Let's talk about dementia stages and the best type of doctor to see. What has your experience been?

Couldn’t possibly speak highly enough about the psychiatric team operating in my LO’s AL.
I actually always feel as though my LO and I are part of the team too.
LO had been on an SSRI before she entered, and when they recommended the addition of the smallest available dose of a second antidepressant that could also reduce anxiety, I was right on board.
I visit often and question and report any changes I notice, and the staff let me know how things are going from their point of view.
All fairly smooth, so far.

I don't know if this is allowed, but I find Teepa Snow's description of the various stages of dementia (gems) is incredibly helpful. You can to go to this link for the information. https://teepasnow.com/about/about-teepa-snow/the-gems-brain-change-model/ She also has some youtube videos on techniques for approach, communication and hands-on caregiving for those with dementia. I have found her information INCREDIBLY helpful.

If you can't find any gerontologists or geriatricians in your area who are taking new clients, another option is to seek out the staff doctor for assisted living facilities. They may be 'generalists', but their clientele will educate them on the needs of seniors and dementias. We had a geriatrician for a while but it was a long drive. She was wonderful, wish we could have kept that up. Our new doc is a generalist who oversees a pretty good nursing home. He is worlds ahead of Mom's previous GP.

Gerontologist. Neurologist. In some cases, a Movement Disorder Specialist.

And if you live outside a major metro area or away from a research university hub, you will have little to no access to elder-years specialists who keep up with current research.

My mother’s county was 1,000 square miles; a mix of insane suburban sprawl and patches of rural/small-town; county seat has population of 15,000.

There were only 3 practicing geriatric specialists in Mom’s entire county. Only one accepted new patients. The other 2 were old enough to need a gerontologist themselves!

In the absence of professional resources, forums like this are a godsend.

Good luck and take care. These are hard years. (((big hugs)))

Levans2008: Yes, the M.R.I. is done by the neurologist and the elder then sees his geriatric doctor.

I think much depends on each person/family and like they say: location, location, location! Location because for so many reason no one can go traipsing all over the place to find another pool of professionals. I think the "scales" that get published are a bit ambiguous and not a whole lot of help..but clearly it helps to know what monster you are dealing with and how it progresses as far as planning and understanding. So too, does age at the time the diagnosis is made. I think, for many, when we look back, the signs were there long before something is done about it or it is identified officially. While there are similarities, there are differences, and no one experiences exactly the same. For our family some things, but not all, were being noticed. Lots of little things...errors in baking/cooking; extended time for routine bookkeeping...and then mom (and dad) went to visit my out of state sister. A plane trip that went fine...but within hours came a call from my sister wondering how I could ever think mom was up to a trip (later we discovered how she had not packed for either of them adequately) and that mom was saying she wanted to come home...dementia speak for being stressed and overwhelmed. When I looked up some basic info on Alzheimer's I found mom really had a majority of the descriptors right under our noses. I contacted their family MD who I came to just love...he did a mini mental exam the next time she was in and got back in touch and was surprised himself because she had been so cool and "normal" he'd never realized what was going on. I knew who one of the best neurologists in town was, but it was a 4 month wait for an appt. On that day I called prior with a routine question and learned someone had goofed and sent a duplicate info packet to MY MOTHER. She immediately called and cancelled the appt, 4 months earlier when it was made! We still got in not long after. She was about 94 at that point. With the history provided there really was no reason we all believed, to subject her to testing, and even the MD, at this point, felt limited benefit to none with any of the drugs. The Alzheimer's Assn can be a great resource, and although I am not a group person, the group for adult children has been very good for me...every group is different...but if nothing else, these are the folks who have already most likely interacted with the medical community and they know who is good and who isn't. ANd while the assn. officially really can't suggest anyone, fellow group members share truthful info freely. For me, I just try to stay calm and take it one day at a time, grateful for the level of functioning she has. I come away from the support group meetings very grateful because I know it could be so much worse.

Wow, this was all so very helpful. Mom's Drs have basically written her off & she's only 85!! I was never told about a Gerontologist but I will be looking that up ASAP. I did take her to a geriatric dr & she was useless. Once Mom's hospice/Medicare/insurance issues are cleared up I will take her for an MRI! Thanks & God bless everyone for all you are doing.

My husband had vascular dementia/ multiple mylompia and his primary physician lead me down a rabbit hole for two years.
I was lead out of the rabbit hole by getting my husband to a Geriatric Physician and a complete geriatric exam. Geriatric health as a primary assessment is not discussed enough in the senior community.

We have a geriatric psychiatrist who manages dad's dementia care.

I just yesterday visited my Mom in law at her NH, and she was really angry at a couple of other super annoying residents in the dining room. I think it is a combination of her feeling helpless etc at this point in her life, but also it may be the next stage of dementia, as she was so nice before. I don’t know what to think, but I know all I can do is be supportive and visit.

The gold standard is an M.R.I. ordered by one's neurologist.

