How does one find a good general practitioner that is experienced with elder care? My parent's current doctor is a quack.

I can attest to the fact that most doctors will not assist with future planning. My help came from the social worker at the hospital where my mother wound up with a UTI that caused confusion, combativeness and violent behavior in her. The doctor she’d seen for 20 years was no help whatsoever.

Barb’s idea is a good one. Geriatricians are primary physicians for the elderly. Chances are though, that even that doctor will refer you to someone else, probably a neurologist. She needs testing and evaluation.

I'm sorry her doctor let you down. Seems to be the norm nowadays.

It surprises you that professionals who are paid to treat patients with Alzheimer's Disease are firmly of the opinion that step one is to get the patient diagnosed so that she can be treated?

But I don't mean to be cynical: of course assessment is essential, and investigation (preferably leading to diagnosis) is in turn an essential part of that.

In defence of your mother's doctor, what I suspect he is trying to combat is expedient labelling. He is considering your mother's best interests. A label that will certainly restrict her freedom of action but will not in itself contribute to improving her quality of life is not in her best interests.

I would argue with both the seminar and, respectfully, with your mother's doctor.

The first thing to do is not "to get the patient diagnosed." The first thing is to investigate the patient's symptoms and determine their probable cause(s). Go looking for Alzheimer's and you are sure to find it. Go asking questions, and you are more likely to end up with a more accurate, more certain diagnosis which will lead to a much better care plan tailored to her individual needs.

The doctor needs to be more patient (adjective) and clearer in what he is communicating. Go back to him armed with a detailed, well-documented description of symptoms, incidents and concerns and ask him to start again.

If you have a teaching hospital near you, call and find out if there is a department of geriatrics. You can ask which doctors in their department are taking new patients.

Call the local Area Agency on Aging; they may maintain a list of geriatrics doctors.

Call good local nursing homes and find out who their medical directors are. They are often geriatrics docs.

Independent and Assisted Living facilities often have geriatrician who have on-site office hours a few times a week.

In my journey with mom with dementia, the best advice and guidance we got was from geriatric psychiatrists; you might consider seeking out that specialty first.

My aunt and uncle's regular internist told my cousin "nice people don't get dementia and your parents are nice people". There are a lot of idiots out there.

Look for a geriatrician who has a social worker on staff. They can be invaluable.

Alternatively, sometimes eldercare attorneys have switched on staff who can help with planning.

Things took a positive turn for my Mother once I researched and got her an appointment with a Geriatric Internist. Her previous doctor wanted to put her in hospice. He had given up on her! The new doctor put her on the correct meds and she is thriving. This all happened over 4 years ago.
she is now almost 91 and is back to how she was maybe 6 years ago.
I know this is all unchartered territory, but once she has the right doctor you will feel confident in the advice you are given. Good luck and God Bless.

MCHSMH, your location seems close to the U of Nebraska so as Barb suggested, they may be a good resource. Geriatricians should be preferred -- they understand the special needs of the elderly and are really good at understanding drug interactions because they deal with it so much and the elderly often take so many. I too am sorry your doc let you down. What a dope. Vote with your feet and find better care and accurate diagnosis. The internet is a rich, free source of information and Teepa Snow videos on YouTube will help you understand your parents' condition as things progress.

Current doc may have been trying to figure out if, once diagnosed, you planned on still having him treat your mother or if you'd then be taking her elsewhere with the diagnosis. I have a feeling that was his real question. However, his delivery and the appearance of putting the burden on you is something I would find difficult as well. On the other hand, the driver's license thing is crazy! He was non-assertive enough to clear her when he should have stopped the process right there and not rely on the DMV to refuse her. And then DMV didn't refuse. In terms of her future care, she definitely needs someone who communicates more clearly and who understands the elderly. I guess it could be neuro, geriatrics, possibly psych. The answers will start becoming more clear once you start making calls.

