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On this board, a recurrent theme seems to be that general practice MDs won't help caregivers getting elders "committed", and won't give a firm diagnosis of AD and 'dementia' and are loathe to sign papers that will hasten an interaction with Social Services. They're supposed to be patient advocates, as I understand it. I've run into this with a GP. Are they worried about liability, lawsuits, other time-consuming legal involvement, actual medical issues, or what? Because this is the interwebs, you don't need to be an MD to answer, and your speculation is welcome ;-)

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Ya we are 8 ys in and I am having her tested just cuz I want to kinda know what to expect some kind of indication how advanced things are now and if possible some inkling, sp? to how much time she has left...just because not sure if can still keep her here taking care all alone much longer. I don't think they will be able to firmly tell me that anyway just want it done cause It should have been done long time ago and just want it done! it will not harm her so why not is my question cuz I did have the same thought ...it aint gonna change anything! but the level of comfort of just having these test done I think will help me feel in control somewhat!!
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It honestly does no good to find out if they have dementia, Alzheimer.s, bi-polar, schizophenernia, depression or any other type of mental illness because it boils down to 2 things: either long term commitment which they will either not agree to or can afford or a family member quitting their job, going into financial ruin and having their family live in fear that this person is going to kill them. I honestly think it has gotten to the point that doctors are letting certain things slip by or not treat because it is prolonging the agony and yes I think it is on purpose.
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I forget, Lol!! to say, all of mom's missing files were found in the trunk of her car!!
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My PCP, also my mom's PCP, will do mini memory tests, he will diagnose dementia and prescribe Namenda, Aricept. He will not diagnose Alzheimer's Disease or a psychiatric illness, he will only suggest an evaluation by specialist. I believe it is because it is not in his licensing as a dr. to diagnose outside of PCP. Because a neurologist is more specialized in dementia, they can state in 90% of the time whether it is vascular dementia or Alzheimer's (and other dementias) by testing and ruling out. My mother has always been distrustful, suspicious, obsessive, accusing family falsely, needs to be the center of attention,etc. I am not a dr. but I decided my mother had a paranoid personality disorder years ago. My sis says mom has Schizophrenia. During 2012 as mom progressed into Alzheimer's, her paranoia got worse. Her PCP could not help us because mom was still mentally competent. Her PCP would not diagnose mom as mentally incompetent but when the time came, he did write a letter for us stating she had severe dementia. We then went to a neurologist, after testing mom, getting a ct scan and blood work, he said she had Alzheimer's Disease and was mentally incapacitated, could not make decisions for herself. Believe me when I say 2012 was a stressful year because was accusing me and sis of stealing, coming in her house when she wasn't at home and taking her financial and medical files. Her PCP would not report mom to DMV, but once sis and I reported mom as unsafe to drive, her PCP got on board and helped. It was frustrating and now that we are through that stage, I feel her dr. helped us as much as he legally and medically could. I truly appreciate everything he has done and is continuing to do in treating her for Alzheimer's. She is now on Namenda and an antidepressant, both drugs are keeping her stable even though she has recently gone through a major life change by us placing her in assisted living/memory care. I continue to take her to all dr. appts., and all the things I was doing when she lived at home except giving her the medication, making sure she was eating and was safe. She has even gained 5 lbs. I work part time, my sister works full time. I visit 3 times a week.
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oh ya ....I will pray for that, I had completely blocked him out of my thoughts but I will start to include that, justice is served...I hate him but wish him no harm , however he needs to know he was wrong...I will send dad to haunt him!!!! lol !!!! I should have at least filed a complaint against him with the medical board, but I was beaten by then! I had to focus on MA n frankly she needed the money!!! I was pissed and if no benefit came to ma I was going to move on! But that is wrong it should be on his record!!!
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This doctor will be caught up with someday. And I hate to say it, but because he was 78, he won't generate much punitives because he was old and sick, so sadly that is how the courts view it too. But for his negligence, the doctor should be held accountable somehow, someway, someday.
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"I felt and still feel" completely failed and disgusted with the entire system!
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oh how ironic bonfire..i was going to add that last part about the lawyer but I was tooo emotionally upset to go back to thread...
I contacted Idk how many lawyers, by phone, explaining our story...I could not even get anyone to respond. most politely said they would not take the case..but one did get a little more graphic...
"well he was 78 and on SSI...no lost income so max allowed for pain n suffering is 250k...you will probably settle out at half that if lucky add legal fee and taxes.. your down to under 50k...its not even worth the effort, I wont do it" I am a little grey on the exact breakdown of numbers but pretty close! And so coldly matter of fact about it....I was disgusted with the whole system and just gave up! I would do it all...hahhahhha!!!!
But thank you so much for understanding...it was the most horrific experience I have ever lived thru.....I felt completely alone and failed by the world!!!
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Jujubean, get in contact with a medical malpractice lawyer. You may have a good reason to sue this butcher.
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Medicare paid him to kill my dad! I wanna barf!!! I HATE this F #$%^\G system
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The appointment after dad's death too I'm sure that was billed even tho it was 5 mins and he didn't even know dad had died, I just had to look him in the eyes....so basically he got 4 office visits to do nothing for us!!!
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And that bastard got paid by Medicare to say "sorry I cant help you" cuz he surely billed for the appt!
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I have to add to above I agree...I cannot even find a dr that will take a medicare client up here she is now going to the low cost community clinic, the only ones who will take her...I am going to search again as I can, cuz this is BS I need the right DR Bobbie!!!
What pisses me off is we have to take the burden of being the advocate and researcher but that is what they get paid to be/do to know the medical field for the client or don't accept the damn business, not because of medicare...who the hell is paying me for my time..i drive a broken down jalopy with a leaking roof over our heads.... I know they don't!!!
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You know, Juju, you triggered a thought on a topic I have discussed with people for several years now with regard to medical intervention: Just because we CAN, does that mean we SHOULD? The human body is only designed to live for a finite period of time. At some point (sooner for some than others) things just start to break down - not unlike your car. Time and time again I have seen elderly people being given surgery, meds, etc., which may improve quality of life slightly, but they also may just drag out the inevitable. Sometimes I think medical decisions are driven more by what Medicare will pay for than by what is truly in the best interests of the patient. Also, doctors are supposed to do whatever they can to prolong life, but at what price to the patient and the patient's family? So we bankrupt elderly people by making them pay for assisted living and nursing home care for YEARS, when they are not really living, just existing and only because medical science has enough chemistry to keep them on the bubble indefinitely.