The entire health care system was practically useless for my mom, despite seeing neurologists who were focused on treating her recurring TIAs no one ever mentioned the word dementia - mind you at that point (91 yrs old) her symptoms were physical. Around the time mom's health declined suddenly we lost our GP and she languished in a no mans land of seeing whichever physician her clinic assigned that day, I learned to take everything we were told with a grain of salt (I was assured more than once that she was showing end signs 5 years before her final demise). By the time we found a full time doc mom was already in steep decline and it was all about symptom control and palliative care. EVERYTHING I know about caregiving, dementia, and living with frailty I learned on the internet, I can't imagine what I would have done without sites like this one.

I switched my mom with Alzheimer's from her General Practitioner to a Gerontologist about 7 years ago. The Gerontologist took her off a dozen unnecessary medications, gave her an MRI of the brain and confirmed that mom was suffering with Alzheimer's, as well evidence of damage from mini-strokes (which may have been caused by one of the meds she was taken off of). We were supported and they gave mom the very best care. They even cared about me - asking if I was OK and taking care of myself, they gave me information on resources to get a sitter if I needed one, support groups, etc. It made all the difference in the world for mom and our family. It was one of the best decisions for her care that I ever made. She passed away last year, and she is now at peace.

Wishing you the best.

Florida has 16 Memory Disorder Clinics that are affiliated with experts in the field. A dementia diagnosis is not enough. It is a group of symptoms that can be caused by many, many things. Treatment is determined by what has caused it. In Brevard County our Memory Clinic we work with geriatricians that specialize in Memory. They see only Memory patients over 65. We do comprehensive Memory evaluations and provide recommendations based on the specific diagnosis. Social workers and pharmacy people are here to support the families. We have classes and trainings for families and those working with this population. Look up your local or state agency on aging.

This is our experience: My mom's pcp of many years was aware of her forgetfulness. repeating herself and did nothing. My mom thought the world of him. I had been in turmoil for a while over it knowing there were meds available. WELL God on our side, that DR took early retirement and I took her to my pcp who immediately picked up on her mental state. HE asked me questions, then my mom. He immediately started her on meds. and a slow pace with rechecks frequently. He through the years has started to focus on geriatrics. In my opinion, if your DR is not doing anything. move on. I wish I had sooner. But at 94 going on 95 she is doing much better. I believe a regular MD who can detect and use medication, and require 3 to 6 mo check ups is fine. Just remember if you are not seeing an MD who stays on top of it... seek another physician.

Hi there, I'm surprised your GP didn't refer you to a neurologist or gerontologist, even psychiatrist. While anyone can administer the basic cognition test questions, a specialist such as the above (especially neurologist or gerontologist) will examine them at length and can fill you in on where on the progression scale they think they might be, things to look for, and what to possibly expect next. They will question you at length about the patient's current behavior- that is a better indicator to them of the patient's current baseline than anything the patient themselves can tell them. Then they'll likely discuss meds that might help with current symptoms. Most importantly, as others have noted, every dementia patient is an individual, so person A who is in the "late early" stage and person B in the same stage may exhibit a different set of behaviors, and that those behaviors can change for that same person from day-to-day. Some meds are great for one person, not so much for another, They have "good days" and "bad days". See if you can find a good neurologist, and then keep educating yourself! The info you'll find here in the forum from the wonderful people going through the exact same thing as you are will probably be a more valuable to you than even the BEST physician.

My mom has been on antidepressants for about 2 years. I see no results. She was never depressed a day in her life. When she received the dementia diagnosis, her pcp said dementia causes depression. She was also prescribed donepezil. She’s gotten worse. Once this started, about 3 years ago, the meds were prescribed. She’s had 3 falls. None required hospitalization, one nurse said anti depressants may increase her fall risk. I don’t know. I do know , it takes a long time for her to recover from a fall. My mom was working / driving / bathing/ cleaning/ socializing even up to 4 years ago. I asked her dr when dementia was first diagnosed, is this Alzheimer’s? Her response was I don’t know. I took her to a phd in neuro psych. That was a long day for her about 3 hours. That was about 6 months before she was diagnosed by her pcp with dementia. The phd said she had “mild cognitive impairment “. And that could stay like that for a long time or get worse. Her MCI did develop into dementia.

My experience with my mother who had Alzheimer’s is that there is no pattern to the disease. For example, my mother was pleasant, cooperative, didn’t complain, didn’t wander, didn’t have delusions. My Mom went to Cleveland Clinic for Brain Health in Las Vegas. But basically, all that was ever done, was they prescribed medicine: the patch and Nemenda. We found out Nemenda supressed her talking which meant everything to her. So i would recommend against it.

Maybe the refusal of an antidepressant is generational? My parents were from the "shake it off and get out of bed and man up" generation! I had to get Ativan when my folks moved in with us, and now my mom is on "happy pills" for depression since dad passed, and she is living with us instead of living the retirement she planned for. She is not happy about the pills.. I assure you! But they do help. As for the stages of ALZ,, that timeline is fluid and everchanging for each person. The stages slide back and forth,, sometimes overnight. My mom and (passed) dad saw my GP, who is a geriatric specialist and has done a great job with them.

Whey would you resist putting a dementia patient on an antidepressant? It's probably the most useful move you can make.

Some will say a Psychiatrist. I took Mom to a neurologist because a head injury exacerbated her Dementia. She went every six months. He made sure to explain to Mom what would be happening. I took a list of new things that he referred to when questioning Mom.