I took mom to a local clinic. The first Primary Care MD actually gave us referrals: Neurology (he checked her vitamin levels and thyroid) Gastro ( she had an Endoscopy done and had lots of imflammation) a Kidney specialist. Then this wonderful MD left the practice. The next Primary Care MD we saw said she would have NOT given us any referrals at all, I guess she felt confident that she could fix everything herself. Now after seeing 3 Primary Care MDs from this clinic, I feel like Mom has fallen thru the cracks. I hear that the MD has to write a RX for MediCare to cover a wheelchair or a rollator- walker, that there are meds that might help Dementia patients, and that there are MDs that care about their patients. So, I am switching Mom to my Doctor. He is not a Geriatrician but he is very thorough. So my question is this, how do you get a diagnosis of Dementia? Mom had some small strokes before I moved her into my house. The Neuro in the ER said she had Dementia. But she never had any follow up treatment due to being moved out of her Healthcare area. Do I need another diagnosis? Will that give me more choices to care for Mom? I dont know how Mom will be in the future, but I want to be way more informed that I am now.
Since its been so cold, she doesnt want to get out of bed. Even with the new room heater on, she will be totally dressed but just covered up with blankets. She says her ankles hurt so she doesnt want to walk too much. Just to the kitchen and back. On a good day we sit outside and watch the birds and squirrels. I am so wanting to take her out for a walk or to the mall to just to see other people. We could go get a pedicure! She says her ankles hurt too much to walk, even tho I know she can walk on them. I think she just gives up too easily. I need to find a walker or rollator so she can sit when she gets tired. I was hoping the Dr would write a RX so we could buy one and not have to pay full price.
Mom is 92 and so far the only pressing problem is her Dementia. I had her taken to the ER two weeks ago because she was apparently dehydrated. She felt sick, but couldnt tell me where. She felt like she was going to vomit, she spit up a bit. She turned down all foods and liquids. When the paramedics arrived, they did a quick assessment for stroke. She couldnt lift her arms on her own, she was weak. She wasnt answering their questions except to say she felt sick. At the hospital, they gave her an IV of fluids, and after 12 hours she sounded much like her old self. From now on I will make sure she drinks lots of fluids and occasionally give her Pedialyte. Oh, and all the tests that the hospital ran came back normal. MRI and CT included. Whew, dont want that to happen to Mom again.
It can be important to get a diagnosis because different types of dementia respond to different medications. If she has had strokes, it is good to try to prevent more. If she is very frail and incapacitated, there may be little value, but if she will be out and about for the next few years, why not try to keep her as "with it" as possible?
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I am a strong proponent of thorough evaluations and dementia diagnoses as specific as possible. But once the patient is in her nineties it seems less important to me. In either case, the treatment plan is basically to minimize the symptoms. Sometimes it helps to know what the cause is to do that. My husband developed dementia symptoms in his mid seventies. I was glad to have a specific diagnosis (Lewy Body Dementia) and to have his treatment plan established and monitored by a world-class expert in that disease. My mother is in her nineties. She was unable to tolerate Aricept. We never use the D word in front of her (denial is her coping mechanism of choice) but we know she has some form of dementia. It is important for us to know and accept that as we deal with her. It is not so important that she knows it, in my opinion. And we are doing fine for her with just the diagnosis "dementia, type unspecified".
I am glad that your mom had her vitamin levels and thyroid checked -- sometimes a deficiency can cause dementia-like symptoms. But once treatable conditions have been eliminated, at her age I'm not so convinced that the extra testing and experimenting with drugs, etc. is worth it. (It took us a full year, for example, to get my husband on the optimal combinations of drugs.)
Work with a caring doctor to deal with the symptoms she has. She should definitely have a rollator, for example, whether she has dementia or not! Staying hydrated is important no matter what the diagnosis. Deal with her feeling cold. I'm glad you have a supplemental heater in her room. My mother wears gloves all day long, and also has an electric hand warmer. If your mom has memory problems you could ask the doctor whether he thinks Aricept or something similar is worth trying, but mainly you have to become her memory. Possibly some physical therapy would help with her ankles, or maybe some pain med should be tried, and possibly less walking is called for -- maybe getting a wheelchair for your outdoor walks would be good.
I'm not trying to prescribe treatments for your mother (!) but I am suggesting that with or without a specific dementia diagnosis you and a good doctor can come up with ways to address the symptoms Mom displays.
Also, if finances are a concern in her care, explore whether she might be eligible for some aid, either from the county or perhaps Medicaid.
Best wishes to you both. Please let us know how the doctor visit goes.
Desiree