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. . . what specific tests should I be asking for?


Mom diagnosed with mild cognitive disorder 10/2019, in hospital, via 10ish questions at bedside by psychiatrist. Since that time, she won’t return because she ‘doesn’t relish the tests they’ll give her’. Her DL is now suspended. Am hoping this neuro office will call Mom to request her to come in....


I want to ask that appropriate tests be given to Mom, to help her process this diagnosis and discuss the prognosis with her. She certainly doesn’t listen to me or want to be shown the hospital reports, which I’ve tried to show her.

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It’s helpful if you write a brief note about any pertinent medical background and say what things you see your mom doing, or not doing. Then give this to the staff when you check in so the doctor can read it before you meet.(Or if the doctor’s office is set up to do online medical record management you can send it in that way.) Mention your mom’s reluctance to discuss- that ensures the doctor doesn’t make your mom guarded. Most doctors have a standard set of tests they will use, but additional information can help them.
my mom knows she has some memory deficits, but since I had shared with the doctor that she wouldn’t want to hear the AD diagnosis, the follow up discussion of her test results just focused on where she was strong or weak. There’s no point in trying to discuss a diagnosis with them if they can’t accept/process it, and with the memory loss it’s like you deliver it anew and upset them each time you try to discuss it. Just easier not to go there, in that case.
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Reply to ElizabethY
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If the patient will even talk to a neurologist just ask the doctor to do an evaluation and provide the doctor ahead of time with a list of concerning behavior. The doctor will decide how to do the evaluation. There are many types of exams. I recently did the MoCA as part of participating in a clinical trial. It seems very unlikely to me that an unwilling patient would even get through it.
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Reply to vegaslady
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I think that you can probably google some of the more common tests and decide what you would want tested most where your own Mom is concerned, at least what to ask about. Usually a good neuro-psyc Doc will know what he or she is doing. I think lately we are seeing some scary messages from OPs who have family members barely evaluated, who get told their elder is doing just fine, when they are seeing some signs of real problems.
There was a fascinating article in last Sunday New York Times in the business section about how many seniors are getting into real money problems with loss of executive function showing up many years before a diagnosis, often as many a 6 years. That is concerning.
If you are at all keeping a diary of what is going on, what symptoms are occurring, do share your information and it may help the MD made decisions of which tests to do.
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Reply to AlvaDeer
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The MoCa exam is very commonly used to diagnose dementia, based on a score from 1-30, but a neurologist would know best. Don't expect your mother to accept ANY diagnosis she doesn't want to hear! My mother was diagnosed with progressive dementia in 2016 with a score of 19 back then, and still to this day will tell you she is perfectly fine, has no dementia whatsoever, does not belong in Memory Care and on and on. In 2019 she scored a 10 on the MoCa exam! She's at the moderately advanced stage of dementia nowadays and is in pretty bad shape, but still insisting she's fine, and the others are "stupid" and "crazy", not her. It's really awful, actually. I never talk to her about her dx either, she's just that far in denial. Thank God she lives in Memory Care Assisted Living is all I have to say on the subject.

Good luck.
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Reply to lealonnie1
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