As to addressing the main topic of this thread, I think docs are largely driven by trying to avoid medical malpractice - that and doing whatever Medicare will pay for. I agree that your average GP is maybe not the best equipped to handle geriatric patients, but there are very few geriatric specialists - maybe because Medicare is their primary insurance plan and Medicare pays less than private insurance. The GP who has been my parents' doc for many years will not even treat his patients if they are in a nursing home or in the hospital. So he only sees them when they are ambulatory, never when in crisis. In this way he is usually unaware that there has even BEEN a crisis, since the hospital and nursing homes NEVER send the records to their primary doc. Even if they did, I doubt he'd read them. Now that my sibs and I are caring for our parents, their doc is told a LOT more about what REALLY goes on, and the quality of their care has improved.
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Juju,
It sounds familiar. Just keep writing it out.
I wonder how Roscoe is doing. I know that he has got it very rough.
Thinking of you Roscoe and everyone.

lovbob
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She is my pseudo child i guess, since i don't have one, i want to mother her but she will not be growing up!!
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allright this is stirring up more stuff...so i have to get it out.
I just realized, i am doing this for me as much as her. Ironically i left home so young because of her, not him! She was angry depressed woman who worked constantly...i had no relationship with her. she loved me i knew but we did not get along at all...when she was home and not dealing with dad's shenanigins, she would be taking out all her fustrations on me the youngest home. My dad and i had the good relationship! cause he was home more often, drinking n crazy but home, and we did get along great. I think she hated that fact not purposefully but just her only baby girl and he n I were the "buddies" that has got to hurt...anyway, once we moved out we had a much better relationship and dad n I waned. As i matured and understood more of the situation.... We still never got along great but it was much better. She was always angry and depressed, passive aggressive, and i couldn't deal with it! I had my own life now. Well 20 ys and distance i didn't see them often..holidays n bdays etc..
When i picked ma up from Nursing Home, she had changed dramatically since our last visit 8 mo ago! when i had her in my home those first few months figuring out our next move. i realized she had cocooned into a sweet loving most adorable creature on earth. I want to spend every minute i can with her...she cant be mom in words of wisdom etc...but she is still my momma and i love seeing her happy for the first time in her life!!! I don't want that part to end!!!! Oh god i am balling like a baby again...i am outta here!!! SORRY SO DEPRESSING AND OFF TOPIC!
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Last thought tho...I just realized that dad in that last month was so combative with me probably because I had mom and he wanted her home...we were 2 hrs apart, and I was holding on to my job by a thread thru this! he saw me as withholding mom from him....Maybe? idk he was a very ill man, all his life, that is why I do what I do for my mom...she deserves a good end, she lived in hell! I got to move out and did at 15! I really have no idea how she stayed married to him for 58 ys but they did love each other....in dads hospital stay the only thing he sed before going unconscious forever. "I just want to see my wife, and for the life of me I cannot figure out how to get to her", it broke my heart! And "give me a cigarette would ya" lol, that's dad!
K sorry done!!
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Joyce-I have thought about that too, are we living way beyond our years? why Is this an epidemic now...as to 50 ys ago. Is disease on the rise or are we artificially extending life...
Bob-yes I agree it is up to us to be our own advocate! I remember when sherriff called and had found dad..first thing I did was Google lithium toxicity. webpage appeared with a skull n crossbone logo on it...after reading that I knew things were not going to turn out well!
Thank you everyone for your support! That was another healing post here!!
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I know that nite dad died was the nite I started to believe there is a "higher power" out there....that HP took the decision out of my hands for me! Seriously I am eternally grateful, It was a decision I did not want to make! Something is out there!! Karma, Jah, God, Buhdda... idk...but it is there!
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When I realized that I had to intervene in my mom's care, her GP was useless. He went as far as trying to intimidate me into backing off of my position that my mom had Dementia by accusing me of 'wanting to take over'.
Well, yeah, I had to take over because mom had, um, Dementia.

