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star42 Asked November 2012

After the memory test, what are the battery of tests given to dementia patient?

My husband scheduled an appointment with the V.A. doctor and asked for a memory test, planned to go behind my back without me. I found out and took him today. The memory test was 21; the doctor assured him that with this score he has dementia. He wants to live on his own; she told him the only way would be if his score was 27 or 28. He now is demanding more tests. She said it is a battery of tests. Can anyone tell me what these tests consist of and how long they take? If he scored 21 and was determined to have dementia, would these "battery of tests" provide the same results or could they determine no dementia?

I'm so anxious to have this done, he has turned his entire family against me, lies, lies, lies. He lies to me, covers the "private" meetings with his bro & sis in law, lies to the doctors, etc. I really need to have some sense of peace. I'm trying to help him, but with his sarcasm, lying, sneaking around behind my back, the mean looks he gives me, I just can't take any more of this!!!!!!!!

I know he's sick and I've tried so hard to help him, but he acts as though I'm his jailer. I hope someone can tell me something about the "battery of tests".

Thank you for any insight you can give me.

casp74 Nov 2013
This information shared is great and I am thankful...I am in the process of having my mother tested. She is 55, and having some severe issues..she has lost ALOT of weight in four months (she weighs 92 lbs right now). She is basically starving herself to death and she wont bathe, repeats herself constantly. She has also started hoarding things, has severe OCD, and wears the same clothes for days on end. Recently, she has started asking me common sense questions like...will the dryer burn my clothes? I live out of state, and this is devastating to me. She calls me everyday, sometimes 20 times a day and tells me the exact same thing every time she calls. I am in the beginning of all this and I already feel lost and overwhelmed. Thank you for all your postings, they are helping me head in the right direction.

star42 Dec 2012
The serious complication with this mess with the bro & sil is that my husband & I have never, ever communicated with them (for some reason the sil and my husband have always hated each other long before I knew either of them). That's why I'm so suspicious and scared; NOW? they decide to be his bosom buddies?? They are after something. I'm terrified that sil will convince him to change his will. We have wills in effect now. I'm wondering if she could convince him to remove me and put her in his will?????? She's done this type of thing before, she's always around, ready to "help" (behind closed doors) when she find an older person who is quite obviously vulnerable and gullible. Don't know how that could happen since everything is in both of our names. So scared.......... I tried once again talking to him about this. He's in such denial and is so deceitful, I carry on a more meaningful conversation with my 1 year old grandchild and my dog than I can with him.

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susie379 Dec 2012
What a mess star42! You should be concentrating on your husband but you have to be worrying about underhanded actions of other family members. You mentioned an attorney. I hope it is a top notch one experienced in this sort of thing. Follow the attorney's advice in order to protect yourself and your husband. Do not allow family members to push your buttons or engage you in a confrontation. Nothing good comes of that. Stay calm and strong, concentrate on your husband's care. Best of luck to you.

star42 Dec 2012
Igloo572: I am durable P.O.A (27 page document) and medical P.O.A. We have investments in both of our names, I also provided them with copy of the P.O.A. Everything there is joint. They suggested that I take everything out of there and put it somewhere else (although the process is quite involved and I would pay a substantial fee, and lose a lot of interest). They also have letter from the doctor stating he has dementia. His bro tried to get P.O.A. after a month of phone calls and letters the atty finally said his wife (me)needs to be P.O.A. and it would not be in his best interest for his bro to have P.O.A., since until this came up his bro had absolutely nothing to do with him until all of this came up. The bank called and strongly requested that I close the joint account and transfer it into my name only because he called them several times every day wanting to know how much money he has. I am so concerned that he may have confided in the bro & sil re: fianances. This really scares me because I know that's what they are after. The sil has done this with some of her elderly relatives, taken care of them, gotten their money, had them put her in their will, etc. I know this for a fact she is very sneaky and is known for doing this type of thing. My husband is now sneaky around behind my back, lying, keeping important info from me, etc. He was heard saying, my wife has to have her nose in everything to the bro &/or sil. I've tried many, many times to discuss this with him, since I know the bad history between him and his sil. However, either he's oblivious or lying. I do believe he is lying. I've tripped him up recently on a couple of lies re: the sil. I am terrified; she is so experienced with this type of thing. I can not confront her, she loves to fight and she will think that I've got a lot to lose and she will become more aggressive. The attorney said he would call her, but cautioned me that if he does that's as good as me accusing them of have some sort of unsavory plan. This may make them more aggressive. What do I do? I've talked with someone who knows her well who has cautioned me to do anything I can to protect my husband and myself from her!!!!!!!!! Oh, please I hope I can find some help somewhere, it looks as though the atty. can't even help until they make a move and by then, who knows how much they will have gotten out of him (us). I'm so concerned about my husband, and now I have all of this to deal with. I am honest and don't have a mind like the sil, I just don't know how to fight this!!!!!!!!!!!!!

susie379 Dec 2012
Elizabeth, it sounds like your Dad had a bad experience with his testing. Testing aside, after reading star42's description of her husband's behavior, it is highly possible that he does have dementia. The lies, sneaking, pitting family members against each other, arguing with the test administrator that he has dementia, are all typical of dementia patients. My mom has mild dementia and we family members have had to learn a new language of sorts. She often talks of someone stealing this or that, which really means she cannot locate the item, or it is something that is long gone from the past and she has forgotten that it no longer exists. "Oh, let's not talk about that now" may mean she is having to concentrate too hard and cannot follow along, it's too difficult. Star42, it is more important than ever that you and all your family members communicate well when it comes to your husband. Dementia afflicted folks tend to say different things to different family members ( but don't tell so and so I said that, but...) and can/and do stir up family troubles. Talk to each other, please.

