Mom now wants a second opinion on her diagnosis. Thoughts?

Good diagnostics require a Neurologist specializing in dementia and the associated tests such as an MRI or CT of the brain and a neuro-psych evaluation. That way proper treatment can be described and a better prognosis will be part of the picture.

Thank you pstegman. I have requested the referral from mom's GP, and hopefully mom will be able to handle whatever the outcome of further testing is. Right now, she believes she has old age related memory loss, and is in denial of Dementia/ Alzheimer's diagnosis. She has been on Aricept and Namenda for the past year to help with memory. A well meaning friend of moms told her that these medications can make her worse off and more confused, so now she wants to stop her meds...Arrgh...

When Mom wanted to stop her meds I told her "OK, stop all of them. Where's the Will, because it will all be over in 48 hours."

Imtired2 where are you? I'm just wondering if you're in the UK because you refer to a GP - didn't think that term was common in the US?

Mother's GP referred her to a Memory Clinic for formal assessment of her suspected dementia. The referral would have led to a brain MRI if she'd been able to have one (she had to have a contrast CT scan instead, not so useful but better than nothing); following that the assessment included a detailed questionnaire, questioning of me as her primary caregiver, and an interview for both of us with an Older Age Psychiatrist specialising in dementia, who has now sent recommendations back to her GP for action.

Now, if you are in the UK, the above is mandatory - which means that the waiting lists are a nightmare because every GP in the land is required to conduct initial memory tests on request, and refer the patient if the initial test shows a problem. So of course the Memory Clinics have been swamped (the new policy guidelines came in last April, 2013). In our neck of the woods, they're triaging by sending mental health nurses to interview patients at home, trying to filter out frank Alzheimer's cases so they can get them in and onto medication a.s.a.p.

In our case, the initial referral in May 2013 led to ongoing support from the Community Mental Health Nurse (and she's terrific, no complaints) but no appointment until December because mother's main presenting symptoms didn't suggest AD.

The whole system's in a bit of a mess, but the good news is that things ARE moving, awareness is rising, and eventually the support structures will more or less fall into place.

How much do you think your mother really wants to know? This is one of the direct questions the OA Psychiatrist put to my mother, and it's an interesting one. If she wants a second opinion because she's hoping she'll be told she's fine, the GP has got it wrong… hm, where do you go from there? But if the second opinion is as thorough and detailed as the one we've now had, she may find it helpful and in some ways reassuring. They were very good at addressing the stigma of Alzheimer's, for example; and explaining the disease in terms of brain function rather than sanity/insanity; but what cheerful thoughts can they possibly supply when it comes to prognosis? "Don't worry, something else will probably carry you off first?"

The only positive things I've been able to think of to say to her are: that whatever happens, I and her lovely professionals will be there to make sure she's safe and comfortable; and that she's doing the right thing getting as much information as possible so that we all know where we stand.

Would you say that the Aricept and Namenda have actually helped? I'm not suggesting they wouldn't, just wondering what you think; though I must admit I wouldn't be hugely keen on my mother's taking them without a really good evidence-based diagnosis (of course I wouldn't dream of stopping them, either, without full medical back-up). What other medications/conditions are in the picture?

Thank you Countrymouse, and I loved pstegman's reply, ha! We are located in California. Mom wants a second opinion, as she is in denial of her doctor's opinion of her condition. She went from thinking highly of him, to saying, "What the hell does he know!?" I feel the meds have helped overall, but god only knows if she is taking them regularly and as directed. I have tried weekly pill boxes, notes, labels, doesn't matter. Mom says that she wants to know what's wrong with her, and prognosis, but I know she will not take it well. Mom has no other health conditions to speak of and pretty healthy other than short term memory loss and confusion at times. Shes in her early 70s.

Can't blame your mother for being livid about the diagnosis! - it's just that she's wanting to shoot the messenger. Very hard. But facts are facts; they won't change just because she doesn't like them; and if she won't listen to all the information at least you can. Best of luck x

I am assuming mom is still competent. If she is asking for it then let her have it. I would look for a good neurologist. There are a lot of meds that can slow down memory loss to almost a halt. My mom after her stroke was diagnosed with dementia (not caused by stroke) neurologist actually referee her to a psychiatrist to be evaluated and to help her deal with the diagnosis. Definitely helped her. So if she is asking for it go with it.

I just wanted to follow up. Mom told me to cancel the doctor's appointment, two days before we were to go. She said it would not be in her best interest, and doesn't want to be asked a bunch of questions. I think she knows she has a problem, and does not want to hear it. I can't say I blame her...Back at square one...

Ugggghhhh, feel for you. Have you actually cancelled it, though? Would it be worth holding back and seeing if you can just whisk her casually into the car and off to the consulting room, la-dih-dah, making nothing of it, all routine, nothing to worry about mother…?

Never could see how it was ever in anyone's interest not to get a clear picture of reality! Whether you want to look at it or not it's still THERE...

Imtired my heart goes out to both you and your mom. I imagine she knows in her heart that something major is going on in her brain and she both wants to know what, but is afraid to know what. And you're caught in the middle.

My mom has virtually no short-term memory, but she still read the newspaper and works the daily crossword puzzle in it and cuts out articles for my brother and myself. She can't tell you what she ate 10 minutes later or remember an hour later what my brother said in his phone call, but she still knows how to heat up her own food and run her dustbuster.

My friends refer to her as having dementia, but I don't think that's correct. She has lost some of her problem-solving capabilities, but she's very oriented in time and space and manages in an Independent Living apartment with lots of help from me. I hope your mom has something like my mom's situation instead of Alzheimers. I've never had a full work-up on my mom because I've never felt the need.