I did the research and came up with Namenda and Aricept and told him to give me prescriptions for both. After arguing with me (pointless) I got the scripts and noticed an improvement in my mom.
You don't have to fire a doctor, you just never go to them again.

After more research I found a specialist and took mom there. The experience was 180 degrees away from the obtuse GP.

I stated in another post that if you are not dealing with a specialist, then whomever you are dealing with is not the smartest person in the room. More than likely, you are.

The Internet is an amazing tool and the bane of doctors everywhere.
With it we are better informed and less likely to be relegated to a position of 'whatever the doctor says...'
You know when you're getting bs'ed. Move on to someone who gets it.

lovbob
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I think we are living in a society where medical advancement has been a blessing and a curse. We have individuals that would 15-20 years prior died of cancer, heart failure or some other medical problem and they are living longer and many times it is like dealing with zombies because while the body is still going, there brain is gone.
And it is all the families fault.
My FIL has been found with a gun held to his stomach and it was reported not only to the visiting nurses but to the police. He cut himself on the abdomen over and over with a knife when he did not get his way and lied to the nurse and was told, "ohhhh....that's okay honey, we get to feeling that way when we are dying." Problem is? He isn't dying. In fact, Hospice has been called off. He is in rehab and physicall stable.
We are told he is depressed (2 anti-depressants are doing squat), he has a paranoid disorder and that he has excessive sexual fantasies (he is 86). He has seen a psycharist and we are told to just dismiss all of it because he has a touch of dementia and to not be shocked by his outlandish behavior. The problem is, we have told them he has had this behavior for decades, has been committed once before (for one year) and they just sit and smile and say, "okay now...what are you going to do about bringing him home?"
No one takes us serious so since we can't get him committed, there is the next best thing -- long term nursing home care. We don't care if it takes all his assests, his house and pension, let someone else deal with his "issues."
So no...they will not sign for them to be committed because they want to blame the family. We are not understanding enough, we should spend more time, quit our jobs, mortgage our home and live on the street. Oddly enough, I don't see these doctors doing the same thing...
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And one of the last sheriffs we dealt with. who although could not force dad to let us enter the home could suggest that if his vehicle where to somehow mysteriously become disabled by doing XYand Z that mite be some level of comfort and he was going back to his cruiser to do some paperwork before he had to escort us away from the home!!! ANGELS!!!!
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Thank you so much for understanding...it does mean a lot coming from a medical professional!! and your words are graceful and comforting! it amazes me how fear of malpractice can override decent common sense and the oath to serve a patient...but Im no expert...
I do know the last night of dads life an angel was sent to me in the form of a nurse....it wasabout 10pm sunday nite, 3 days after he was transferred to "3rd floor", I was getting ready to go back to our motel for nite and a nurse pulled me aside wrapped her arms around me and said..."im not saying this but what are you really gaining here..i sed dr yesterday said 50/50..she shook her head and said honey you need to be brave and just let it go, he is not coming back! after that I had a long talk with my dad begging for guidance and to just let go if need be, "oh dear god. whoever you are, I don't want to make the wrong decision but I am compelled to confront DR first thing in AM"....I was beat and went to hotel, showered, hopped in bed and ringy dingy....they sed things were changing we mite wanna come back and we did...dad was gone by sunrise! I will forever be thankful to this nurse, who I have no idea who she is but was the only one willing to give it to me straight....she will forever be an ANGEL OF MERCY in my life!!
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Jujbean, you have every right to blast us with the details. That is a horrendous story. Your dad did not recieve the care he needed and you were left helpless to do very much if anything about it. In the name of preserving individual freedom the system failed to take of someone who simply could not make the decisions needed to take care of himself, and what possible reason that particular doctor would not sign off is certianly a mystery to me. Was Dad threatening to him? If so, surely he should have seen through that and acted accordingly and proceeded with doing the right thing instead of succumbing to the temptation to avoid conflict. If I could validly apologize to you on behalf of our entire profession, I would.