Lizann Dec 2012
Your father may have a slight case of dementia but the label is handed out rather freely by medical professionals (generally young) who have little to not patience for the elderly. Everyone will slow up a bit but not every old person has dementia.

My father kept his mind throughout his life but I was informed by the medical folks that he had dementia. The dementia was labled on him because he took a bit more time to formulate a response to a question spoken to him in a rapid speed. Rather than giving him time to respond and assessing if the answer was to the question asked or logical, they would fire off another questions at a shouting tone of voice because they mistakenly thought he didn't hear them. Now the elder is trying to answer 2 separate questions and of course looks confused. Anyone would be confused. I really think most of the medical profession lacks the inability to constructively work with the elderly. They are there because the care of the elderly is paid for (quite well) by medicare funds.
They didn't really want to work with elderly people and are very dismissive of them in general.

Take a dementia lable with a grain of salt unless you see behaviors daily to support it.

Elizabeth

star42 Dec 2012
Thank you all for your responses. Thank you igloo572 for the list of tests. I'm fairly sure it was the MOST; it was brief, didn't take very long and the questions sound familiar. The doctor showed him the results of the exam; she pointed to the _________line between 20 & 21; he scored 21. She said that 20 is severe dementia (I confirmed this score with the manager at his AL, she also said 20 is severe dementia) and 21 was just one point above severe. He said "then I'm ok". She told him no, you have dementia. He argued with her, told her nothing is wrong with him, he once again insisted he's ok. She told him they would perform more tests and will schedule them. I called re: the appointment which has not yet been made and was told they have a week to 10 days to set the appointment, prior to scheduling there will be a consult. Does anyone know what the consult consists of? I have to continue to call them since he tries to schedule doc appointments, keep them from me, schedule on days I'm not available and tries to have his bro & sis in law take him. He has now changed his address to his bros house (he has never had a relationship with them until now, and I know they are working on him to get control, because the sil tried that with a 92 old man 20 years ago, it was an ugly ordeal, the family sued and won.) My husband also had the nurse read the list of meds to him and tell him what they were for. He proceeded to tell her to take half of them of the list because he does not need them.. He's on two medications for dementia, plus many others for his health. He said he does not need blood pressure med, however he had at least one tia, which may have something to do with the onset of dementia.
Once again, thank you all, any other information you can provide will be helpful. I've talked to an atty. I sounds like not much can be done with the bro and sil, since I have no absolute proof. He could contact them, but he said that would essentially be my accusing them of being up to no good, and that could make them even more aggressive and sneaky. It makes me sick that my husband is going behind my back, lying to me, and relying on the bro & sil that never, ever had anything to do with him. The sil has spread vicious rumors about me and my husband in the past that had no grain of truth to them. I have no idea why she and my husband were always bitter enemies, it was that way when I met my husband, now, they'r best buddies??????????????

DanielRomero Dec 2012
Hello, My mom was dignosed 14 years ago...she recently passed away. At the time and I believe what is still true now is that only an autopsy can confirm Alzheimer's. When my mom was dignosed other causes of dementia were ruled out i.e stroke, brain tumor....now with technological advances MRI, PET scan and spinal fluid analysys.there are more testing options....Speak to the neurologist and good luck....

Mamoogins Dec 2012
You really need to take heed to all of the answers above. They may do 1 to several of the tests as well as the MRI's and/or CT's. This gives them a good baseline from which to start.
The medications are very helpful, depending on the type of ALZ or dementia he is diagnosed with. The ALZ meds do no good for my father's multifract dementia, but the mood stabilizers make him much easier to deal with. He has a whole list of diagnoses, so we have to be careful that he does not wind up with poly-pharmacy.
If you don't already have an attorney, seek out a good elderly care attorney, not only for all the things mentioned above, but also to assure that when the time comes for the NH, all your financial affairs are in order and for your future as well.
Our prayers are with you.
S.

igloo572 Dec 2012
DEMENTIA TESTS: 3 main tests. Different yet similar….

1. Folstein aka Mini Mental State Exam (MMSE) - 30 point test. Takes about 10 - 20 minutes & looks at math, memory, orientation, basic motor skills. MMSE is copyrighted & needs training to do, so usually done by gerontology MD’s; MD’s,residents, student MD’s or trained staff @ teaching hospital; or nursing home with teaching hospital staff. Score is 27 or more=normal; 21-26 mild; 10-20 moderate; under 10 severe. Folstein has problems for bilingual persons.