So..first lower your expectations. Expecting a general practitioner to help plan in a 20 min appt is not typically realistic...but then there are the compassionate exceptions who would at least aim you in the right direction. My opinion is biased. The stories I have heard among friends as well as being in the field as a social worker is that oftentimes the medications are not of much, if any benefit...but your best hope for an honest assessment is a neurologist who specializes in the dementias. I'm sure you know that this is a situation that can be maintained...but progresses. I don't know who did this seminar you went to or if they had any biases. Sometimes, from a legal perspective getting the "official" diagnosis has relevance. And that brings me to the point if you are fortunate enough to have a good certified elder law attorney (try to find one that charges by the task, not the hour), they may know of some local MD's that would be what you are looking for. Another thought would be to attend some support group meetings of the local Alzheimer's Assn. While some professionals seem uncomfortable speaking openly and can't officially refer, peers can be very direct about how they have been taken care of by local professionals and steer you in the right direction...if you latch onto a good person, do not be surprised if it is months to get in and be seen. I picked the neurologist we used having seen him speak publicly and hearing things that confirmed what I thought. I love the guy though he is research oriented and I am less so. We also had an outstanding and beloved family medicine guy who was capable of caring about all of us. With my mom it all came to a head when she and dad went on a trip to visit my sibling and the change in environment made it clear how impacted mom was...when I connected with the MD to let him know mom appeared to have nearly all the 10 warning signs he told me to stay home the next appt they had...and did the mini mental exam. Mom had been so outstanding at routine appts he had been unaware of what was going on. But again, the support groups can be a wealth of insight and information. I personally am not thrilled with changes in how the AA is operating, but they do have some care coaches and people available to help with the issues you are facing. Due to the complications of this miserable virus, they are doing support groups via conference calls that you have to let them know you're interested in attending. In our area we are blessed to have some groups for Adult Children which are great. In the end there is the reality of no one's circumstances being identical...it will come down to day to day caregiving issues, if you want support and can afford support at home, finances for long term care...It's a lot to take in. Good luck with it all...

Most GPs are not able to provide a "plan" for any person who might have Alzheimer's. Even providing a firm diagnosis of dementia is beyond the scope of what they do. The best they can do is to refer you to another physician who has more expertise in dementias.

Also, it's not the responsibility of any physician to "make a plan" for an elderly person with dementia. The family or POA needs to determine whether they want to try the medication, to care for the person at home, to place them in assisted living, etc.

BTW - if anyone feels that an elderly person is unsafe as a driver, all they need to do is to phone the DMV and report it. They will give a driving test to the person - and "pull" their license if they are deemed to be unsafe.

General practitioners often do not have enough experience with issues of the aging to make a firm dementia diagnosis and other than some meds they may or not be familiar with, they will not be able to effect a "plan". I would look for a geriatric physician - you can google, look up on webmd or medicare.gov). That doctor may also refer to a geriatric psychiatrists (they unfortunately are few and far between). These people can give you a better diagnosis of what issues your loved one may be facing and what medical options you may need to review. In terms of social plans, your best source will probably be a social worker (the above physicians will likely be able to refer you to a social worker). Even without the pandemic, be prepared to wait in line to get to see them even if is by teleconference. Use the waiting time to get your legal ducks in a row. Call the office on Aging to see if you can get a free 30 min consultation with a certified eldercare attorney. Not sure if your loved is still able to do this but you want to have Mom's will in order and you should get a durable power of attorney as well as an advanced directive. The attorney will be able to lay some options our for your but basically you want to consider the following options: Mom living with you; Mom moving to MC in an AL; Mom moving at some point to MC in SNF; hospice care in some location. An attorney can give you the particulars of all of the above but the final decision will be yours and your Mom's (assuming she is able and willing to participate) and may change (which is why you need to know about all of it) as her condition progresses. You should know that none of the current meds being used for Alzheimers/dementia is a cure and many of them work at slowing the progression of the disease only for a limited time. While research is still going on, funding has been limited so research has slowed a bit. On the other hand, one of my clients exhibited many signs classic signs of what appeared to be dementia/forgetfulness to the layman. Her GP was clueless but smart enough recommend her to a geriatric specialist who in addition to the mini mental did a lot of blood work. Turns out she was suffering from a severe vitamin deficiency! She knew something was wrong and that made her fearful and she started to isolate. Right meds, better diet, deficiency correction and she became a social butterfly. Who the heck expected that? That turnaround was about 5 years ago. She is 97 this year and learned how to use Skype 2 weeks ago. She is still a social butterfly and every kid in the neighbor fights to visit Ms. Jennie! Moral: you don't know what you got until you get her to a good geriatric specialist. Start searching now and good luck.