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He has not been diagnosed yet. My friend has many symptoms I've seen here in this forum. I think he has noticed his memory problems, but will not admit to it. He has a Dr. appt. in June, for a full physical. Will the Dr. tell him he has dementia, or Alzheimer's, If that is the case? Or will they want family to do it? I feel is coming up soon.

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Is your friend married? Will his wife be going with him? What kind of doctor is he seeing? For example, it is a geriatrician (specialist in elder care)?

From what I've seen, often a PCP will avoid a diagnosis of this kind but send the patient on to a specialist who will do further testing if dementia is suspected. In our case the specialist talked directly to my husband about his diagnosis. I think this varies a lot from practice to practice.
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The Dr doing the testing told us, but my husband just thought she was talking about someone else, and this was early on. I tried to broach the subject, it was a no go, at that point I felt there was no need bringing it up again, that was 8 years ago, to this day none of my husbands doctors say the word Alzheimers - The good thing about having Alzheimers, is you don't know you have Alzheimers. I have read of some that are told and they actually keep logs on themselves pertaining to their changes, but that is mostly a younger onset of the disease. I would not push it, let the Specialist do it, if he accepts it and wants to talk about it, it's ok. One important thing is Power of Attorney would need to be done before he gets worse and is not mentally capable of understanding what he is signing. That's harder to tell the person then the actual diagnosis. But on here you can find the answers.
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Your profile says you are caring for this friend, but he still lives in his home. Are you close enough friends that you would be accompanying him to the doctor? A physical usually doesn't include any neurological examinations. Just heart, blood, lungs, that sort of thing. The doctor should be told to look for memory problems and then maybe he/she can recommend further testing.

However, If there is a diagnosis, you can expect that he would have to be told many times over the course of the years, because he will forget. I have found that it isn't important to tell MIL that she has dementia. In the early years, we just put forgetfulness down to normal aging, and after we received the "official" diagnosis, it really wasn't that important. We were already doing what we were doing, and nothing would change. Just support your friend in any way that you can, and become his memory as it becomes necessary.
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He will tell his primary he is just fine. The primary will agree he is fine. I've seem my MIL do this many times. It's called "showtiming".
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Unless you are on the HIPAA form, your friend's doctor will not even ask for your input, even if you are the fulltime caretaker. My MIL has been diagnosed twice with "stable dementia" because her son coaches her on what day it is, who is President, etc. She hasn't done well on the memory tests, but they seem to feel she's just fine. I could say otherwise: she doesn't swallow solid food anymore, she talks about things that happened a week or a decade ago as if it were today that they occured. She sundowns, and walks the floor all night. She relieves herself into a cake pan on the floor and hides the evidence. She calls my husband my Dad. On and on. I have learned not to even go to the dr. appt, since no one will ask me to describe what I see. It is very frustrating. I'm trying to just be loving and hope that she cant fool her son and the drs forever.
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I coach my mother so she doesn't get upset if she can't answer the questions. How does it serve anyone if she is told she is demented? I like to just address each "episode" and hope for the best next day. I keep the doors locked so she can't get out at night and have a full time caregiver. We coddle her in her dementia at age 104, why do I want to upset her?
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My Mom goes to a neurologist. He didn't use the word Dementia but he did sit down in front of her and tell her what may happen. I told her she had Dementia becauseshe was getting upset abouther confusion. I won't tell her again. I write her doctor a note about her changes. This way he has an idea what questions to ask.
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Throughout the entire journey, my husband knew he had Lewy Body Dementia. It was very important to him to have an explanation for what was happening to him. (He was an engineer. Cause and effect were concepts deeply ingrained.) I am so glad we could talk about it openly. I could say, "You are right. You can certainly carry a full tray. It's ol' Lewy I'm worried about. I'll carry the tray this time, just in case Lewy tries to interfere." I could hug him and say, "I'm so sorry Lewy is being such a bother today. We'll start over tomorrow and maybe he won't be around so much."

My husband, dear Coy, donated his brain to be used in dementia research. This was extremely important to him and I think to research as well. He knew there wasn't a cure for him, but he hoped our grandchildren would have better odds.

