I'm wondering if I need to find a doctor who specializes in dementia?

There are many different answers and helpful tips for you to guide you with your mother. We are all different, and our situations are different, your mother is much older than mine, and you are much younger than I was when I found myself alone in a situation where I understood that I was all my mother had. I had raised two children without blinking over my responsibility to being all they had, they were my children, who but me knows better about what my children need. But, suddenly I was on a reverse side, and was responsible for what the woman who raised me and knocked into my skull that I was the mother and better act like one with my children, to be a care giver and the voice of reason to the very voice of reason I had listened to all my life, my mother was now my responsibility. I truly remember the day that my two older sisters and my younger brother turned their backs on my mother and gave her an ultimatum that she would have to deal with me, or they would put her in a home. As my second oldest sister said to her, "I'm not going to take care of you, or wipe your butt." That really broke my mother's heart, it was nasty to say to my mother, and it was unnecessary. Anyway, my mother and I looked at each other and the realization dawned on both of us, I was all she had. She began my training in how to work with her that day, and when she got worse, I made her remember. She always counted 1-2-3, and on 3 I lifted her, and she knew it was time for her to use her strength to help me. That was such a small thing, but it was big. It made her focus on what I needed from her, and when I would be helping her. Goofy little things like counting to 3, or saying, 'Go MaMa, Go Mama', that energized her and reminded her who she was. It was not easy and many times I had to walk away from her, cause I was at the end of my rope. But, I always came back, and she was always glad that I did, and so was I. I miss her, and all the annoying things she did. I used to call her "Lucy", cause the woman could get in trouble without trying, and she did it all the time. But, it beats what I have now, which is nothing.

The answer is yes; you could take her to a neurologist, who can evaluate her. You may first wish to start out with her primary care physician.

Has your mother ever been evaluated for dementia? You could start with her primary care physician or you could make an appointment with a geriatric psychiatrist for a cognitive evaluation. If you find yourself wondering about her condition, it may be that your conscience is telling you to take action.

Definitely sounds like dementia. She will need somebody to give her medications, meals, and remind her to bathe, toilet, dress, go to bed... At least she is pleasant about it - huge blessing.

Just feed her 3X a day and don't ask. Feel blessed she is just starting to show signs at her age. My mother is 84 and decided to use the oven door as a toilet today.

Sounds like perhaps your mother has early stage dementia - short term memory goes first, long term sticks around longer! Not remembering whether she took or to take meds, not remembering when she ate/if she's hungry are signs of some cognitive decline. If so, she is only early stage and it could take years before it impacts her life. Her regular doctor can have the mini-test done in the office. The recent doctor we changed to tried to administer this to mom, knowing full well she was in MC for almost 2 years! Failed miserably. My visit was shortly after and they tested me too! Staff also told me how one time mom just finished breakfast and demanded they feed her breakfast as she didn't remember she just ate!

Mom is 96, just finished year 3 in MC and had early stage before that. Her only other medical issues are BP, osteoporosis, serious hearing loss, and should have had her knees replaced long ago. She's still ticking along, although recently she has been refusing to stand/walk. The bigger issue with testing is if they need to determine if it is Lewy Body or the like. Run-of-the-mill ALZ/dementia follow a similar path, while some of the others are much more difficult to manage and care for. You mentioned heart condition - that would need to be monitored as she might get to a point where she doesn't recognize any negative body changes!

I agree with others that even if they can find meds that help with some symptoms, there are no magic pills to really delay or stop dementia. Unless she needs something to calm her if she shows any "sun-downing", I wouldn't mess with drugs - too many chances of side-effects. The only one we use, and only when absolutely needed, is Lorazepam (anti-anxiety), needed mostly for the UTI she got, which induced some serious later in the day sun-downing! This doesn't work for all and is often counter-indicated with Lewy Body.

Your mother doesn't seem to be exhibiting any UTI-related effects, but if her behavior changes drastically, do suspect that. When I first found this forum, I dismissed all the comments about UTIs until it happened to us! More recently the UTIs have resulted in nighttime bed-wetting (twice in few months.) Once treated, the bed-wetting goes away.

We tried keeping mom in her condo by hiring aides (they had only a 1 hr minimum, so it was only to sanity check and make sure she took her meds from a locked/timed dispenser - they can only remind, not dispense meds.) I didn't care what they did for the remainder of the time, but after about 1.5-2 months she refused to let them in, Plan B, get her to move (MC was my first choice as I couldn't do the hands-on care she would need, but she refused offers from my brothers AND AL.)

Try to keep your mom's mind and body active as it can help, and socializing is good too, if you can get her out or bring others in. Find simple activities you can do together, offer choices of food/snacks/drinks rather than asking if she is hungry or thirsty. Learn all you can about dementia and what you might expect (I am still learning new things, even after 5 years!) Each person is different and stages are only suggestions - some progress faster than others, some plateau before stepping down later, some experience it all, others only a few effects are noticed. Always try to be one step ahead (this is where the learning comes in.) Offer choices (fewer is better), never argue or try to convince her of something she says or does being wrong, learn to redirect/refocus - so much information out there to help you and know that we are always a keyboard away!