2. Mini-Cog: a 3 item recall & a clock drawing test. 2 -3 minutes to do. Should not be used alone as a diagnostic.

3. Memory Orientation Screening Test (MOST): 1. Memory -3 word recall; 2. Orientation - to year, season, time, month etc.; 3. Sequential – memory for a list of 12 items; 4. Time – organization and abstract thinking using a clock face. The MOST takes 5 - 7 minutes. Gives a score from 0 – 29. Highly reliable.

Other tests: If Frontotemporal dementia is suspected, can have an Addenbrooke’s Cognitive Exam done. Not all dementias are the same: orientation, attention and memory are worse in ALZ; while language skills, ability to name objects and hallucinations are worse in other dementia’s.

Data analysis found the MOST to be more reliable over time and more accurate in identifying cognitively impaired patients than either the Folstein Mini Mental State Exam or the Mini-Cog. The MOST also measures changes in a patient’s memory over time. This permits the doctor to identify progressive loss or positive responses to treatment.

My mom is in a medical school gerontology program and has had all 3 tests done over the past decade. Also CT and MRI's to measure brain shrinkage.Once her MOST score got to a 13 and repeated it was stopped. She probably has Lewy Body Dementia and has hallucinations (one of the hallmarks of Lewy). Her point source for stealing and doing stuff is either strangers (that she see's outside) or this one lady who was at her IL who was my aunt's friend in high school. This lady died but in my mom's mind she still exists and steals from her and often and comes to my mom's NH just to do this. This is just one of her "fixed false beliefs". My mom is on Exelon patch and Remeron and I firmly believe medication makes a huge positive difference if taken correctly. Good luck!

igloo572 Dec 2012
Star - As far as the test score - he either had a Folstein or a MOST test done to get a a score of 21. I'll do another post with what the 3 main dementia tests are.

Hang tough because it is only going to get worse. What is your legal situation...by that I mean are you his DPOA, MPOA, Guardian in Case of Incapacity? Has this paperwork been done? If not, I'd suggest that you (not him but you) go on your own to meet with an elder care attorney to see what the options are in your state for you to take charge of him and also take all your financial so that the attorney can evaluate what your situation is as far as "community spouse" assets are and what you can do now to plan for your long-term financial. It is looking like as your hubby will need to go into a NH in the near future and you want to be proactive financially so that this does not leave you with a difficult financial situation.

Not to be rude, but it sounds like he is going to be the supremely mean type of dementia patient and he has decided that the point source of his inability to be cognitive and competent is your fault. Is it the case that whatever you suggest - whether it's medications or choice of what to eat or TV show to watch - you are always wrong or stupid? If not, then be prepared that is to come as he is fixated that you are the problem not his disease. No amount of talking is going to change this as it is a "false belief" and a part of dementia. You need to figure out how you can deal with it that doesn't drive you loco or get your blood pressure up. Most Agency on Aging have ALZ caregiver programs that can help you with this. This site has a drop down list of AoA's by state - it's your tax dollars, so use it!

It sounds like he has a ready audience that believes him too. So sad as they could be so helpful if this wasn't the case. But eventually, he will start to fixate on one or more of them too as he has done to you. Good luck. Will post test info next.

naricinfo Dec 2012
According to the Foundation for Health in Aging a healthcare professional will "do tests of mental abilities including attention, memory, thinking, language, and decision-making skills." The National Institute on Aging says:
To diagnose Alzheimer’s, doctors may: ask questions about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality; conduct tests of memory, problem solving, attention, counting, and language; carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem; perform brain scans, such as computed tomography (CT) or magnetic resonance imaging (MRI), to distinguish Alzheimer’s from other possible causes for symptoms
You can contact the Alzheimer's Disease Education and Referral Center and speak to an information specialist.
Good luck!

turtleval Dec 2012
Anti-anxiety meds can help with paranoia and ill moods, and they need to be adjusted as the dementia becomes worse. They have been invaluable with my mom. Good luck!

Mamoogins Dec 2012
These tests can be performed by a neurologist, psychiatrist, a gereatrician, a mental health social worker, behavior specialist; a list of individuals. Your best option is to call your husbands doctor or the local Alzheimer's Association and find who gives these batteries of tests in your area. Since you have the internet, look up your local number and give them a call. They may even list on their website a number of doctors or places that can administer the tests.
You won't find the test on the internet, because they can only be given by a trained specialist.
The Alzheimer's Association or your family physician is a great place to start. BTW, paranoia and ill moods are part of the disease or ALZ and dementia. I know, I've gone through both of them with my father and it can get worse.

michsoph1 Dec 2012
I am also interested in this answer. My father is forgetting things, especially new and short-term conversations, schedule changes, etc. He is also misplacing things that newly arrive in the mail. I am worried he is going to forget something significant soon. I would like him to be diagnosed so that I can make sure his bills are followed-up on.

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