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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
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By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
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V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
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The OP is asking whether, now that the GP has made the diagnosis and the time has come for specialist advice, she should consult a) a neurologist or b) a psychiatrist.
Alice, I don't know how services are set up where you live, but as an example of what you *might* look for here we have memory clinics specifically designed for people diagnosed with dementia. The process is, broadly, as follows: 1. brain imaging; 2. more detailed cognitive testing conducted by a clinical psychologist; 3. interview conducted by the clin. psych. with the patient and if possible the patient's primary caregiver and/or medical POA; 4. consultation with an older age psychiatrist. This leads to as accurate a baseline diagnosis as possible, and the idea is that the person is then supported by his or her GP along with community mental health teams. [Note, this system has completely fallen apart over the last year for obvious reasons - you can't have demented older people hanging about in outpatients all morning. But God willing it will start up again before long.]
I would expect a psychiatrist specialising in dementia and other diseases typical of older age to be pretty familiar with the neurology, and certainly knowledgeable enough to seek a neurologist if the brain imaging or anything else is ambiguous. But ask your GP for recommendations and find out what you can about the specialists' practice. You may well want input from quite a range of people before you're done, hugs to you.
My 91-yr old mom, who was an RN her whole life and eventually worked on all floors of several hospital, told me to always go to a specialist. This is not to disparage GPs, but by necessity they are "Jacks of all trades and masters of none". There are just too many health issues with which to keep up. A specialist focuses on the latest and greatest studies, breakthroughs, treatments and therapies, etc., and knows the nuances of their area of medical expertise. And they rub elbows with other experts and learn from them as well. A GP can't keep up even if they're willing and able.
A GP doesn't have the training nor for the most part, or the clinical experience to diagnose AD. At best, a GP can only suspect dementia after administering a short cognitive test. Usually an appt with one lasts for about 15 minutes. What they can do in that short time frame is to try to eliminate other causes that could be the reason for dementia by ordering blood tests, brain scans, etc. With any suspicion of dementia by a GP, the patient should be referred to a neurologist, neuropsychologist, gerontologist, or other specialist skilled in dementia behavior. Because AD is so prevalent among the elderly, GPs tend to default to AD as the reason for dementia without the thorough screening a specialist can give. You say he's progressed since his “diagnosis”, so it's important for you to know what you're both dealing with and educate yourself about the disease. To answer your question, yes, you should follow up with a specialist skilled in dementia care. A good specialist will give you information about what the disease is, how to cope, and direct you to some resources to address the problems ahead.
My LO’S diagnosis was done through a psychiatric group that specialized in GERIATRIC CLIENTELE ONLY.
I think the specific training in working with geriatric clients is the bottom line. My LO’s issues were largely behavioral, and the group that assessed her was part of the MCF’s external staff.
We got a brief letter after her workup was completed that stated that she was unable to manage her personal affairs. This proved EXTREMELY HELPFUL to her POAs.
If such a letter isn’t offered when your husband is tested, ask the examiner(s) to provide one for you.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Alice, I don't know how services are set up where you live, but as an example of what you *might* look for here we have memory clinics specifically designed for people diagnosed with dementia. The process is, broadly, as follows: 1. brain imaging; 2. more detailed cognitive testing conducted by a clinical psychologist; 3. interview conducted by the clin. psych. with the patient and if possible the patient's primary caregiver and/or medical POA; 4. consultation with an older age psychiatrist. This leads to as accurate a baseline diagnosis as possible, and the idea is that the person is then supported by his or her GP along with community mental health teams. [Note, this system has completely fallen apart over the last year for obvious reasons - you can't have demented older people hanging about in outpatients all morning. But God willing it will start up again before long.]
I would expect a psychiatrist specialising in dementia and other diseases typical of older age to be pretty familiar with the neurology, and certainly knowledgeable enough to seek a neurologist if the brain imaging or anything else is ambiguous. But ask your GP for recommendations and find out what you can about the specialists' practice. You may well want input from quite a range of people before you're done, hugs to you.
I think the specific training in working with geriatric clients is the bottom line. My LO’s issues were largely behavioral, and the group that assessed her was part of the MCF’s external staff.
We got a brief letter after her workup was completed that stated that she was unable to manage her personal affairs. This proved EXTREMELY HELPFUL to her POAs.
If such a letter isn’t offered when your husband is tested, ask the examiner(s) to provide one for you.
I would try to find a diagnostic team--neuropsychologist, neurologist and psychiatrist or psychiatric nurse practitioner.
If husband is having behavioral symptoms, he would benefit from seeing a well qualified geriatric psychiatrist.