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Friend is 80 years old and suffers from vascular dementia. He complains every day for months of headaches in the back of the head, but when at the doctor does not have a headache. He also suffers from sleep apena and refuses to use a cpap machine.

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You can't always make the person tell the doctor what's happening. And the doctor can't talk to You unless your the p.o.a. or guardian. But you can write the doctor a short concise note about your friend and then the doctor will be aware and it can be noted in the chart.
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The symptoms sound quite familiar. I would try to explain the situation to his POA and/or family member who can step in and see just how advanced it is. As this develops, he will likely need around the clock care. By the time I got my LO to a doctor and then an MRI, she had multiple strokes and significant dementia. She had refused to see a doctor too, but, eventually, I got her there with a lot of creativity and persuasion.  It may be a project for the person who's going to assume responsibility of his care and personal affairs.
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Yes, he could be suffering from strokes. When Moms was having a problem with her left eye, they tested her for strokes at the back of the head. Seems like strokes in that area can effect the eyes. I agree, get a family member involved.
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Do you know he doesn't have headaches or share that he has them often when at the doctor because you are with him or just because that's what he reports? I ask because this often happens with my mom, something she has been complaining about regularly she neglects to mention at her doctors appointments because she isn't experiencing it then. This is part of the reason we don't let her go alone anymore. During the review and "what's going on" session if she neglects to mention something my brother or I (whichever one is there) will mention it or gently remind her to mention it, I try to make sure it's casual, including her so she isn't being usurped but if she minimizes it we don't let her get away with that and her doctors are aware enough now that they take the mention and run with it, asking her questions to try and get at the bottom of it. If you aren't the one present, as others have mentioned maybe bring it to the attention of the person who is or his POA so they can bring it to the doctors attention. If he doesn't have someone doing that with him and resists implementing that you could just point out that while the headaches may be nothing it's particularly important for him to report small things like that given his vascular dementia diagnosis so if there is the possibility it's a warning of some sort they can intervene before it becomes anything more. Of course if the headaches aren't related at all to that diagnosis the doctor may have still have the key to stopping them and it could just be something very simple. Several times in the last year or so my mom has had nagging complaints she was willing to "live with" writing it off to aging that it turned out there was an easy fix for. All she had to do was tell someone! I think we all do this. The other thing I try to do is keep a list of things to mention or questions for the next doctors visit (one for each specialty) maybe suggesting that go on a list he takes with him. It's so easy to forget to mention something when your there, whether your the patient or not!
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