Discussions

Hello ebrandon.  
 
I have an elderly family member who's cognition has markedly declined in recent months, and we suspect it's something like Alzheimer's or Dementia. There's been several conversations with her doctor over her memory problems and language troubles, but darn it! she aces any brief exam he does in office when we take her!  
 
What are our next steps? Do we just ask the doctor outright for some sort of referral? Who does the actual diagnosing? How does this work if she's uncooperative?  
 
A bit of help and guidance from anyone who's been there would be appreciated. We want to know what our options are and what the process might look like before it becomes critical. TIA

Mom's Dr referred her to Dr vipul at Victoria and Russell clinic. He did a mini mental test on her. One of the questions was draw ten to two. She couldn't comprehend it. Also asked her to repeat some words he had said earlier.  
I would ask for a referral. Keep on top of her symptoms. It's amazing how quickly things change and they go downhill. Good luck.

I was wondering if that would come up. In re-reading my OP, it maybe sounds like we're trying to force her into a home or something. That's not the case (our goal is actually to keep her in her own home for long as humanly possible).  
 
This is something that has been building gradually over several years, but has accelerated recently. She's very confused a lot of the time and starting to believe events happened that never happened (or just plain forgetting things that happened just the other day) and is starting to have trouble with self-care (such as cooking meals and eating properly, or taking medication correctly, which that one the doctor is aware of). It's been some time that she refers to several people in our family not by name, but relationship only (so-and-so's wife, your daughter, the baby, etc). She has a very skewed sense of time - last week was a year ago, something that happened last year was only a month ago - and her sleep patterns are all over the map.  
 
In short, there's something significant going on.  
 
If anything, the presence of the doctor has the opposite effect - she performs much better than she does in her daily functioning. We don't expect her to get diagnosed from a cursory exam, but we *would* like to see her get referred, if that's how the process works. We've just unsure how the process should look.

I would ask her Dr for a referral for a proper consult, describe what you are seeing at home (if you cannot do this in front of her, maybe write a letter?). But don't rule out physical causes as things like a urinary tract infection can also cause confusion.  
 
You mention difficulty with medications and self-care. Do you have Home Care involved? They would be able to assist in your goal of keeping her at home. You would just need to phone and ask for an assessment, they may also be able to help getting a letter for a referral from her Dr for a cognitive assessment.

I can't help you referral wise, but through studying herbs, I do know of some herbs that can slow the progress of either of the things you mentioned. If you are interested, I can pass on the names of the plants so that you can do further research.  
 
I have an interest in this subject because I know it is something I will be dealing with more in the future.

Review all of her medications. Sometimes people get unnecessary drugs from different doctors that put them into a fog.

is the best for the elderly! Is he still working at his clinic? I know he did retire but maybe just from the hospital?

Sounds exactly how my mom was. Please ask the dr for a referral.

Thanks for the offer, but she takes a couple of medications already and I don't want to risk messing with interactions.

We've gone down that route a few times, but she refuses to let them in! LOL We keep gently suggesting home care but so far she's been uncooperative. We've also suggested one of those life-alert things, but she's also refusing that.  
 
She's basically refusing to do anything other than the status quo. Which I get. Change is scary, and it must be doubly so when you're confused a lot of the time.

We probably let out Mom go too long before a proper diagnosis .  
But we never had to deal with it before.  
The turning point was she was getting very thin, forgetting to eat and neighbours reporting her out side looking for stuff.  
We employed meals on meals but she wouldn’t open the door.  
We did finally get her in for a assessment. She knew we were up to something . She was assessed and result was 24 care.  
For her own safety , she hated it , but within 6months settled in.  
5th floor Fairview is the Dementia ward and really can’t say enough about how good they are.  
With the anxiety of the move the Dr,s percribe different sedatives but in time have all but completely removed them.  
She eats well and is generally very happy.  
She will need family support , lots of visits, outings , and a POA to be involved in decisions.  
We are glad we finally got her in. It would have been worse is she’d walked away from her house and never return or any other scenario that comes along.  
It’s like taking care of a young child now , just have fun and be involved.

I missed my editing window, but have something else to add that I learned lately.  
 
First of all, I would see a different doctor.  
 
Second of all, get him/her to review her medications. Quite often, medications can affect brain function, whether it is one directly or a combined effect. See if there is anything that can be done with what she has; if there is a reasonable substitute or if she truly needs to be on certain drugs.  
 
I saw something about this on the news. The guy seemed to have dementia/Alzheimer's. They changed his meds & he could walk better, & his memory mostly returned. It was a result of the meds.  
 
It is worth checking out further.

We're confident that's not happening as she only has her GP prescribing things and he's basically the gate keeper. She does take a couple of medications, one of which she needs routine bloodwork so she's monitored closely that way. Her son is also in charge of organizing and filling her pill thing to ensure she actually takes her medication.  
 
