The OP is asking whether, now that the GP has made the diagnosis and the time has come for specialist advice, she should consult a) a neurologist or b) a psychiatrist.
Alice, I don't know how services are set up where you live, but as an example of what you *might* look for here we have memory clinics specifically designed for people diagnosed with dementia. The process is, broadly, as follows: 1. brain imaging; 2. more detailed cognitive testing conducted by a clinical psychologist; 3. interview conducted by the clin. psych. with the patient and if possible the patient's primary caregiver and/or medical POA; 4. consultation with an older age psychiatrist. This leads to as accurate a baseline diagnosis as possible, and the idea is that the person is then supported by his or her GP along with community mental health teams. [Note, this system has completely fallen apart over the last year for obvious reasons - you can't have demented older people hanging about in outpatients all morning. But God willing it will start up again before long.]
I would expect a psychiatrist specialising in dementia and other diseases typical of older age to be pretty familiar with the neurology, and certainly knowledgeable enough to seek a neurologist if the brain imaging or anything else is ambiguous. But ask your GP for recommendations and find out what you can about the specialists' practice. You may well want input from quite a range of people before you're done, hugs to you.
My 91-yr old mom, who was an RN her whole life and eventually worked on all floors of several hospital, told me to always go to a specialist. This is not to disparage GPs, but by necessity they are "Jacks of all trades and masters of none". There are just too many health issues with which to keep up. A specialist focuses on the latest and greatest studies, breakthroughs, treatments and therapies, etc., and knows the nuances of their area of medical expertise. And they rub elbows with other experts and learn from them as well. A GP can't keep up even if they're willing and able.
A GP doesn't have the training nor for the most part, or the clinical experience to diagnose AD. At best, a GP can only suspect dementia after administering a short cognitive test. Usually an appt with one lasts for about 15 minutes. What they can do in that short time frame is to try to eliminate other causes that could be the reason for dementia by ordering blood tests, brain scans, etc. With any suspicion of dementia by a GP, the patient should be referred to a neurologist, neuropsychologist, gerontologist, or other specialist skilled in dementia behavior. Because AD is so prevalent among the elderly, GPs tend to default to AD as the reason for dementia without the thorough screening a specialist can give. You say he's progressed since his “diagnosis”, so it's important for you to know what you're both dealing with and educate yourself about the disease. To answer your question, yes, you should follow up with a specialist skilled in dementia care. A good specialist will give you information about what the disease is, how to cope, and direct you to some resources to address the problems ahead.
My LO’S diagnosis was done through a psychiatric group that specialized in GERIATRIC CLIENTELE ONLY.
I think the specific training in working with geriatric clients is the bottom line. My LO’s issues were largely behavioral, and the group that assessed her was part of the MCF’s external staff.
We got a brief letter after her workup was completed that stated that she was unable to manage her personal affairs. This proved EXTREMELY HELPFUL to her POAs.
If such a letter isn’t offered when your husband is tested, ask the examiner(s) to provide one for you.
Alice, I don't know how services are set up where you live, but as an example of what you *might* look for here we have memory clinics specifically designed for people diagnosed with dementia. The process is, broadly, as follows: 1. brain imaging; 2. more detailed cognitive testing conducted by a clinical psychologist; 3. interview conducted by the clin. psych. with the patient and if possible the patient's primary caregiver and/or medical POA; 4. consultation with an older age psychiatrist. This leads to as accurate a baseline diagnosis as possible, and the idea is that the person is then supported by his or her GP along with community mental health teams. [Note, this system has completely fallen apart over the last year for obvious reasons - you can't have demented older people hanging about in outpatients all morning. But God willing it will start up again before long.]
I would expect a psychiatrist specialising in dementia and other diseases typical of older age to be pretty familiar with the neurology, and certainly knowledgeable enough to seek a neurologist if the brain imaging or anything else is ambiguous. But ask your GP for recommendations and find out what you can about the specialists' practice. You may well want input from quite a range of people before you're done, hugs to you.
I think the specific training in working with geriatric clients is the bottom line. My LO’s issues were largely behavioral, and the group that assessed her was part of the MCF’s external staff.
We got a brief letter after her workup was completed that stated that she was unable to manage her personal affairs. This proved EXTREMELY HELPFUL to her POAs.
If such a letter isn’t offered when your husband is tested, ask the examiner(s) to provide one for you.
I would try to find a diagnostic team--neuropsychologist, neurologist and psychiatrist or psychiatric nurse practitioner.
If husband is having behavioral symptoms, he would benefit from seeing a well qualified geriatric psychiatrist.