My wife and I have been blessed to have had the opportunity to live where we do since 1973 when I finished College. I have also been blessed, that in that time, I have had only two Primary care physicians. It’s no secret that your relationship with your Doctor is one you should feel pretty good about, after all, you are literally putting your welfare in his or her very capable hands. One of the things that my physician does that has earned my trust is refer me to a specialist when he knows he’s not the best guy to address my issue(s). So as you’d expect, over the years, at his directive, I have visited orthopedists, urologists, cardiologists and more.
Whether it was in one of these articles or in my “Memory Care Minutes” that are heard on the radio, I often mention the importance of making sure that you’re taking the loved one you suspect with Alzheimer’s to the right Doctor. When I had chronic shoulder pain, I saw my orthopedist, when I had a glitch in an EKG one year, it was off to the cardiologist (everything was fine). When you’re dealing with Alzheimer’s dementia, it’s just as important that you are working with the right physician.
Before I go any further, you should understand that the only way to be 100% sure that you and your loved one are dealing with Alzheimer’s is through an examination of the brain tissue. Since this is usually done by an autopsy, we’re going to take that option out of the equation. So now the question is, what can you and your loved one expect your specialist to do, especially during those first visits where you’re looking for answers?
The first thing you can expect is a comprehensive evaluation which would include information from you about their behaviors. It is with this in mind that I encourage all caregivers to keep an actual written log of their loved ones behaviors throughout the entire caregiving process. In dedicated environments, nursing homes and hospitals, at the end of every shift, the staff does what is called “report.” e.g. Mr. Jones was agitated and refused to eat lunch. Mrs. Smith was very confused and spent the afternoon worrying about where her father was. Mr. Brown refused to shower etc. As you’re loved ones advocate, the information you are providing the Doctor is critical. Remember that as they advance in the illness, their ability to communicate, recall and understand becomes more and more difficult. Also, if at all possible, try NOT to talk about them and their behaviors with the physician while they are in the room. The physician is going to need their complete medical history, they’ll perform a physical, neurological and mental status exam along with doing checks of their blood, urine, perform an EKG and may even do chest X-rays. They may also request a CAT scan, an EEG and more than likely do a psych workup and maybe some neuropsychological testing.
It’s a pretty comprehensive process and it should be and it makes the case for the importance of dealing with a specialist. It’s always important that we all remember that dementia is a symptom of something else that takes away their ability to think, remember and reason and not a diagnosis. Furthermore there are reversible dementias with a variety of different causes. I don’t think anyone would argue that it would be in everyones best interest to know, as best they can, exactly what the cause of the dementia is. That’s something that a specialist will certainly be able to do.
If there are any questions you have, please email me at repe@careforcare.yabanjin.com and I’ll answer then directly or in a future article. And remember…Join the Journey.