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decidedimdone Asked August 2019

Who do you contact for testing for dementia and Alzheimer's?

Who do you contact when you suspect the person you're caring for has Alzheimer's or Dementia? Me and my brother have been caring for his father for several years now (who's been living with us), yet now his mental health his started to deteriorate.


When left to his own devices, he's started talking to himself (which was always a 'thing' with him), but now he's arguing with people who aren't there and accusing me and my brother of things we didn't do. He asks us questions, but doesn't accept the answers and constantly complains about everything we do.


As of late he's almost always confused and stays up the entire night talking to these voices, to the point of arguing and screaming at them; which he first tried to explain away as coming from TV, neighbors next door, 'demons' or now blaming us for causing it. Talking does no good, because he not only does not trust us or believe us, he vehemently denies this behavior and desperately tries to blame it on something else, instead of actively seeking help.


His primary doctor has tried a battery of meds like Lexapro to help with the anxiety and now insomnia he's been having, with no luck. He's been doing home dialysis for almost a year now and we've been through a crisis of him having an infection, so the confusing is definitely not from that.


We've stuck with him through a lot, but I honestly don't think we can deal with something like Alzheimer's or dementia that not only needs specialized care, but someone around full-time, not when he has so many bills piling up and we've long since gone past part of neglecting our physical and mental health.

decidedimdone Aug 2019
OK. Short update - my brother was able to setup an appointment with a gereactic specialist for next month, for his dad and he saw his kidney doctor, sent in blood and urine work, before his father blurted some nonsense about his brother being murdered to anyone who would listen, including his kidney doctor.

His kidney doctor is fine with ending the home dialysis and the social worker at the clinic gave us some documents for a health directive/health agent/dpa. We just need to see legal aid and get things notarized. Unfortunately, my father isn't sleeping neither during the day nor at night and is literally confusing his dreams with reality; and accusing us of trying to harm him along with making open threats to kill people.

Geaton777 Aug 2019
Decidedimdone, you cannot get PoA from someone who is not in their "right mind". Also, does your client have any relatives? Any children? You can try to get durable Power or Attorney through an attorney who specializes in elder law. This way, if your client is deemed "competent" by the attorney and is able to sign the PoA and voluntarily designates you, the PoA authority can not be questioned. You will be above reproach in regards to your client voluntarily giving you that ability. You can go online and download DPoA forms and get those notarized but I think that document can be more easily contested. You will need 2 non-family witnesses at the notarization. Hiring an attorney will cost about $400 but your client should pay that fee. Financial and other forms of elder abuse is rampant. That's why going to the attorney is best option.

Yes, as mentioned do get him tested for UTI. Also, you can start assessing your client's mental capabilities by having a basic dementia/cognitive test done by his regular doc. You can request it discretely. You will also need your client to sign HIPAA waivers for each doctor otherwise they cannot legally share any information with you, no matter what.
decidedimdone Aug 2019
Thank you for the reply and advice, Geaton777. I've called the local Agency for Aging in my area, as 97yroldmom suggested and am waiting for them to contact me back. As for the DPA; my brother and I already setup a Durable Power of Attorney for his father shortly after he had two strokes in his eyes and became legally blind, due to complications from an older surgery he was willfully ignoring. However, it was for finances, until he was well enough to manage on his own, which we got notarized and witnessed with a lawyer. Unfortunately, his health never improved and now he's showing signs of dementia.

His primary doctor is aware of his condition and how long we've been caring for him, along with his kidney doctor and doctors as the hospital he used for years. I've also talked to my local legal aid and they told me it's possible to amend the current DPA to add health-related coverage, given we're both legally able to sign for him, due to the issues with his vision and hearing. I honestly do not want to leave his care to the state, due to the horrible experiences I've had when my mother, prior to her passing away. I'll contact his primary doctor about doing a basic dementia/cognitive test.

As for the UTI test, he'll be going in to see his kidney doctor tomorrow, for his bi-weekly checkup for his home dialysis, so with his usual 24-hour urine and blood-work, I'll ask them to check for a UTI, though it honestly doesn't seem like it since this has been going on for over a month and getting progressively worse. As for your other question, my brother is his only living child and there's no other relatives in this state who are willing to help.

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97yroldmom Aug 2019
You can contact your local Area Agency on Aging and ask for an assessment. It sounds like maybe he’s already been checked for a UTI? These infections can make dementia symptoms worse.
Testing with a neurologist might help nail down what is going on but getting him into alternative care can take time.
Should he have to be hospitalized for any reason, refuse to bring him home but know that depending on your state, placement may be difficult without spending a period of time on a waiting list. So best to look into things now. Let us know how things progress.
decidedimdone Aug 2019
Thank you so much for the answer. I'll look into getting him a neurologist and talking to my brother about alternative care, if things don't work out with the neurologist. As of now, I'm chiefly concerned about him hurting himself or others when me and my brother are out running errands. I'm also looking into setting up a power of attorney to deal with his health decisions, now that it's gotten to this point, but I don't know about the costs to set that up in Eastern TN.

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