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I need to start discussing meds for Mom's dementia. How to provide enough info. Mom has been diagnosed with Mixed Dementia -Alzheimers and Vascular dementia. She experiences delusions (super complex), some hallucinations, wanting to go home, etc. Other times she is her former self, so it's intermittent. Even went almost completely away for like 2 months!
Mom had a stroke 6 yrs ago, right side weakness, so is bed or wheelchair bound. "Lucky" that way because she can't wander. I am her daughter and full-time caregiver. I think I'm managing OK, but so many people tell me I should start talking to doc about medications. Her doc gave me a referral to the psych pool in our network (Kaiser) but none seem to specialize in geriatric or Alz. When I go to the appt, how do I discuss symptoms in front of her when she hasnt acknowledged the disease and always reacts negatively when psychiatrist is mentioned. She imagines talk therapy. Would love to hear your suggestions.

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You matter-of-factly discuss them. I did, and mom just sat there smiling. *shrug*

You've reminded me of an incident in the ER. It was April. The doctor was talking to mom about his suggested med change, handed her a scrip, shook her hand, said it was nothing serious and told her to have a good day.

Mom gave him her cutest Southern Belle smile and said, "Merry Christmas!!"

I will never forget the look he gave me. I laugh even now. I just had to share. She's been gone a year plus. I still think of her every single day.
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Few ways...

Send a letter (many medical practices won't give out e-mail addresses to the doctor beforehand), emphasizing that to respect your mother, these issues will NOT be raised in her presence. However, you want him/her to be aware of them before the appointment, and to raise and address them then.

Or call and speak with his medical assistant or the nurse practitioner.

When you do go to the appointment, try to sit a bit behind your mother so she can't see your facial expressions, such as when you need to shake your head if she responds affirmatively to something that really requires a "no" answer, or when you need to nod "yes" when she says no.
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I made an appointment for my sister and I to consult with the geriatric psychiatrist referred by the doctor, to discuss our concerns and review our parents meds before their appointment. He was great! He also made suggestions to alleviate our stress from caregiving. I called the neurologist and spoke to him before their last appointment and brought a note that I discreetly handed to him listing our concerns. The general geriatric doctor sometimes pulls me aside in private or I call him after we leave the appointment.
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GardenArtist, I did the sit behind the patient and did the "yes" or "no" as my parents geriatric doctor always would glance at me whenever she asked my parents questions.

It was always a bit comical on the ride home, I would hear my parents in the back seat discussing their appointment and I would wonder if I was in the same room as them???
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I was an evil person and gave a hand written letter to the nurse that did the height and weight. I could usually slip that to her while she was preparing her chart notes for the doctor. I also did facial expressions. ....but had to be careful because my father could charm anyone into believing anything.....he really could wrap the doctor and nurses around their fingers....But you have to try whatever you can get away with.
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you all must have big exam rooms lol there is usually only 2 chairs and they are side by side. my mother sees like a hawk and notices *everything* including nodding, notes etc. she denies any symptoms, says we are full of it, that its normal to forget things at her age, its only been "a couple of months" she's had some forgetfulness (she was diagnosed in 2009), etc When I took her to the urologist she denied ever wetting her pants and contradicted everything I related to the doctor. Fortunately, I had the foresight to call the dr's office the day before and tell them about her Alzheimer's and that she was not a reliable historian so to please listen to the history I give them, not hers. That worked.

But when we were with her discharge team at the rehab center, she got very very upset when they discussed her care and condition like she wasn't even there and talked over her to me and my father. I really hated that they did that. I wanted to ask if they could consult with us privately but they made it clear that they include the patient in consults. I think that's silly because it treats them like a nonentity. How would you like it if you were in a room of people who talked to your spouse or adult child about you but you didn't think anything was wrong with you, yet they were saying you do this or that but you think you don't! then when you protest, hey I don't do that, they simply ignore you and don't believe you. Its awful. If she is ever in rehab again, I'm going to demand they do the discharge consult w/o her there. Its the kind thing to do.
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After you've played the back seater raising eyebrows and shaking head games, the doctors remember and look at you alternately while glancing at the patient. They've been through this before!

I too like the Christmas in April tale - it's so sweet.
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Garden, great suggestion to sit behind them and and make faces!
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Maggie, thank you for sharing that. You made me giggle. Christmas in April. Why not? Bittersweet memory for you, I'm sure.
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Most of the time the doc never did any examination beyond taking mom's bp, so now when I have an issue to discuss with the doctor I make an appointment without my mom to go over my concerns. Sometimes they want to see her, but often I can renew scripts or get advice without the hassle of taking mom out.
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