On the other hand, my mother's main coping device all her life has been denial. No one has told her she has dementia. We don't see the point. Today when I visited her she wanted to know how she was going to get to dinner. I explained (as we do on each visit) that a helper would come and wheel her into the dining room when it was time. There are a lot of helpers here. Now that you are almost 95 there are some parts that aren't working as well as they used to. It is good you are at a place where there are so many people to help you with getting to the dining room and remembering your appointments and seeing that you have what you need." She is very proud of her age, and intends to live to 100, so for her blaming her impairments as just part of aging seems logical and acceptable. She doesn't need to know she has dementia. My husband did.

This is not a one-size-fits-all situation. It depends on age, personality, life outlook, and other intangibles.
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Jeanne, that was well said. You handle everything with class. I don't have that ability.
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The subject did not come up with my friend. He just accepted that he needed more help when his family moved him to Long Term Care. He is very accepting but I am very sad because we were close friends for 15 years and I miss him so much. The separation does not seem to affect him too much but he is delighted when I am able to visit. He is 95 and I am 92. Old age can be a sad time! .
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I do think we become sadder than they do as we lose our loved ones to dementia. They become less aware of it. I'll answer any questions honestly but we don't dwell on the subject and he forgets or seems surprised when someone mentions it pertaining to him. His doctor (geriatrician) wrote it on the notes he gave us after his last appointment. He used to get the memory test from a social worker as part of his annual physical. To be truly diagnosed with Alzheimer's, you need to go through more extensive testing.
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A dementia test is not normally part of Physical Exam. A certain amount of memory loss is normal as we age and not to be confused with dementia. If you aren't your friend's Health Care POA, it is illegal for his physician to discuss any of his health issues with you directly and unless you are sitting in the room with them and your friend tells the doctor that it's ok to discuss his medical issues in front of you it is in violation of HIPAA. If you are concerned about his mental health, maybe you should let his family know.
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SamanthaW, a person can sign a waiver that allows his doctor to discuss his health with others besides his health POA.
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That's kinda what I meant when I said 'tells him it's ok'
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It's fine to "coddle" someone and keep them safe and secure...no need to tell the elder that they are failing. I do object to keeping the physician in the dark, though. How does it serve the level of care to pretend that there's no problem? In my case, everything depends on me and my skills. I believe my MIL needs 24 hour nursing care, and I'm only capable of giving her 18 hours. A diagnosis of dementia would help my husband understand that it's not ok, it's not getting better, and that his Mom is not getting the care she needs.
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The Dr sat in front of my Mom and told her what may happen but didn't mention Dementia. She was really upset one day because she thought she was going crazy. I told her then she had Dementia. A couple of days later she showed me an article in the paper on "what I told her she had". Does she understand what that means, I don't know but I won't tell her again. When she's upset, just tell her its part of her problem.
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JoAnn, we handled it the same way. They DOo want to know they aren't going crazy but also that you understand their needs, will be there to help them through this, and they aren't alone.
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If your friend is cognitive enough to notice some memory issues then the doctor will discuss it with him. He may have something medical going on that causes symptoms similar to dementia. All you can do is support him and continue to be a friend.
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79-yr-old:memory loss pt: went from hosp., to rehab and into nursing-home: Ans: 'His' PCP (pt. states), tells him "nothing wrong with you." This is stated over and over again, to the point one must believe it is probably true. The nursing home (end-stage unit; assume located there due to inability to pay) does not indicate his "true" stage of health (or mind), altho he seems to have the "run of the place, and chooses own-eating-schedule including "not" eating if he so chooses). The state-appointed-advocate (very apparently) has continued to "stonewall his questions and gives more general-answers (often mis-leading answers) to him. Due to his continual thought that he "can=will be permitted to" go home", his frustration-levels have risen as the months have gone past from summer into winter now. There exists a point, also, at which the Pt., will no longer be able to comprehend what is "told him," altho he may still be actively making (a few) decisions for him/herself. "Many" people are aware they are not remembering what they "should" (appt.s, appliances running, buildings torn-down): the reasons are numerous from Rx-use to simple over-tiredness, to over-fractioned-time-planning, which may include any of different-types of dementia; not forgetting physical-injury (concussion,etc.). At the point when a type of dementia is determined finally, it is often at a later-stage when the Pt. will not be able to comprehend the reality that he/she is "forgetting."
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These are scary posts for me to read.
I had several weird episodes before I was diagnosed with afib. During the testing before diagnosis, I was sent to almost every department in our clinic, then to a neurologist, and my physical test with him was normal. At the time I described being on a walking trail, or in the water at a swim class, or on my rider mower and sort of snapping to or waking up abruptly and not being able to figure out where I was. The neuro listened to my neck artery and then said, afib can make you feel really weird, sent me to the cardio finally and I was diagnosed after extensive cardio testing. That was 9 months of goofing around.
I am being treated now, but am having more and more memory issues. I go to make deviled eggs and don't realize until after I've done it that you shouldn't dice the whole egg for that, got stymied by an onion one time knowing I wasn't holding it correctly to chop it up and just stared at it in my hand for about 10 seconds until I worked out which way to turn it and put it down on the cutting board, filled in forms online only to find numbers transposed and Wrong from what they should be time after time, or take off to go to one shopping area and find myself driving to the other shopping area across town. I got lost on my way home from a friend's house out of town... and was dumbfounded when I came to a well known intersection with a highway because I couldn't believe I was clear out in that area! this is my last 4 years or so.
I am trying to chalk this stuff up to stress, but too many weird things going on and when I tell people about them?... they say "oh, I have the same thing all the time!" Hmmm, really? You snap out of your fog and don't know where you are???
It is easy to see how even the idea of early dementia gets blown off. I'm keeping track of these things. If I'm lucky, my mind will clear and I will get back on track without so much overwhelming stress... but what if I'm Not lucky? I'm relatively Young.. is this going to be a problem if I ask for testing and an mri? Will anyone believe me?
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Branchingout, I really admire your frankness and clarity in describing what you've experienced. So many people do just keep it to themselves and hope it'll go away.

