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My mom used to live 2 hrs away from us & had the same doctor for 30+ years. When we moved my mom in with us (it was the only way we could get her to agree to sell her house), she insisted on keeping her doctor. In the past year, we've made the 4 hr round trip for appointments. Recently, a few significant circumstances have taken place. 1) Mom has finally agreed that it's too much to drive back to her hometown for doctor appointments; 2) Her physician has agreed that we're going to need medical care closer to where mom now lives and 3) the doctor agreed (finally) with me that mom is exhibiting dementia. So, ok. I've got a 91 yr old with cognitive decline & I need to find a new doctor for her. The closest geriatric doctor is 40 minutes away in downtown Boston. NOT an option as far as I'm concerned. Should I go with a regular PCP? Should I be looking for a psychiatrist instead because of the dementia? The current doctor has been rather vague and unhelpful and hasn't done much else but say, "Yup, dementia - and that'll be $50 in administrative fees for copies of her medical records." *Sigh*

Try looking in the umass system, they have a lot of drs in central mass.
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Reply to kellse
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I would go with the 40 min geriatric. It was worth it to me and my parents to see doctors 3 hours away. We weren’t lucky enough to have a geriatric only 40 min away. Saw them once a year. A professional visit where everything was checked from soup to nuts and what came up handled over the phone and through home health.
With my aunt (92) we see her geriatric primary only two hours away once a year. Now that urgent cares are here if I get antsy I have a good one within a mile for sniffles or UTIs etc. I also utilize HHC for her blood work.
For things like eyes, ears and feet I use local talent.
if you can get it all handled in a day from the top physicians then it’s worth it to spend the time driving ( to me) rather than sitting in a waiting room. Sometimes you have a great doctor but subpar ER and hospital in the smaller markets. I have found that it works to go to where I can get the best of both for my loved ones.
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Reply to 97yroldmom
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I know the insides and outs of Boston driving and I don't recommend. The specialist that your mother needs is a neurologist, who will give her an M.R.I., which is the gold standard for dementia diagnosis. Where are you located in the state of Massachusetts? I can help you because I hail from Massachusetts.
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Reply to Llamalover47
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Teri4077 Jan 30, 2019
Definitely a neurologist, not a psychiatrist, and the neurologist should also have you work with a neuropsychologist. But you do need a PCP who coordinates everything. If she just gets a cold, you want to have someone to whom you have easy access.
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I don't have an answer for you, but I know that this is a tough time! My mom is 87 and is about stage 4 with her dementia. We do not have a geriatric doc or a psychiatrist, but with her depression, hallucinations and paranoia, I have considered looking for one. But with my mom, there are very few meds her docs say could be a possibility, and sadly, the one they thought might help, made things worse, Others are not an option due to all her other medical needs and current meds. I think that drugs for mental health do not work the same in the elderly as they do for younger people. It seems to me we are in no-man's land, just waiting for the inevitable, eventually. I don't think the medical system has any answers! If you had a geriatric doc within a reasonable distance, I do think that would be your best bet. It is unbelievable how difficult dementia can be for the patient and for the caretakers!
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Reply to Bflogal
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If you're at all close to a large city, there may be something available in a clinical study on Alzheimers. I've seen several listed on line; might be interesting.
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Reply to partsmom
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Join NextDoor. It will ask for your location. Then you can ask your neighbors (as close as your neighborhood and/or as far away as Boston) for recommendations. I live in Florida. It’s how we find everything down here. You definitely about the best ones, as well as the ones to stay away from :)
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Reply to BeckyT
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Most local hospitals will have a "find a physician" tab/application or phone service listed on their website. This is a good place to begin as you can look at Physician reviews, who is accepting patients, the insurance they accept, location/address, etc. Definitely consider a Geriatric Specialist or an internist at the very least. Then it's a matter of filling out the paperwork to ensure that they do indeed accept her method of payment/insurance. Geriatric practices are typically better about working with Medicaid/Medicare and some even have ride options for those who do not drive.
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Reply to RaesAuntieP
