My brother, 83, was diagnosed in 2017 with Alzheimers. I have POA and manage his Dr appointments and medications, as well as pay all his bills. I have been doing this for 3 plus years. His wife has passed and he currently lives at home with a full time caregiver. She’s not my choice, but the only one he wants living with him. My brother has become increasingly opposed to me going to his Dr appointments with him. He will loudly say, “My mommy is here!” He said it makes him feel like an imbecile, and that I need to cool my jets and stop managing his appointments and medications. One of the meds he takes is Hydrocodone for sciatic pain. He really wants to mange those all by himself because he’s been taking them for a long time and is addicted to them. When I try to go into the exam room with him, he gets angry and tries to leave the Dr’s office. I fully understand his desire to be in control of his appointments, but his memory is getting worse and I need to make sure the Dr has all the correct information, and what the Dr tells him regarding treatments and/or medications. How can I make my brother feel ok with me assisting him with his Dr appointments?
"Yes, hospice can cover dementia care. Dementia patients are eligible for hospice if they meet certain criteria related to their stage of illness and prognosis, indicating a life expectancy of six months or less if the disease runs its normal course. Hospice provides palliative care focused on comfort and symptom management rather than curative treatment.
Hospice Care for Dementia:
Eligibility:
Patients with dementia qualify for hospice when they are in the advanced stages of the disease and have a prognosis of six months or less to live, provided they agree to forgo further curative treatments."
When I took Mom to the Neurologist, I had one page of notes. They were only one sidebof the paper. 14 Font and double spaced. No long explanations, short and sweet. I handed it to the receptionist and asked her to see that the Dr got it. I sat off in the corner of the room behind Mom. Dr would ask questions referring to my notes. He would look at me and I would shake my head yes or no. This Dr., loved him, told me in the beginning to let Mom answer his questions.
Realize, though, that your brother will need to be placed eventually unless he is rich and can afford 24/7 care.
Or discuss ahead of time with his doctor about your brothers objections of you being in the room with him and let the doctor tell your brother the importance of you being there and why it is necessary. Perhaps he will listen better to his doctor that he does you.
I'm not sure at this stage in his ALZ that you can reason with him or get him to see things from your point of view. You can try telling him a therapeutic fib: that being his PoA you are responsible for taking notes in the appointments to make sure the doctor follows up on what was discussed and decided. Maybe you are talking too much for him in the appointments? If so, talk less and sit behind him so that you can confirm or disagree with his answers to the doc's questions by moving your head. I did this with both my MIL and Mom.
I also agree that if he can get away with just a televideo appointment in order to represcribe his Hydrocodone, the do that and don't give him any choice. Hopefully the caregiver isn't the one picking up those pills...
Maybe it's time to talk his doctor privately about other meds for his agitation, anxiety, depression.
Do telehealth appointments as often as possible. You and brother are together at his home, doctor appears on your phone or the computer, and visit proceeds normally. No need to actually be at doctor's office.
Have his chosen caregiver take him to doctor's and you are on the phone participating at home. Aide briefs you on anything you want to know when they get back to his home.
Before an office appointment, send a note through doctor's patient portal outlining all your concerns. Do this at least a week before the appointment. Take a couple of copies of the list with you to the appointment and give to doctor and assistant or nurse before brother goes into exam room. You speak in person to doctor after brother is through with his exam and sitting outside exam room being watched by the nurse.
Ask for a hospice evaluation. If he's eligible for hospice care, hospice doctor supervises and keeps you informed. No more visits to his other doctor's office.
By fully understanding his need to be in control, you're thinking of him as he was, not as he is. The truth is that with his dementia, he isn't capable of being in control of a lot of things (which you already know). Ask doctor about meds for his OCD and anger. Meds might help a lot with the symptoms you're seeing now.
Best of luck in dealing with this difficult problem.