no means that dire. We've just noticed that she seems to be confused more, usually when she's telling something and her memory is getting worse. While I suspect dementia, it would certainly be the very early stages and she's completley capable of making her own choices. I would just like to alert a doctor to the issues she's having and see if they can suss out exactly what's happening. She does not need me to monitor her or anything like that.
As for the POA, my understanding of the law in my state is that a medical POA is only for situations in which someone is unable to make decisions for themselves, usually in the case of end of life issues or they have become incompetent. Again, that's absolutely not the situation here and my father is perfectly fine. Although I don't think they have a problem making me their medical POA (and need to only for when it's necessary), I don't think it's particularly helpful in this situation. My father would prefer I speak only because he doesn't feel comfortable trying to express himself and I have additional details from my own experiences with her. It's just that, like all families, we have dynamics and I'd just rather not be the one to bring it to her attention and it would be easier if it were in the course of a doctor's visit if the doctor had the heads up to ask those questions. I don't go to her doctor's appointments and I don't want to ask her to, I don't think her dignity would like it.
It's a touchy situation.
You never want to be in a situation where you wished you had your parents prepared a POA.
My parents had a POA and Wills that were older than dirt, and the Will was a nightmare the way it was written. The legal language wasn't clear. Thank goodness I got my parents to update all the legal documents....
My Mom who was still pretty sharp with just minor age related memory issues, fell in their kitchen having a serious head trauma. She spent her final months in long-term-care where she didn't even know her name. Without the POA it would have been a royal mess and a lot of stress on Dad and I. And Mom's Medical Directives gave me the guide lines for her final care.
I am sorry that you are having this worry about your mom and that it is complicated by concerns as to how she will react to your involvement.
There is no violation of HIPPA for you to give whatever info you want to to your Mom's MD. HIPPA only goes one way, it is a legal restriction on the medical professionals sharing their info with you, not the other way around.
You are acting from sincere concern and love. Please so not burden yourself with thoughts like you are "sneaking around".
If I were in your situation, I would call the doctor and ask for either an appointment, or a return call (you will likely not speak to him/her that day and this may require a couple of calls). Be careful about sharing concerns with whomever answers the phone, that person is most likely NOT a medical professional and I have seen them mishandle this sort of situation. I would just say, "I would like to speak with Dr. Jones regarding my mother's health". If it is possible, I think an in-person appointment (which you pay for) may be more satisfying for you than a phone call.
To maximize your appointment, I would bring notes about the specific concerns that you have regarding specific examples. Also, verbalize your question about if medications can cause the symptoms you are seeing.
It is called Polypharmacy, and it can cause many symptoms. Even if she has been on the medications for a period of time, if she is over 70, this can cause issues especially if she is on 4+ medications.
When you first start the conversation, ask for the doctor's discretion, say that you are trusting the doctor to keep your concerns confidential because you fear for your relationship with your mother could be damaged. Be sure to re-state this need for confidentiality before you leave the office (or end the call).
Regarding the POA, I am a Nurse Anesthetist with over 20 years experience in hospice, ICU, trauma and now anesthesia. I can tell you that I have never seen anyone regret having a POA, they only regret NOT having one. If your parents are over 65 years old it is not at all unreasonable to have a POA (actually, I think it is never unreasonable to have one at any age). Several older members of my family have them, we keep them in a file and never think about it. As you say, they are for when/if a situation comes about that your Mother or Father is unable to speak for her/himself. There is literally no downside to having it done. Situations can change suddenly (due to accidents, etc) and if you have the POA you will be glad. This is especially true if something should happen to your Father. If your Mother is having symptoms of dementia, it could be a nightmare for you to be "in charge" of your father's health decisions because unless your Mother was declared incompetent, you would not have legal authority. But if he makes you his POA, regardless of her health status, you would be able to make decisions for him.
In any case, it is a lot for me to dump on you all at once! Maybe deal with getting an appointment with her doctor. After you have done that you can think about getting the POA for both your parents. It is just like an insurance policy. You hope you never have to use it, but you need to have it for peace of mind.
Best of luck to you. Let us know how it comes out.
Margaret
Read the book 'Being Mortal' to understand what is important to elders for the last stages of life.
How old are your parents? Are they retired?
The advice FF gave is appropriate for any age.
Do some reading on POAs on this site. It's often too late to get one by the time you need it.
Life events don't always happen in an orderly fashion.
About talking to your moms dr.
Some people call the doctor and discuss concerns with a nurse. With my FIL, we faxed a letter to his doctor. It sounds like you already take your mom to appointments. Why not ask the doctors office if your mom signed the appropriate form. If she hasn't just ask that they make it available on the next visit. If she did then ask questions about her meds, etc. "Could they make her ..... " Whatever the issue is.
If your mom is having a reaction to meds it might resolve. It might not.
If she has a UTI it can cause dementia like symptoms and she might have no other symptoms. As we get older we don't have the usual symptoms that let us know there is a problem. UTIs can be fatal. It is one of the first things that should be checked when someone starts showing signs of dementia. Has she recently had a procedure that required anesthesia?
That can also cause dementia symptoms. Does your mom have a history of mental illness that may be getting worse?
As a loving daughter your first job might be to work on having a relationship that would allow you to speak candidly with your mom about your concerns that something is wrong.
Also know that sleep and diet are very important and problems with either can cause acting out.
So you see, not saying something might be more damaging than saying something.
This site is filled with mother daughter stories where a mom is difficult to deal with and the daughters life can become sheer hell. Please don't put yourself in the position of having to apologize to your mother for being concerned about her.
We are all aging. Things will go wrong. It's good to have an understanding of what that might look like going forward with our family members. It's totally appropriate to ask what your parents plans are for when their health declines. Don't be too quick to throw yourself into the caretaker role. It can take over the next 20 years of your life affecting your career, your own retirement and other relationships. Parents can develop a level of entitlement that leads them to expect you to make concessions about your life while they plan to continue living their own lives as they always have. When you say "I will be the only one in a position to help them. " it's like a red flag that you need to slow down and be careful of what you commit to.
Good luck and come back to let us know how things are going.