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Geriatric would be my first choice. A PCP, you can go online and look at the credentials and find out if they have geriatric in there as well. Regardless, I would go with the doctor that acts like they care about your mother and wants to do more than just maintain her health but to actually keep her healthy. Doctors who are in it for the perks, or overwhelmed with too many patients, or too egotistical, are a dime a dozen. Also, dementia is progressive, as you may surmise, and there is medication to slow down the process but it cannot stop it. You need to get that medication as quickly as possible to help that situation. Good luck!
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Reply to Lizhappens
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Lizhappens Jan 29, 2019
Yes and a neurologist to diagnose the dementia. You will need a specialist for that actually. somebody else mention that and that’s correct. A PCP and specialist for the dementia that’s what we did.
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A neurologist would be the doctor you would want for a "grey matter,brain" problem, a psychiatrist would be the person to turn to for a "mental" "fixable or manageable " problem with the brain.
It sounds like you are not pleased with the doctor now at any rate.
If she has insurance look to see what doctors are in the area, and what you can determine by any ratings that there may be. Look for both Neurologist and if possible a Neuro-psychologist. A neuro-psychologist will work with a neurologist to help form a good plan.
Frankly, in my opinion, at some point there is not much that a neurologist can do but prescribe drugs that are supposed to slow the progression. The kicker is at what point are they no longer effective and at what point do you discontinue them...They do not make better what is wrong.
A good Primary Care Physician can prescribe the same medications, a good PCP will refer you to another doctor if there is something that he or she can not handle. And at that point if you trust the PCP they will refer you to someone they trust.
So what I would do is look first for a good PCP and then if you need to find another or a specialist search after you see them.
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Reply to Grandma1954
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I found it difficult to get my mother into see the highly rated doctors. See if her current doctor can get her in to see a primary care doctor in your area. The New primary care doctor can then help you get in to a neurologist that specializes in dementia care. My opinion is you should have her evaluated by a neurologist. This assessment will aid with knowing if her brain is impacted or is there may be something causing the dementia like condition. Based on my experience you will need both to confirm and potentially treat dementia.
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Reply to linda2019
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Oh so hard. Since she is 91 bkess you both. But if u can get a PCP for general appts or a geriatric MD or even Nurse pratitioner that specializes in geriatrics even better. Then get a psychiatrist that specializes in geriatrics if possible for the mental disorder.
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Reply to Levans2008
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Try calling your doctors office and ask them for a reference, explain that need someone who has experience with geriatric and dementia. They may know of a few in the area.
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Reply to mistyanne7
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Choose a PCP close to you since she needs general care including medicine refills. Go to.her insurance webpage to find a doctor under her insurance. If she has medications for the dementia, use the geriatric neurologist as a specialist that she would visit less frequently.
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Reply to MACinCT
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You might use “Yup-er” for her general medical care and try to seek out SOME specialist with geriatric experience and training.
During our search we found psychiatrists, psychologists, and social workers who had training and experience with geriatric issues. Once again our experience only, ANY specialist without geriatric training was pretty useless.
Our BEST experience has been with a fine psychiatric PA, who got to know LO, initiated a trial of a very small dose of antidepressant/anti anxiety medication, and has followed her during her stay in the MC Unit of a good AL.
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Reply to AnnReid
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Marylin Jan 28, 2019
If you can, please tell me the name of the anxiety drug prescribed. TY
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My sister found a great doc for my mother on FaceBook. She just threw out the question "who knows of a good geriatric physician in the such and such area" and pretty soon she had a list to cull from.

In a smaller town, yes, there would be fewer candidates---but you'd be going on the word of friends.

Also, Google the "Health Grades" of drs in your search.

Mother was switched to the "new dr" didn't like her and switched back to the one who is her age (89). Heaven help us. He should have retired 25 years ago.

You can lead a horse....good luck with this.
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