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My mom is 93 years old. She had a seizure about 2 years ago and has been taking Keppra ever since. She is also taking Lysinopril for high blood pressure, Lasix for swollen ankles, and Potassium pills. Over the last few months she has been dealing with confusion, anger and diarrhea. Her doctor cut her Keppra dosage in half 3 mos. ago and stopped her daily baby aspirin as well. She was better for awhile, especially in the 'anger' dept., but is now showing heightened signs of confusion and anxiety (her diarrhea problem has been constant with her). Her doctor just recently cut her Lysinopril dosage in half and has hopes of getting her off completely; her b/p has not been high for quite a few years and it is almost too low now for her age. Doctor would also like her to get off Keppra completely in the near future as well. She has been through many doctor visits, lab tests, ECG recently too and is fed up, wanting no more testing... I agree with her Doctor's philosophy of fewer drugs in the elder years... Life is difficult enough with all the changes she is facing.
My question is this: Mom has an appt with a Neurologist next week. My siblings and I are torn with whether to go through with this appt or not. Would that mean more tests? (MRI, EEG??) and more medications? What kind of help can a neurologist offer that my mom's primary care doctor isn't able to? Thanks for your help!!

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We once met an awesome gerontology st when mom was in the hospital. We knew that for a variety of reasons, mom wouldn't be able to see him on a regular basis, so he gave me the short course in his philosophy of geriatric medicine.

1. If you are not going to do the treatment, don't do the test. (We were not going to do chemo or radiation, we didn't do the bone marrow biopsy)

2. Less medication is more. Fewer interactions, few side effects.

3. If a doctor proposes a treatment, etc., ask, "what would you do if it were YOUR mom".

4. Aim for quality of life. Meds that help with depression , mood, anxiety can be blessings to an elder. As they shouldn't have to deal with physical psin, they shouldn't have to deal with psychic pain.

I think keeping the appointment is a good idea. Just remember to ask questions about what the benefit of proposed tests are and what the possible treatment would be. DO ask about her mood.
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Yes. Keep the appointment.
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Just my opinion, but at 93 what are they going find and what how will it be treated and does it really matter at that age. I deal with my Mom and all her pills and have had some success in getting to eat and hydrate better. If she eats a little fruit each day it really helps with her chronic diarrhea and we've cut back on some meds.

Docs are trained to trouble shoot, treat and cure and that involves all the attendant hassles of appts meds etc. I think we need to find a balance between maintaining some quality of life, keep elders comfortable and as pain free as possible. We sometimes over diagnose, over treat and over medicate and end up destroyed what little quality of life elders have.
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An antidepressant might make a difference for the better. Just a thought.
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The neurologist is local to my mom's location. Wondering if confusion could be due to meds she's already taking (maybe a combo of them). She's old and very tiny and seems to react more readily to things than ever before. Just don't want to confuse Mom's life anymore than it already is...
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So you want to ask about the confusion and anger and if there might be meds to ameliorate those?
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Do you have to travel a distance to get to this appt? It seems to me that since you already have it scheduled and it is only a week away you may as well see what the doctor has to say. You don't have to consent to more tests or drugs unless they make sense to you.
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