I am not sure what I would have done if the pscyhaitrist and the primary docs at the assistive living had not given me the letters certifying mom's being unable to manage for herself which offically activated the DPOA I had in hand...running around to get second opinions is not easy, especially with an uncooperative patient.
And you can bet I was angry about mistakes and lapses in my mom's care, which happened, fortunately none of them with disastrous consequences, just aggravating to her and to me. I am sorry not just for your loss, but that you have such bad memories and the knowledge that it could have been handled so much better...you have every right to express your heartache here.
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oops guess I did get into details...I get so darn passionate!
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Without getting into detail, dads Dr killed him basically...by not signing the order, dad had already endangered mom per his(DR) own statement she had finally been picked up found in her own waste on the floor of their home, and taken to a facility and he would only release her to me. was taking minor spills, cut n bruised, he was hallucinating and thought we were trying to harm him and break into his home he was so sick n frail, flooding the home, leaving gas on attemting to drive, already having had a recent accident, etc... this was all documented and presented to the DR Anyway we contacted the lawyer prepared paperwork and he refused to sign! THe lawyer had a previous telephone conversation with him stating he would sign anything needed to help us but when we got to the meeting with the paperwork, he said he would not....that my dad should just rely on his family and social network and stop all this nonsense! We battled the system for a month (on our own APS didn't help us either, no kidding) until he went missing one day and was found in hospital suffering from severe lithium poisoning...he OD'd on his own prescription.
3 weeks later he was dead! I went back to that DR and told him dad was dead, face to face, I was so furious with him.. He had the nerve to tell me well that is unfortunate but one can OD on Tylenol...I told him oh no, you will not go there this time...Lithium is toxic medication and dad did not release us to have his records so we did not know what he was taking...it was your job to follow this thru...you dropped the ball...it was your damn job to know a demented hallucinating patient on a toxic med is in danger!!! To this day I hate that man just for his stupid cop out! anyway...I wonder now maybe the attorney never did get a positive response from him we weren't in on that conversation, maybe he just took our money! I swear I don't trust any of them so called PRO'S dr or lwyr!!! anyway I rant but yes he was a coward to go to battle with my dad idk why but he would not do it. but SURELY my dad is dead because he did not, and it was not pretty, he suffered!!!
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Physicians, either MD or DO, unless they have special interests or special training, just don't have the inclination or the expertise to do social work or serious geriatrics! Most will not even know how to do an MMSE (mini mental status exam) and are easily fooled by a little "show-timers" and will even miss the early cogwheeling tone that happens in Parkinson's and with antipsychotic drug side effects. They (ok, we) generally tend to avoid things that are going to take a lot of time and coordination efforts, and also could be fearful about the possibility of being the middleman in a family conflict over driving or competency...they would be rightfully concerned they would not have the tools to distinguish someone out to steal money versus someone out to keep an elder safe from scammers or living at home alone when they really can't. I really recommend geriatric specialists or some neurologists to properly diagnose dementia; please note while you'd LIKE all the docs who serve as attending or primary physicians in nursing homes or assisted living facilities to be geriatricians or geriatric experts, most just aren't. And espcially if you and/or your loved one don't overtly look like you are about to fall apart, you will have to ASK to get a visit with a social worker who might really know how to help.

One of the better things I did for my mom was to get her to a fairly comprehensive visit at the Benedum Center in Pittsburgh, and I got my hubby into our Longevity Center clinic here, though now he is back with a good family practice doc instead and it is working out OK, but then I often have to be in on it to nake sure he actulaly tells the nice doctor or the PT what is actually going on.
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Hi everyone - thank you for this discussion. My mom needs to be diagnosed with whatever she has. I am so tired of the depression, the crying and the phrase, "just let me go". I had one doctor that when my Mom almost had me in tears in his office and just being hateful to me say, It is hard t o take care of older people. Jeez, I know what she needs but how do I get it. I don't want to get her committed I just want to get her diagnosed. Take care of yourselves.
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First of all, a GP is hardly the type of doctor you should be visiting if your loved one has a dementia (there are many types). Neurologists are the doctors who make this diagnosis along with EEG testing (brain wave), an MRI (imaging of the brain), physical exam, and the standard short and long psychological exams. There is much to making a correct diagnosis, so it is not a simple task. It would also take probably a psychiatrist and a neurologist testing results to convince a Court the loved one is a danger to himself/herself and others. I don't know who you are trying to commit, but if the loved one is in imminent danger, then adult protective services can be called. No one will give you a definitive answer that the person has Alzheimer's disease until after they are dead and a brain biopsy is performed. They will give an insurance ICD-9 code of 331.0 which is Dementia, Alzheimer's type. I am a nurse, and have been dealing with my husband's dementia illness for over seven years and know more than I want to.
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