How do I get the doctor to take my mom's situation seriously?
I have read so many responses that others have posted about getting someone tested for dementia. I have just changed mom's doctor to one who supposedly deals with dementia, etc. in the elderly. This is the second doctor that has given her their "twenty questions" test, which mom passes and they are all surprised. Yes, she can remember the date, the day of the week, maybe the month and the year (sometimes), but she can't remember how to answer the phone, work the microwave or stove, take a shower, get dressed, take her meds properly, handle her own personal hygiene issues, or a number of other daily tasks without help. I have told her doctor this, but I can't seem to get them to help me with ordering more detailed testing to see where she is on the dementia line or what type she may be suffering from. How do I get this done and who do I go through to schedule it?
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I need a letter of incompetence from the Dr. (and they are very reluctant to provide). But at least your documentation will be part of the medical record should you need it.
You can make an appt for her with the Neurologist. If you need the referral for insurance, be persistent with the PCP and insist on it -- or go to another geriatric care physician.
Dementia will worsen. Your PCP should be able to diagnose that even without a Neurological exam confirmation. Alzheimers may show up on the MRI or CAT scan but Dementia may or may not.
My mom is always able to pass these silly questions even when she was sent under a TDO to a behavioral med center for the dementia -- yet they noted over and over her paranoia, hallucentations, depression, dementia -- and after all that; they still wouldn't write an incompetency declaration. A big dissappointment and frustration and without out I have no legal authority to get my mom the help she needs in a memory care facilty.
They are not deliberately trying to "ignore" it, but they often are so overwhelmingly busy, they do not hear it.
That is why it is so important to do exactly as described, in documenting, it, taking pictures, etc., and submitting them to the Docs office to put into the patient chart.
Making it clear that they are DIFFERENT from how they used to be...for some reason, makes a huge difference, as well.
...not just that the behaviors are not OK, but that they are different.
When I tried to tell the Docs Mom was getting worse: stove fire, unattended cooking things, burners left on, inability to take care of her affairs, forgetting, etc., they didn't take it seriously, as I was unable to tell them when it started
--it has been going on a long time, very tangled with her mental issues of a lifetime....subtle, but worsening differences. For that, they totally blew me off...
The only thing they did pay attention to at all, was her drug-seeking--THEY witnessed that.
Just wanted to say I couldn't agree with you more. The people in this situation should be seeing a specialist who will also take them seriously. I think some doctors get the mentality that just because their patient and the patient representative aren't doctors that they couldn't possibly know what they are talking about. It's ridiculous. They are dealing with human beings who have "real" problems. Especially for the daughters, sons, and others who are asking genuine questions about their loved ones health, they should be heard by the doctors. They know what goes on because they witness it first hand. I get frustrated with this type of thing because in the very early stages of Alzheimer's my MIL refused to believe she had a problem. She was in total denial about her memory loss and other strange things that were happening to her. I think she was probably just scared to find out something was wrong, which is completely understandable from her point of view. Now, she is in the late stages, bed-ridden, and needs constant care. I can't stress enough how much all the caregivers and patients NEED to find a doctor who will listen. Sometimes our relatives are stubborn, but we just have to push past it and find a way to get them to someone who can help them. Believe, me I know how frustrating it is to deal with someone who refuses to see they need help. I truly feel for all those on here who are only trying to do the best for their loved ones. God bless all of you and may He be with you and your loved ones in your struggles.
==Docs do not like to DX anyone with a dementia, it means the person loses their autonomy;
==It changes how billing is done, and changes what facilities people seek, and which will accept them.
==Systems as they are, are inadequate. ESPECIALLY if someone is Medicare/Medicaide, the systems are overloaded, States are pretty much broke, and they simply do what they can to keep people at home, rather than in a facility.
==Docs require caregivers to "Quantify & Qualify" what conditions are observed. That is, how much of what, is happening? [specifics,given in short sentences]
==Sometimes there are key words to get the message across.
Key words may change depending on situation.
Like, telling a collection agency to stop "harassing" familly for debts of a deceased elder, who "...died owning no assets; I am not blood relative to that person; the spouse has no assets and cannot pay that collection".
Or, tell the Doc your elder is "behaving in ways that could endanger themselves and/or others"--and specify what those are, how often, when, related to what.
Specifics.
I only managed to do some things to reduce impact of things on our household. Unfortunately, due to Mom's ability to be a spectacular "showtimers" expert, they all missed diagnosing her actual problems, and she therefore never got proper treatment for them. The only reason she was able to skate past them, was because
==Social workers doing in-home evaluation, only stayed 2 hours; if they'd stayed longer, they'd have caught her at it. If you can get SW's to the house to evaluate, ask them ahed of time, to please stay longer than 2 hours, to best chance catch her at things. AND, make sure your elder is already kinda tired out from some activity--anything--ahead of time. If they've made dementia-related messes, take pictures, or leave them for SW's to see.
==The hospital Psych only interviewed her briefly. The hospital did put a sitter in her room, as I had told them she'd attempted suicide in the past, and had been threatening it again, but that fizzled, too. I was at a loss as to what to tell them, as, I was not doing a good enuf job of describing things, to get them to take it seriously.
Bottom line, she's poor and on Medicare/Medicaide--the payment rate, with no assets left to pay for facility care, is too low; and, I'd already told them she's a mega-hoarder who can be combative and has rages---it meant, they really didn't want her in any facilities...they left her in our care, tearing us to smithereens, instead. But she did turn things around on us, by telling others we were abusing her, only in inuendo, then recanting sweetly
...I almost was willing to let them remove her on those grounds, by that time! It would have been a relief--instead, one sister took her out of here, believing that was happening.
It was terrible beyond belief, what she did here, and their methods of getting her out were hurtful, but the end result was, Mom got moved out of here, and we've been slowly recovering from the damages--some cannot be fixed.
Last week (I posted earlier) I left a message asking for a consultation without Mom present since I have dpoa as well as her signature on the hippa info with my name. I know he is not required to talk to me, but it is not illegal if he chooses to do so. That was 5 days ago still no response from him....... She will not go to another gp, so I am stuck.
I am so glad msstone55 posted this question.
But, if you've described your mom's inability to manage even the most basic activities of daily living and he hasn't delivered a dementia diagnosis (or other cause) at all nor any advice about her care requirements and prognosis, then it's time to move on to another doctor.
There are many types of dementia, and some of them affect memory first, while others may affect judgment or another type of functioning.
I'd try to get her in to a neurologist for a battery of tests. As one of the doctors for a referral. If he or she refuses, ask you own doctor how to go through your system so that she can be seen by a specialist.
Good luck,
Carol