So you're being treated by your cardiologist now? Some of what you described sounds like TIAs, I expect s/he's explained that to you? But I do urge you to keep a diary of your symptoms and make sure the cardiologist listens. It could be a good idea to get a repeat MRI done too, if only to compare with the last one and make sure there haven't been any major changes.

Better to know where you are and where you stand than be frightened to blazes and imagining the worst.
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Thanks, Cm,
Have to admit, I am Alarmed this year especially.
Yes, I'm on a tiny dose of bblockers for paroxysmal afib, because that's all I could physically take. Am afraid my cardiologist is no longer at our local clinic but only serving his local area an hour away and I will be checking in with a new cardio in a couple of months. I hate that...since so many of my doctors retired in these last few years.

I haven't had an mri. I had a cardiac cath test where they checked for problems and found a congenital heart issue that they said should Not be a problem but could be Causing some symptoms of chest pain - along with the afib. (this was controversial in the cath lab - 2 surgeons arguing - my cardio basically trumping the younger one) At least no major blockage.

The neurologist physically checked my reflexes, looked into my eyeballs and asked me a few questions before he listened to my carotid and heard arrhythmia. He said he didn't think there was anything wrong with my brain at that time and suggested age related memory loss and the afib.

The most concerning memory stuff has been After that since I started aspirin & BB. But yes, I've started a list and will be asking if there's some cheap and easy way to see where the heart issues are now. And I will be asking if a different med can be given, but so far... only anti-rhythmic drugs have been offered and those have way more serious side effects, I hear. I went back and forth with my cardio on this. He told me consider what your symptoms were Before the meds and what symptoms the meds Cause, then Choose which you want to deal with. Ok, I opt for no chest pain, dizziness. I am told the BB does not stop afib, but rather keeps the heart rate down so... less dizziness, more efficient pumping etc. I tried several times to get off the BB because cardio said I could try that, but had too much arrhythmia to make it past one day of that.
I hadn't, of course, thought of bringing this memory stuff up with Cardio, but will now. It is interference in my daily life now. I doubt many things, including my ability to continue long drives to help my mom, my ability to work much or on anything more than menial labor since I can't keep numbers or words straight. (I am one of those ones who inserts words that are Close to, but not quite right, or just plain Not Real Words, when I am talking and can't come up with the right one) I don't have to worry too much since my husband has a nice job... but you know.. a person likes to have Options.
It's thawing out here this week, so I get to walk outdoors and that is usually the best thing for me. I mean, I just can't go when it's below 20 anymore.
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