Many of my senior patients in family practice came to me and never mentioned that they had dementia or any problems thinking, remembering, or having any difficulty with common day functions or any difficulty with common day functions. They do not want to speak of dementia, let alone get dementia diagnosed.
It was only when their loved one, a daughter, son, spouse, or partner came in with them that I could begin to understand what was really going on. These are the folks who will guide the physician through the diagnosing process and are the greatest help to get dementia diagnosed.
Why? Because a 15-minute visit with a patient is never enough time to figure out dementia.
The biggest mistake? THE DIAGNOSIS.
The biggest mistake a family member or carer can make is to assume that there is just one test to diagnose dementia.
In truth, there is no one test to diagnose dementia and all the different types. But there are ways to finally get to the correct diagnosis, but all of this takes time.
Step #1: Evaluate everything in order to get dementia diagnosed.
The family member brings in a list of behaviors and dysfunctions to evaluate. The doctor then knocks out the things which COULD look like dementia but is caused by something else. Once these things are taken out removed from the playing field, we are left with the behaviors and functions that still look like dementia, but still, there is no explanation.
Now it is up to the carer, or family member to go back to the drawing board. At this point, the family member is crucial to the diagnosis of dementia because they are going to continue to evaluate these behaviors to see if they are improving or still getting worse.
See the FREE GUIDEBOOK to help you understand their behaviors, COULD IT BE DEMENTIA?
Now do not let your loved one know that you are doing this because they can be offended by your actions and may try everything and anything to not do these behaviors or functions, thus giving you a false test.
Step #2: Make a Copy.
NEVER give your journal to the doctor but make a copy of it. Papers get lost in a clinic and you need your own personal record not only for safekeeping but if you need to take your loved one to another doctor, you will have the record with you and not have to call and get it released.
Step #3: Write a Letter.
Unless your loved one has given you permission to speak freely about your concerns, you may need to go behind their back to give this information to their doctor. This is NOT a HIPAA violation. It is OK for you to GIVE information to a licensed professional. It is NOT OK for them to give it to you, without your loved one’s permission. So how do you do this? The best way is after you made a copy and clarified all your notes, put it in an envelope with big words “TO BE READ BEFORE YOU GO INTO THE EXAM ROOM to SEE Mrs. So and So (your loved one). Let the doctor know in a note that you have tried to talk to them, and they have refused to discuss it and you would like him or her to open the discussion.
A professional will know exactly how to handle this. All doctors appreciate a team approach to evaluating this kind of disease.
WARNING! Personally, if the doctor just tells you that this is common aging. Thank them. Politely get up and go find another doctor. Better yet, find a geriatrician. Explain to your loved one that these folks work with the elderly, just like a pediatrician, works with babies. A geriatrician will always take your concerns to heart.
Examples of typical behaviors or functions seen in a dementia diagnosis.
- Your loved one never used to have trouble with reading, writing, or arithmetic but now struggles and you are seeing little mistakes. (They tell you you’re crazy when you try to address it.)
- They are making poor decisions.
- Your loved one had always been kindhearted and gracious and now seems “put out” by people. (They tell you it’s because they are tired.)
- They are forgetting the year or the month.
- They are having trouble with money or worse, giving their money away.
- Their thinking isn’t quite right. They say things that seem “off” or unrealistic.
- You begin to notice their memory slipping. You just told them something and now they ask you again.
- They seem frustrated with day-to-day activities like dressing, cooking, cleaning, etc.
- Delirium – This comes on quickly. See medical help immediately. They seem confused or hear and see things that are not there. They may not be aware of their surrounding, avoid eye contact, do not know where they are, and see and hear things. May have slurred speech and talked about things that do not make sense. Sometimes they get restless, attack you, and cannot be consoled. Delirium can also be caused by depression, medications, or grave illness. Do not assume it is dementia, but dementia must be ruled out. So get help quickly and let professionals take over.
Think of the diagnosis as a train trip. You start out at the train station #1: this is YOU giving the doctor all the information you have after 7 days of journaling your loved one’s behavior and dysfunctions. At the next stop, the doctor may go over the test results after running some labs. On the third stop, the doctor may order an MRI of the head. This is not a definite way to diagnose dementia, but it helps.
Each time you and your loved one’s doctor eliminate a cause, you are one step closer to the diagnosis of dementia. Keep that journal nearby.
Along the way, your doctor will eliminate more than 10 other things that can cause dementia. To get dementia diagnosed, you need to be patient.