My Mom has been referred to a neuropsychologist for an extended memory test. What should I expect?

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I'm looking for feedback from others who have had a loved one go through this process and what to expect.

Answers 1 to 10 of 48
You expect to sit in a waiting room for four hours. It is not the sort of thing they want you there for. Too many patients will look to their family member for answers. Even for the mini-mental, mom kept looking at me and the MD was relieved that I kept my mouth shut.
A neuropsych is a several hour battery of tests, not just of memory but of reasoning, problem solving and the like. You will not be present. You may be asked some questions separately about your mom's mental state and ability to manage everyday tasks. Bring something to read and be prepared to hear lots of complaints afterwards about how stupid the questions were. Make sure she has a good breakfast, goes to the bathroom beforehand and have her bring a sweater in case the room is cold. After several weeks, you'll be asked to attend a debriefing session with your mom. In other words, you probably won't get immediate feedback; these are tests that have to be scored and analyzed.
My husband went through this process. Since he was still driving, he went alone, but ba8alou's answer is accurate. Al's testing was quite extensive and took two visits. I was "allowed" into the office for the followup visit and the conclusions were sent on to his neurologist. It didn't really prove anything, but aided in the eventual diagnosis.
My Mom's was a couple of days worth of tests, we no longer see her after the initial diagnosis and a few follow up appointments we decided her geriatric doctor could handle the meds, and neuro p could not offer much more unless we wanted it.
We took my mother for an evaluation to diagnose her dementia. It took 4 hours with a lunch break. They write a lengthy and detailed report, which was later used as evidence for guardianship.
Allot of testing which they do without you present.They test so many areas takes hours.I suggest you 1) find a cafeteria 2) a fast food place 3) give them your cell phone number and go shopping 4) bring a long book( "War and Peace) might actually get your through the day...they write a very lengthy long detailed report .They test memory, reading skills, reasoning etc and so forth.But it is necessary and you will be relieved after it is all done and the conclusions are firm and complete.You can refer back to it in the future.Good luck
Pam is absolutely right about the cognitive function tests - the best thing you can do is make yourself scarce. Even your being in the same room is likely to distract your mother because she'll keep looking to you instead of concentrating as well as she can on the test.

I don't know if our Memory Clinics (I wish they wouldn't call them that because they're actually Brain Function Clinics, but anyway) work to quite the same system, but the other thing they did was interview us together (with my mother's agreement). This was partly to get accurate information about how she was functioning generally; partly to gauge how much she understood of what the clinic was all about and how much she wanted to know about her own condition; and partly to give me their assessment of how her dementia was progressing.

My experience was that it was interesting and useful, but yes do take a good book!

If you're concerned about mobility or hearing or sight or any practical issues like that, just flag them up to whoever takes charge of your mother - these people know what to do.
Top Answer
Babaloo's answer is spot on.

Your mom has probably already gotten the mini-mental testing done at her referring doc's. Mini-mental are the ones with the 3 word memory test & the clock drawing. For my mom, the neuropsch involved testing was over a 5 year period. Now her MDs at the time were affiliated with the medical school and so she was involved in a dementia study of 90+ yr olds. Started when she was living at home, then when she moved to IL and stopped when she went into NH. It was immensely helpful. Once she hit a certain # in testing, it got repeated and then she was discharged from the program as she had plateaud out on changing her testing numbers. I was in an adjacent room watching the testing via video feed with medical students and the gerontology residents. It was really heart wrenching seeing mom work really hard to answer the questions and her frustration at not being able to process.

You will likely be interviewed. If you can detail specific "incidents" that have you concerned it could be helpful. Dementia signs fall in the groups below.
Signs of Dementia:
Recent memory loss - ask you the same ??’s over & over.
Difficulty performing familiar tasks - cook a meal but forget to serve it. Put on pants but not panties.
Problems w/language - may forget simple words or use the wrong words. They can’t finish a sentence. (If their bilingual, this can be an issue for testing.)
Time & place disorientation - get lost on their street. Can't get out the the parking lot of the grocery store they have gone to for decades.
Poor Judgement - forget simple things, like to put on a coat before going out in cold weather.
Problems with abstract thinking - Classic example is balancing a checkbook, people w/dementia may forget what numbers are and what has to be done with them.
Misplacing things – Putting things in the wrong places like iron in the freezer or a wristwatch in the sugar bowl.
Changes in mood-fast mood swings, going from calm to tears to anger in a few minutes. Irrationally suspicious, paranoid or fearful.
Loss of initiative-may become passive

DEMENTIA TESTS: 3 main tests. Different yet similar….
1. Folstein aka Mini Mental State Exam (MMSE) - 30 point test. Looks at math, memory, orientation, basic motor skills. MMSE is copyrighted & needs training to do, so usually done by gerontology neuro MD’s, or trained staff. Score is 27 or more=normal; 21-26 mild; 10-20 moderate; under 10 severe. Folstein has issues for bilingual persons - even if they were bilingual when children.

2. Mini-Cog: a 3 item recall & a clock drawing test. 2 -3 minutes to do. Should not be used alone as a diagnostic. Usually used to base a referral on. Most geronotolgists do the mini each visit to document changes.

3. Memory Orientation Screening Test (MOST): 1. Memory -3 word recall; 2. Orientation - to year, season, time, month etc.; 3. Sequential – memory for a list of 12 items; 4. Time – organization and abstract thinking using a clock face. Gives a score from 0 – 29. Highly reliable.

Other tests: If Frontotemporal dementia is suspected, can have an Addenbrooke’s Cognitive Exam done. Some places will do a motor skills ability score - like the laundry basket sequencing activity.

Not all dementias are the same: orientation, attention and memory are worse in ALZ; while language skills, ability to name objects and hallucinations are worse in other dementia’s.Data analysis found the MOST to be more reliable over time and more accurate in identifying cognitively impaired patients than either the Folstein Mini Mental State Exam or the Mini-Cog. The MOST also measures changes in a patient’s memory over time. This permits the doctor to identify progressive loss or positive responses to treatment. Having a baseline tests done & repeated is really helpful to be realistic about what careplan to take. Same with scan on brain shrinkage & what part of the brain. My mom got tests & scans done annually for 5 years for the study group she was in, we were very fortunate to be in it. If they suggest that your mom participate in one and you have the ability to get her to the appointments and commit to a 2 - 3 year study, please do so. Good luck and take your iPad or kindle too.
We had a great experience seeing a neurologist in a teaching hospital in the memory dept. I was never asked to leave the room, like others have mentioned, and mom benefitted so much from the appointment. One of the best outcomes was the referral to physical therapy for 2 months that rest helped mom build back strength and muscle. The testing wasn't the rigorous 4 hour kind, but a much more intensive assessment that didn't make her upset or stressed. BTW- the drive was 1 hour for us as I checked on various programs and this is one of the best in my area (U of K Neurology Dept) with top notch doctors. We go back in a couple of weeks. It took 2 months to see him, but well worth the wait. Make sure to ask your neurologist to have blood tests at your regular doc if there's a long wait. That was the one thing we didn't do and waiting in the overly crowded waiting room was very long - we won't do that next time. The CT scan was very quick. Good luck and I hope your neurologist specializes in memory studies or dementia care.
Big difference between a neurologist and a neuropsychologist. Neurologist is an MD and does clinically based tests. Neuropsychologists generally have PhD and do cognitive/reasoning/memory testing. Different fields, different training, different testing. Neuropsych is what takes a long time.

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