Follow
Share

We made an appointment today to begin the process for Dad to see a doctor. He has declined mentally and physically for years, but as a very stubborn doctor himself, has never been seen or assessed.


Wondering what kind of testing would accurately determine whether one has dementia or Alzheimer’s, and how do you distinguish them apart in testing? Is there a superior method? Can any measure test how severe it is?


What questions should I be asking the doctor and what can I expect in terms of initial intake and recommendations? There is no health insurance and though he is 83, he has not used Medicare. All of this will be out of our pocket, but we need to do something yesterday - simple things like a handicap tag, a walker, and occasional help would help us tremendously. If he suddenly declines, I am terrified we have no plan. Can’t just pull up to a home and say here he is! And drop him off. Been in denial of how bad it’s been for awhile and we need help on how to get the most accurate diagnosis and what he needs, especially because there’s no coverage.

Find Care & Housing
Excellent advice everyone. I suggest that you also look into medicare supplement programs. Some are PPO and some are HMO. Talk to friends and find out what is available where you live - more in large cities, less in small cities. The medicare website has so much valuable information. BUT, the FIRST thing you need to do is get your dad to a doctor for a primary visit. Again, ask friends for their input regarding who is who in your area. Be honest when you call, without giving a lot introduction. You are calling for your elderly father who has medicare but has not used it. He needs an initial physician's visit and physical and mental health assessment. Good luck.
Helpful Answer (0)
Reply to toriej113
Report

When I noticed changes in hubby I told him since I was having memory problems WE both should get checked out. They did a CAT scan on his brain and said he had dementia. We got into a Medicare funded program that paid for everything. We got a PET scan with a special machine that showed his brain shrinking and the dreaded tangles and plaques that define Alzheimer's Disease. The CAT scan showed the shrinkage in his brain, the PET scan defined it as Alzheimer's. If you can get him to go, I wouldn't even worry about his personal physician, I would go for a geriatric doctor. You may not be able to get him to go. If you can't, I recommend just learning as much as you can. Teepa Snow, Caregivers: Dementia Care Heros, this site, and other places are good sources of information.
Helpful Answer (0)
Reply to MaryKathleen
Report

We found with my mother that it didn't make a difference whether she got an official "Alzheimer's" diagnosis. Her doctor evaluated her without any expensive tests and said she had severe dementia. We proceeded from there.
I agree with GenKazdin to start the education process. My mother has died, but my father now also has dementia. This website has been extremely valuable, not only for legal suggestions, but also helpful hints on know how to understand and survive dealing with our confused loved ones. : )
My sister and I were able to get a Personal Services Contract that protected some of my dad's assets. Medicaid Done Right was extremely helpful in getting him on Medicaid. We found a wonderful assisted living facility. My dad is very happy and my sister and I have gone from being nursemaids and house cleaners back to being his daughters. Our time together now is precious.
Hang in there.
Helpful Answer (3)
Reply to piogal
Report

From what I understand, the only 100 percent way is an autopsy of the brain after death. Of course most wont do that. It is generally diagnosed by comparing the behavior of a patient, by a neurologists and through various tests, with the baseline behavior of those who were known to have it. So it is more of a clinical evaluation rather than an empirical one.
Helpful Answer (1)
Reply to Karsten
Report

Just to say, the name tests are often not sensitive to certain dementias.

My mom, with vascular dementia 
was still scoring 15/15 on minimentals until way late in her progression. But she couldn't REASON! 
There were adequate memory skills but no executive functioning, sequencing or reasoning skills. This is a reason to get a full neuropsych workup. It tells the whole story.
Helpful Answer (2)
Reply to BarbBrooklyn
Report

The PCP may have limited knowledge. I hope you have an appointment with a neurologist but that person may ask for a full medical workup with a PCP. Ask for a "mini mental assessment" to start. You can Google it
Helpful Answer (1)
Reply to MACinCT
Report

Medicare A is required at 65 and covers hospitals, etc. Medicare B is available at 65 but must be enrolled in and a monthly coverage fee is deducted from your Social Security check. It covers doctor's visit (not prescriptions - that is Medicare D or get a supplement elsewhere). Call local Social Security office and see what they have on file for him. Do read all the many Medicare informational booklets that they send you.
Helpful Answer (3)
Reply to RetdGovtWrkr
Report

CaringForDoc, five years ago my now 96-year-old dad was diagnosed as having mid-stage dementia "consistent with Alzheimer's" by a geriatric specialist MD using the Montreal Cognitive Assessment (MOCA) test. He was reevaluated three years later, again using the MOCA test, by another MD and was found to be in late-stage dementia. His MOCA tests took about an hour each, as I recall. My understanding is that the MOCA test is similar to, but more comprehensive than, the Mini-Mental State Examination (MMSE), which I believe is more commonly used. Your dad's Medicare insurance will pay either 80% of the cost, or perhaps 100% if it's part of an annual wellness exam.

There are various causes of dementia, with Alzheimer's being the far most prevalent. The MOCA and MMSE are good, quick, non-invasive tests for diagnosing dementia and, as I understand it, help doctors who specialize in dementia determine the root cause, but are not precise in that regard. I think either of those tests is a good place to start and if dementia is indicated, then there should be a discussion about whether more invasive testing is warranted.
Helpful Answer (2)
Reply to bicycler
Report

My 85 year old mother never used her Medicare. We finally used it when she had to be diagnosed for dementia. Unless your father has never enrolled in Medicare, which doesn't seem likely since you are required to do so at age 65, he has it, although he may not have ever used it.
Helpful Answer (3)
Reply to ArtMom58
Report

Start your education process!! You have much to learn and it is all out there for you. Most states have a Council on Aging program. Call them, they have everything you need to know, assistance to offer, (in-home safety is essential!) You're at the point of needing facts, so stop relying on impressions that possibly are wrong. Testing is generally (or was, for us) by a neuropsychologist who did a comprehensive evaluation. It is not invasive and took about four hours. An MRI may also be done to actually see (the best way we have) any present deterioration of the brain. A diagnosis is made with these results. Each case is unique; what is true for my partner may well not be true for your loved one. One size does not fit all when it comes to dementia! I know you will find reliable answers suiting the needs of your family. Set up a Primary Care appointment, get Elder Care involved for local information and assistance, and it was a good idea to come here and ask. We are on this road and have experiences to share. The best of everything to you and your family!
Helpful Answer (7)
Reply to GenKazdin
Report

primary will start the process, call ahead of time to explain your concerns so the dr. can start the referral process to neurologists, etc.
Helpful Answer (3)
Reply to hine57
Report

Thank you for sharing your experience with me, that is reassuring. I was referring to lack of private insurance. I did not know Medicare covered all the testing. I’ve been under the impression Medicare doesn’t cover much, so I’m grateful for that info. Is a primary doc sufficient to start the process or is a specialist necessary?
Helpful Answer (2)
Reply to CaringForDoc
Report

Medicare covered a comprehensive neurological exam, mri, neuropsy testing and consultation with a psychiatric nurse practioner to assess mental health. That's how we got my mom's diagnosis.

I'm curious, if he has medicare, why do you say he has no insurance? Medicare IS insurance.
Helpful Answer (5)
Reply to BarbBrooklyn
Report

He has Medicare, though has not seen a doctor and I do not know what is covered.
Helpful Answer (0)
Reply to CaringForDoc
Report

Why doesn't he have Medicare?
Helpful Answer (1)
Reply to BarbBrooklyn
Report