How do I get a diagnosis?

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My mother has been having mild symptoms of dementia for a few years. We didn't think too much of it but we were careful not to leave her alone for too long (she lives with me). This past spring her symptoms increased dramatically. We met with her PCP who mentioned that she may be suffering from vascular dementia. He did not do any diagnostic testing. No neurological testing, no CT scan....nothing. When I ask him about her confusion, he says "It's probably the pain medicine". Still no assessment of her symptoms. He recommended a book "The 36 hour day". That book confirms to me that she does display symptoms of vascular dementia but that all..... My siblings cover the hours that I work but the rest of the day/night is up to me.
My mother can not be left alone or she becomes extremely agitated and leaves the home panic stricken. She does not know the year, her address or the president. She does not recognize the homes of my siblings....says things like "I like Mary's house, I haven't been there before" . She also says "Where do I live". Some days are worse than others.....she is extremely attached to me and gets anxious if I go anywhere but work. She repeats herself countless times. I am beside myself with unanswered questions. Some of my sibling, who do not spend much time with her, think I am exaggerating. I know a diagnosis may not change her problems but I need answers. Does everyone out there see a neurologist? She can't have an MRI due to having a pacemaker. Any help will be appreciated.

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Babalou, thank you for responding. I guess I am looking for a definitive diagnosis. I am not sure why I need to label this. I do not believe that my mom's MD is convinced that she has dementia....she appears normal and agrees to everything he suggests. I don't know how he would have an opinion since he doesn't check her orientation. I emailed her symptoms so he could review them before her visit but he did nothing. He does a great job listening to her lungs and heart but he NEVER checks her orientation. I know that she is declining rapidly. I have scheduled an eye exam as suggested. I will also look for a specialist that deals with dementia and poly-pharmacy. Thank you so much for your suggestions.
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People can really be in denial when it comes to dementia. It's shocking what they will not believe, even when it's obvious.

I agree with the suggestions above. My cousin's primary doctor diagnosed her with significant dementia and as Vascular Dementia. Since she was so young, I followed up with a neurologist who focuses on Alzhiemers and other dementias and had further tests. The neurologist will do an in office physical exam and determine dementia. Then, he will order tests to help determine what is causing it. I would think his opinion would satisfy the siblings, even if you don't proceed with all the tests.
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I think you are right that seeing a specialist and having some tests would appropriate now. This could be a behavioral neurologist or a geriatric psychiatrist. The doctor should have experience with and an interest in dementia.

Many PCPs don't refer patients for further testing because they think since there is no cure for dementia there is no point. It is true that there is no cure, but there are treatments that can help with some of the symptoms and it is simply good to be able to consult with someone who truly knows what is going on.

Having a "real" diagnosis after some testing will also be good for you. You can share the diagnosis and literature from the specialist with your siblings. You can join a support group for caregivers whose loved ones have what yours does. You can educate yourself on what to expect.

Even after seeing a specialist who performs tests, the diagnosis will only be "probable." Diagnosis at this point can only be confirmed via autopsy. But it will be more definite after testing and review by an expert.

On a slightly different topic, if her PCP thinks her pain meds are causing her confusion. is he trying adjustments to that medication? If he thinks she probably has vascular dementia, why doesn't he think the confusion comes from that?

I hope you can have Mom evaluated more thoroughly. Meanwhile, you need to be more definite about this yourself. Instead of saying "my mom may have vascular dementia," say to yourself and others, "my mom has dementia, possibly of the vascular type." From everything you've said, I don't think there is any doubt that your mother has dementia. State that as a fact. Whether or not it is vascular may be more firmly defined by a specialist. How we frame things in our own minds helps determine how we cope with them. You don't need to leave this framed in total vagueness, even before you have a further evaluation. Mom has dementia. It seems most likely it is vascular.
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I'm a little confused by your question. You say her pcp says that she's probably got vascular dementia. Do want a more definitive diagnosis of dementia, or do you want to know what type, or what stage?

Do you need a referral from the pcp for her to see a neurologist? From what you're describing a psychiatrist who is skilled at psychopharmacology might be more useful. Meds for anxiety and depression would be useful st this point.
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She could have a CT scan of the brain while wearing a pacemaker. A good eye exam would also reveal evidence of stroke activity simply by looking at the blood vessels on the retina. Mom's retinal blood vessels had lots of little dots indicating ischemia and many places where collateral vessels grew around the blockages.
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