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I am scheduling this appointment for the purpose of getting my 92-year old narcissistic Alzheimer's mom on appropriate meds for her anxiety and depression. I would also seek the doctor's opinion as to the appropriate level of care for her. Does the doctor administer tests or just interview the patient? Would I as the patient's caregiver and POA have an opportunity to discuss mom with the doctor?

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Most psychiatrists, geriatric and otherwise, use interviews. My mom had a geripsych exam during a hospitalization and my brother and I were in the room to add information and to confirm stuff. ( Mom has extremely conservative political views and was holding forth on Sarah Palin....the psych turned to us and said "is this typical?" ( meaning, we're these new views or usual ones). My brother said " that's mom; slightly to the right to of Atilla the Hun").

But seriously, I would make up a bulleted list of your concerns and fax them into the office. Bring a copy the day of the appointment.

Mom will need to fill out a HIPAA form for you to get info from the doctor, but even if she won't, you can GIVE all information you want.

In general, I schedule a time to talk to mom's doctors AFTER the appointment, on the phone.
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Took my dementia mom to a neurologist who specializes in dementia and alzheimers. Haven't even met the doc yet, did two hours of cognitive tests and questions and answers. I sat beside and slightly behind Mom, and so I made some big GESTURES like nodding my head in agreement or not. I also put my two cents in, but I was very careful not to interrupt Mom and I tried really hard to be diplomatic. Next is the MRI....then we shall see what happens. I also handed them a folder with info in it so they could read it on their own time.
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My mother needs a geriatric psych consultation because of her anxieties. She will never agree to go, though. I can't force the issue. But I can refuse to put up with her repetitive rantings about things.

Things will have to get a lot worse before they get better. She's in full control of everything. I'm not even allowed in on her doctor visits anymore (because she doesn't want them talking to me and not her; she's very sensitive about people thinking she isn't "all there"). Never mind that I don't think she even hears half (combined with not processing and then not remembering) of what is said to her.
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When Mom, in her late 80's, started having frequent UTIs and behaviors, we took her for psych evaluation, sleep apnea testing, lots of things to see what could be done. Sleep apnea turned up nothing; the psych evaluation was not something I even understood, she is also legally blind, a lot of things can be from that. something called Charles Bonnet Syndrome where you imagine things going on that aren't. Can't really add anything, just sympathize with all the uncertainty, busyness with doctor appointments, ER visits, etc. She now is pretty comfortable at home, is 91, I moved in with her for now. She had a hysterectomy last Fall, she just seems to keep going.
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It does help, indeed. Have already made an appointment and preparing for it as well as I can. Thank goodness for this forum. You have all helped so much.
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My mom back in 2008 (when she was in her 70s) had the lengthy cognitive testing and just refused to cooperate before it was over with. They wanted her to retake part of it but she just would not. I can't imaging putting somebody in their 90s through all of that. I would think it would be best just to try small amounts of medication and see what works rather than put them through the mill. She is now on a small amount of Depakote, her old antidepressant, plus Namzaric at the nursing home. No miracles have been observed, lol.
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I took my husband who had Alzheimer's to a highly recommended doctor for the evaluation after it was recommended that meds might help his anxiety. It was a DISASTER! The doctor told us there was nothing wrong with him or his brain, only that he was lazy and wasn't using his brain. I stopped the appointment and unfortunately my husband was traumatized for days. Just remember, you are their advocate and must speak up when you think something is wrong or should or shouldn't be done, even to the doctors. Good luck!
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I took my mom to a neuro psychologist who specializes in aging after her GP administered a mini mental status which she failed miserably . The neuro psychologist administered a 2 to 3 hour test which results indicated she had MCI with amnesiac features. He suggested she keep driving and working. (Part time job). She quit doing both with in 2 months. I do call her doctors office to discuss her symptoms. I have POA and the medical POA I didn't feel comfortable disputing her responses in front of her when she was being interviewed by either the GP or the neuro psychologist , so I had written my concerns and handed the paper to the receptionist before the appointments.  Hope this helps.
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It seems that 2 - 3 hours of written testing is a lot for an elderly patient. My mother is 91 and bipolar and is treated with seroquel and depacote. She still has manic episodes twice a year but they are milder than without meds. She was referred for a psych evaluation but won't go. At this point I've decided that changing her meds is no guarantee that there will be an improvement so things will remain the way they are.
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There are no perfect solutions for disease and suffering. Mom is 91 with Alzheimer's, vascular dementia, and mental problems that won't quit; a fall risk with or without medications. If medications will ease her misery for she has left, I say bring them on.
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