Dementia Diagnosis: Doctors and Questions

When you or a loved one is concerned about the possibility of having a dementia, getting a thorough evaluation is the next step. Knowing and understanding what is happening will help you with interventions and planning.

So, what should you do? Here is a brief list of considerations and steps to take:

Select a physician.

  • Consider the physician’s knowledge and comfort regarding working with older adults.
  • Consider making an appointment with a geriatrician, a physician who is specially trained to diagnose and treat older adults. Don’t necessarily avoid other doctors, including family practitioners and internists, though; they often have the same knowledge and skills.
  • Understand that additional specialists may be included in the diagnostic and treatment process. They may include neurologists, psychiatrists, psychologists, and other specialists as needed.

Schedule a doctor’s appointment, which will include several types of examinations.

  • Physical exam, including
    • medical history
    • family medical history
    • physical exam
    • laboratory tests of blood and urine, particularly to rule out other possible causes of symptoms
    • review of prescribed medications, patient-opted medications, and supplements
  • Social and behavioral profile, particularly a log of recent changes and concerns as seen by the patient and/or others
  • Neurological exam
    • assessment of balance, reaction time, reflexes, coordination, muscle tone, speech, sensation, etc.
    • ruling out of conditions and diseases, such tumors and strokes
  • Mental status test that evaluates awareness, memory, problem solving, executive function
  • Psychological evaluation, often to rule out other causes of dementia symptoms, such as depression, anxiety, other mental illness concerns/illnesses
  • Brain scans (not routinely administered)

Ask the doctor questions to be sure you understand the diagnosis.

  • Diagnosis by name
  • Evidence that underlies the diagnosis: What did the doctor see in exams and tests that led to the diagnosis?
  • Doctor’s assessment of the current stage of the disease
  • Possible interventions, including therapies and medications
  • The role of the doctor going forward

Would you like help navigating the diagnosis process? Contact Dr. Cheryl Greenberg at TheAgeCoach@gmail.com to discuss your concerns and plan the next steps in getting and understanding a diagnosis.

Caregiving: Can You Make Medical Decisions?

Who Can Make Medical Decisions in a World with HIPPA?

American’s medical records are protected by the Health Information Portability and Accountability Act (HIPAA). Neither friends nor relatives have access to our medical information without the express consent of the patient.

This is usually comforting in a world with so much data and so much communication!

But what happens when a senior needs help with his or her medical decisions? What happens if there are end of life decisions to be made?

Three legal documents give others insight and permissions on behalf of a senior.

  • HIPAA authorization gives permission to the doctor to share medical information with the person(s) that the patient names.
  • An advance health care directive (living will) lists/describes an individual’s preferences about medical care, including whether certain life-sustaining treatments should be administered.
  • A medical power of attorney (health care proxy, durable power of attorney for health care) identifies someone who can act on behalf of the individual if needed.

It is not always comfortable to think about illness and end of life decisions. However, there are many resources available that can help. Attorneys are skilled at advising and preparing the documents. Information and forms are available in print and on the Internet, as well.

For a brief description of medical powers of attorney and living wills, look at WebMD.com’s Advance Directives.

 

Is This Dementia? Memory Changes

He isn’t remembering well. Does He Have a Dementia?

How often has a loved one forgotten something and, for a split second, you said to yourself, “Why didn’t he remember that? What does this mean? Should I be concerned?” Here are guidelines to help you.

The car keys are missing. Is he losing his memory?!

  • We all put our house keys down and forget where we put them.
  • We forget a name even though we know the person.
  • We go to the supermarket for eggs and come home with coffee, bread . . . but no eggs.

Are these signs of dementia?

Everyone forgets from time to time. As we get older, we forget more often.

However, it is not a sign of dementia if we can remember the keys, name and eggs after a little while and our forgetting doesn’t stop us from carrying out our normal activities.

Some forgetting is normal. Taking a little longer to remember as we get older is also normal.

Memory changes that interfere with independent activities – our work, social life, conversations, reading and learning – may indicate a health problem that should be checked by a doctor.

These memory changes may include

  • Not being able to find the right words to express something, not following a conversation, or having difficult completing a thought
  • Forgetting names of people and places
  • Being confused about where one is, not knowing how to get to a familiar location, or not being able to retrace one’s steps
  • Having difficulty recalling the information needed to make appropriate judgements and decisions
  • Not recalling where an item has been placed even with time and effort

HelpGuide.org offers a quick look at how to figure out what forgetting the car keys might indicate at What Does My Forgetting Mean?