If anything, she's not taking *enough* medication, as we've found stashes of unused medication in her house, and her blood work shows it.

Thinness... she seems so frail now! My mom cleaned out her fridge the other day and was shocked at how much food was just rotting in there. Not like her. She also refuses Meals on Wheels, so family has been bringing her stuff a few times a week but then a lot of it goes uneaten anyway.  
 
I think the turning point was this past week or so when my parents were away, so us grands were checking on her daily. One day she got all freaked out because she hadn't seen my parents "for months", according to her (it was 5-6 days). One day one of us talked to her in the morning, but then she didn't answer her phone the rest of the day. My brother went by to check on her in the evening, and she claimed she was "outside" the whole day, but details were extremely sketchy. We didn't push it (we were just glad she was *inside* and safe), but it was still very concerning.  
 
I personally think we'll reach the point of her being in a home in the next 6 months, but unsure how to do it. She's still with it enough that she'll know something is up and just refuse to cooperate.

Boy does this topic bring back memories. All the best to you and your family.  
Definitely demand a referral. Things take so long to happen. Just keep on top of it. xo

She has to be assessed by a Doctor , but think you said she did that already.  
After all the effort we put in and her suspicions , she trusted the doctors after all.  
Keep close and hopefully she gets a proper assessment for her own health and well being.

Please do whatever you can to get her help now! She won't get it unless someone demands it. Daughter on call was very good to us until we got mom home care. Going through home care was a hassle but good once we got it. . They would not provide overnight care at which time Mom went to A400 which I would not wish on any one. She was injured a few times by fellow patients and of course nothing could be done to prevent that. So I was told. The staff were ok but could not be everywhere at once. If you have a lot of family and friends please use them to help every single day. Set up a schedule and take turns. The only other thing I wish I had done was set up a camera in Mom's room at each facility she stayed in. Staff is always good when someone is around! If the daughter on call building had been in existence back then that would have been my first choice. Remember you really have to push to get what you need done.  
 
Edited by posneg, 2019-09-03 11:02:14

Go with your gut feeling and do what’s best for your grandma. The hospital has a great psych unit that will assess her and find out if she has dementia but you need a referral first. God bless.

Thank-you everyone for your helpful replies. I've gotten some good information to follow up on and see what happens next!

You could also contact the Alzheimer’s society by going to their website or stopping by. Their office is near Superstore across from CIBC on 9th. They offer caregiver support groups, have several resources and may be able to help guide you through the process.

I would also suggest Dr Rhynold Geriatrician she is very thorough. Doctor referral required.

It is important to make sure that your mother is physically healthy. As someone said urine infection, blood work, vitamin deficiencies, etc can mimic symptoms of dementia. My mother had a low grade bladder infection which added to symptoms often not found on a general test.  
 
There are prescription medications to not stop but slow down the process of Alzheimer . My mother took them.  
 
I would also review her medications again with pharmacist. They know more about side effects and interactions then doctors as drs don't have the time to know all this.  
 
My mother was taking a couple of medications that made her symptoms worse.  
 
There are medications that actually should not be taken by the elderly even though safe when they were younger.  
 
All the best.  
 
My mother shared many things with me during her journey. She told me when I tried to sweep the floor to stop as it made her feel useless. Having someone come in was different as it was a job.  
 
She also told me I had to be her memory and remind her of things. Her memories were like a filing cabinet sometimes she couldn't find the file, then she would find it and it would be empty or the drawers were locked.

Contact Seniors Mental Heath through PMH. I had to go this route with my elderly parents and workers were great.

was 85 - living on her own and doing all kinds of strange things. The family spoke with the Doctor on many occasions with no positive results. It wasn't until the Doctor admitted her to the hospital where she could be observed 24/7 - that the Doctor finally came to the conclusion that she was in the early stages of alzheimers and could no longer live alone. This took 2 weeks - all I can say is that the nursing staff deserve a big thank-you as as it was their professional observation skills and excellent detail when it came to charting that the Doctor was able to make a proper diagnosis. She is now in a long term care facility where she is safe and receiving proper care and going strong at 90. We have hospitals and professionally trained nurses for a reason - have your mothers family doctor admit her to the hospital for observation for 10-14 days, that way a proper diagnosis can be made and everyone will have peace of mind. Good luck.

Thanks to all the helpful info I've gotten both on this thread and other people who have contacted me directly, we've gotten the ball rolling on having her assessed and the referral has been made.  
 
Thank-you all for your help and advice! Some of your stories have been very helpful as I see others having navigated it sucessfully. Your stories mean a lot to me!

Mentioned nutrition.  
 
Often people have Alzheimer’s like symptoms when you’re malnourished. Perhaps when she gets eating well balanced meals she might be OK I would really pursue a home care assessment as well as the doctor assessment

A good medical assessment can also determine whether she has an infection which can also mimic or cause dementia like symptoms. She definitely needs medical attention