I would definitely make an appointment with a specialist. However, you may want to start with her family doctor as this happened to my neighbors mom, and she had a severe bladder infection which caused much of her issues, she then was referred out to a specialist as she was in the beginning stages of dementia.

Talk to her primary care physician first. You have mentioned some things that show that her mental condition is changing. Make sure that all of her paperwork is in order, will, living will, power of attorney for medical and financial affairs. If she doesn't have these things, don't delay. Get it done now. You'll need an attorney for this. It sounds like she is living with you. As she needs more help, you may also need some help. If it gets to be too much, consider having someone come in to help with cleaning, giving her medications, etc. Look out for changes such as wandering, getting lost, etc. If this happens, she may need someone to be with her at all times, or ways to keep her from doing things that could be harmful for herself or others. You may also want to talk to a social worker to find out if there is any assistance available, but I would talk to her doctor first.

It's like reading the questions that went through my mind, but I knew my mother wasn't demented. When she was 80, I became her only child that would not put her into a home, and therefore her sole care giver, she had the foresight to make me promise her that I would stay in the house, and never allow my sisters or brother to put her in a home. She never thought she would become disabled, but her body gave out, and when the body gives and you can't do for yourself anymore, the mind tends to get bored. For 3 years, I did the same thing, wondering how much more time do we have, and hoping it would be longer than I thought. It became a joke between us, I would go out into the apartment mornings to make her breakfast, and I'd say, "Yo Ma, You still alive?" She'd come out of her stupor and say, 'Yeah, Jo, I'm still alive." Then she'd tell me how she would love some Oatmeal, toast, orange juice, coffee and maybe oranges too. Truly, I'd give anything to still be waiting on my mother today. When she would wake up in the morning, she always told me what an adventure she had during the night. One morning she told me how Crocodiles had infested the apartment and she fought them off with her stick. I looked at the channel she had on, it was on Discovery I think and they had a full night of Swamp People on. So, she was dreaming about crocks, because that was her subconscious mind taking in what she was hearing.
When she was fully awake, she realized reality. I always tested her when I thought she may be getting Alzheimers, and she knew all the answers, she never forgot who anyone was. You know when they no longer have their right mind, they will look at you one minute and know who you are, the next they will ask you why you are in their house, and who you are. She used to be a Physical Therapist and knew how to make the body work, so when hers stopped working she would hate that I would have to help her with her intimate tasks. She'd say, "What a revolting development this is!" But she was the same, and younger than your mother, 90 is a long time to live and keep it together. I don't know how long you have left with your mother, but if you can hang in there, don't put her in a home. She deserves to live with people who love her and won't harm her, does she still walk around, mine couldn't, so I found things for her to do, a friend of mine gave me the idea. Coloring became her passion, she used to be an artist, so coloring I thought would be easy for her, but she was working really hard to color those pictures. She wanted to give her coloring's to my siblings and their kids, but no one understood how much time and effort she put into them, and so they left them behind. I would hide them so my mom didn't know. If you can hang in there for her, please do, if your ready to let go then put her in a home. You are still young, I'm 55, and you have a long healthy life ahead of you. I don't know if your all she has, but if you are, then she's all you have as well. You only get one Mom.

No sense in asking her questions, her mind is declining. Just feed her and don't try and analyze everything, you will make yourself crazy. There are many changes on the horizon, don't awfulize.

Anticipate her needs, and just serve her food. Asking questions imo just confuses them, and then they forget the question.

That is normal for you mom with dementia to not remember she is hungry. I go through it all the time with my 90 year old grandma. So the best way to I go about that is make sure to offer her something to eat at meal time.

If you don’t have POA for both financial and health established already, get that done before you get her evaluated. Once there is a formal diagnosis of dementia, she won’t be able to designate a POA and you would have to get guardianship in order to make decisions for her. And someone will have to. A gerontologist would be a helpful doctor to help manage her needs and can refer you to other specialists as needed. You will have to think about tough decisions regarding end of life and decide how that should be handled. Doctor will be needed to sign DNR form. I have not found the dementia meds to be helpful at all. They are said to slow progression but honestly, how do they know? But use of meds like Lexapro have been helpful for my FIL who was sleeping constantly. So a doctor who is well versed in elder care will be helpful.

Hi Hopeful. You answered your own question regarding eating. your mom is beyond the point of making many decisions. You have to make them for her. Bring her meals without asking. The same with meds. You have to administer them to her. As far as a doctor that specializes in geriatric patients, that could help if you can find one. There is no cure for dementia, no magic pill. you can sow it with good nutrition, exercisize and surrounding her with things she enjoys. A therapy pal would also be helpful (dog or kitty). Take things a day at a time and don't stress or feel guilt. You are probably doing a better job than you think. Many of us are in this same boat.

