My husband scheduled an appointment with the V.A. doctor and asked for a memory test, planned to go behind my back without me. I found out and took him today. The memory test was 21; the doctor assured him that with this score he has dementia. He wants to live on his own; she told him the only way would be if his score was 27 or 28. He now is demanding more tests. She said it is a battery of tests. Can anyone tell me what these tests consist of and how long they take? If he scored 21 and was determined to have dementia, would these "battery of tests" provide the same results or could they determine no dementia?
I'm so anxious to have this done, he has turned his entire family against me, lies, lies, lies. He lies to me, covers the "private" meetings with his bro & sis in law, lies to the doctors, etc. I really need to have some sense of peace. I'm trying to help him, but with his sarcasm, lying, sneaking around behind my back, the mean looks he gives me, I just can't take any more of this!!!!!!!!
I know he's sick and I've tried so hard to help him, but he acts as though I'm his jailer. I hope someone can tell me something about the "battery of tests".
Thank you for any insight you can give me.
1. Folstein aka Mini Mental State Exam (MMSE) - 30 point test. Takes about 10 - 20 minutes & looks at math, memory, orientation, basic motor skills. MMSE is copyrighted & needs training to do, so usually done by gerontology MD’s; MD’s,residents, student MD’s or trained staff @ teaching hospital; or nursing home with teaching hospital staff. Score is 27 or more=normal; 21-26 mild; 10-20 moderate; under 10 severe. Folstein has problems for bilingual persons.
2. Mini-Cog: a 3 item recall & a clock drawing test. 2 -3 minutes to do. Should not be used alone as a diagnostic.
3. Memory Orientation Screening Test (MOST): 1. Memory -3 word recall; 2. Orientation - to year, season, time, month etc.; 3. Sequential – memory for a list of 12 items; 4. Time – organization and abstract thinking using a clock face. The MOST takes 5 - 7 minutes. Gives a score from 0 – 29. Highly reliable.
Other tests: If Frontotemporal dementia is suspected, can have an Addenbrooke’s Cognitive Exam done. Not all dementias are the same: orientation, attention and memory are worse in ALZ; while language skills, ability to name objects and hallucinations are worse in other dementia’s.
Data analysis found the MOST to be more reliable over time and more accurate in identifying cognitively impaired patients than either the Folstein Mini Mental State Exam or the Mini-Cog. The MOST also measures changes in a patient’s memory over time. This permits the doctor to identify progressive loss or positive responses to treatment.
My mom is in a medical school gerontology program and has had all 3 tests done over the past decade. Also CT and MRI's to measure brain shrinkage.Once her MOST score got to a 13 and repeated it was stopped. She probably has Lewy Body Dementia and has hallucinations (one of the hallmarks of Lewy). Her point source for stealing and doing stuff is either strangers (that she see's outside) or this one lady who was at her IL who was my aunt's friend in high school. This lady died but in my mom's mind she still exists and steals from her and often and comes to my mom's NH just to do this. This is just one of her "fixed false beliefs". My mom is on Exelon patch and Remeron and I firmly believe medication makes a huge positive difference if taken correctly. Good luck!
You won't find the test on the internet, because they can only be given by a trained specialist.
The Alzheimer's Association or your family physician is a great place to start. BTW, paranoia and ill moods are part of the disease or ALZ and dementia. I know, I've gone through both of them with my father and it can get worse.
Hang tough because it is only going to get worse. What is your legal situation...by that I mean are you his DPOA, MPOA, Guardian in Case of Incapacity? Has this paperwork been done? If not, I'd suggest that you (not him but you) go on your own to meet with an elder care attorney to see what the options are in your state for you to take charge of him and also take all your financial so that the attorney can evaluate what your situation is as far as "community spouse" assets are and what you can do now to plan for your long-term financial. It is looking like as your hubby will need to go into a NH in the near future and you want to be proactive financially so that this does not leave you with a difficult financial situation.
Not to be rude, but it sounds like he is going to be the supremely mean type of dementia patient and he has decided that the point source of his inability to be cognitive and competent is your fault. Is it the case that whatever you suggest - whether it's medications or choice of what to eat or TV show to watch - you are always wrong or stupid? If not, then be prepared that is to come as he is fixated that you are the problem not his disease. No amount of talking is going to change this as it is a "false belief" and a part of dementia. You need to figure out how you can deal with it that doesn't drive you loco or get your blood pressure up. Most Agency on Aging have ALZ caregiver programs that can help you with this. This site has a drop down list of AoA's by state - it's your tax dollars, so use it!
It sounds like he has a ready audience that believes him too. So sad as they could be so helpful if this wasn't the case. But eventually, he will start to fixate on one or more of them too as he has done to you. Good luck. Will post test info next.
To diagnose Alzheimer’s, doctors may: ask questions about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality; conduct tests of memory, problem solving, attention, counting, and language; carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem; perform brain scans, such as computed tomography (CT) or magnetic resonance imaging (MRI), to distinguish Alzheimer’s from other possible causes for symptoms
You can contact the Alzheimer's Disease Education and Referral Center and speak to an information specialist.
Good luck!
The medications are very helpful, depending on the type of ALZ or dementia he is diagnosed with. The ALZ meds do no good for my father's multifract dementia, but the mood stabilizers make him much easier to deal with. He has a whole list of diagnoses, so we have to be careful that he does not wind up with poly-pharmacy.
If you don't already have an attorney, seek out a good elderly care attorney, not only for all the things mentioned above, but also to assure that when the time comes for the NH, all your financial affairs are in order and for your future as well.
Our prayers are with you.
S.
Once again, thank you all, any other information you can provide will be helpful. I've talked to an atty. I sounds like not much can be done with the bro and sil, since I have no absolute proof. He could contact them, but he said that would essentially be my accusing them of being up to no good, and that could make them even more aggressive and sneaky. It makes me sick that my husband is going behind my back, lying to me, and relying on the bro & sil that never, ever had anything to do with him. The sil has spread vicious rumors about me and my husband in the past that had no grain of truth to them. I have no idea why she and my husband were always bitter enemies, it was that way when I met my husband, now, they'r best buddies??????????????
My father kept his mind throughout his life but I was informed by the medical folks that he had dementia. The dementia was labled on him because he took a bit more time to formulate a response to a question spoken to him in a rapid speed. Rather than giving him time to respond and assessing if the answer was to the question asked or logical, they would fire off another questions at a shouting tone of voice because they mistakenly thought he didn't hear them. Now the elder is trying to answer 2 separate questions and of course looks confused. Anyone would be confused. I really think most of the medical profession lacks the inability to constructively work with the elderly. They are there because the care of the elderly is paid for (quite well) by medicare funds.
They didn't really want to work with elderly people and are very dismissive of them in general.
Take a dementia lable with a grain of salt unless you see behaviors daily to support it.
Elizabeth
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