Hopeful, please try not to panic. I don’t think you need to “watch her breathing”. I’m not a doctor, but this seems like just a little step down in her cognition, becoming a new normal. In November you said she was using her computer, and may write her story down. That’s wonderful and I hope you and she have started on that while her long term memory is pretty much intact. And put names on the backs of old family photos together. I wish I had been more focused on documenting our family history.
Help her live each day to her potential, hopefully with hugs and laughter.

If you don’t already have her durable POA, and on her Hippa, now is the time to get that. I would take her to the doctor, perhaps you could write him/her a note in advance letting them know your concerns.

Again, try not to panic. This is a slow progression and you will see more changes in the weeks and months ahead. Just be prepared. Hugs to you and her.

Beware that there is no cure for Alzheimer’s disease. It only gets worse over time. Slow for some people and faster for others. There are drugs that treat some of the symptoms but they are only temporary, and have after effects.

she Needs a Geriatric Neurologist.
i wasted 2 yrs with a regular neurologist who really couldn’t help Mom with Alzheimer’s..

Oh, yes, get her to a specialist. The sooner she gets on the right dementia meds (like memantine, NOT risperdone), the better for both of you.

She sounds to be in good shape for her age. These meds help a lot to slow the whole thing down.

Good luck!

My Dad has had dementia for years - a slow transgression. I have attending seminars through the local dept of aging and did some research on line. What to expect, how to communicate, how not to challenge them. If they say the sky is purple - you say yes it is pretty - not no it's blue. Keeps your frustration down.

It is best to have the understanding and work with the situation and accept it. I learned that notes helped as he can read and understand but if I tell him the football game is on at 1:00 he will not remember. Helpers and I don't ask if he is hungry - just keep him on a schedule. Myself and helper give his meds in morning. He is still living on his own. We leave healthy snacks and gatorade by his TV chair - again he sees them he will eat. I use the zipper plastic bags to open easy for snacks.

None of this is easy. My friends commend me that I searched out the knowledge - a doctor can confirm but you have to navigate on how to handle what is best. Senior Centers may also be a resource as well as talking to a caregiver with a dementia client.

Each dementia case can be different so see what works for her. Best of luck and this forum is awesome for opinions and direction.

Barbara

Instead of worrying about the 'what' or 'whether' in your mother's decline, surely it is advisable to have her condition properly diagnosed so you know exactly what you are dealing with. In Australia a patient is referred by the GP to a geriatrician who does extensive testing. Depending on the score and the quality of responses will determine any decline, and whether it is mild cognitive impairment or has already tipped into dementia. Psycho geriatricians are used when the patient's behaviour appears to become psychotic. Undoubtedly it is a similar process in your country, just the terminology and descriptions might differ slightly.
As far as both MCI and dementia are concerned, there is no cure, nor is there an imminent cure. There are a few drugs that can slow the dementia side if taken at the optimum time once it has tipped out of MCI. But progress will still be relentless, there is no return path. Behaviour modification is a useful tool to manage both MCI and dementia, and to maximise a sufferer's enjoyment and quality of life. A geriatrician helps guide a carer and sufferer through those options.
My mother managed to hide the decline of her MCI, then her dementia, very well. Unwittingly, we aided and abetted her in that quest. Whether she did it on purpose or whether it is just the way it goes, who knows! Your mother's attitude towards food is a perfect example of that ability to hide a problem. Other terms like 'I don't know, you decide for me', 'I cannot find my glasses, could you work out such and such for me', 'why is the alarm ringing' when it is the door bell or telephone ringing etc, with hindsight all pointed to her declining cognisance.

In my experience it didn't help. We've seen two neurologists and one psychiatrist that specialize in geriatric dementia. I haven't been able to discern any benefit. In fact, the psychiatrist told us there was really no reason to see her since there's nothing that can be done for dementia.

She can no longer manage her medications nor her eating.
If she is living with you YOU need to give her the medication when she is supposed to take it. You can not set an alarm for her as she will probably have no recollection what the alarm is for or what to do or take if she does.
You can not ask her if she is hungry. She may not know or recognize what hunger feels like.
Begin fixing her a small breakfast, then a few hours later a snack a few hours after that lunch then in a few hours a snack then dinner later. The snacks can be small a bit of cottage cheese, fruit, yogurt or if she will drink them a product like Ensure or other protein/vitamin beverage.
There will come a time when she will refuse all food and beverage, PLEASE resist the urge to do a feeding tube.
This also might be a good time to consult Hospice she is probably qualified and they will help you through this time. And you will get help and equipment when you need it as well as a lot of support.

As for a doctor that specializes in dementia...there is not much they can do other than tell you she is declining and you already know that. But if you wish to consult one look for a Neurologist and or a Neuropsychologist.

Start with her family doctor and ask for a physical and mental assessment. She may have age related decline or it could be more.