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Old 04-30-2013, 06:22 PM   #1
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My mom was tested today

Hi Everyone,

I wrote last week describing my mom's issues and telling you I was about to get her tested. We went today and I feel so confused after seeing the neurologist. He was asking my mom questions about her living arrangements. She explained part of it and when I went to add to it he cut me off to say he was trying to engage her. So I sat quietly while she answered his questions. Most of the time she was giving partially true answers or was misleading. He didn't know this because I was now quiet.
He asked his test questions- what is today's date? She answered april 30th 2020. He asked 2020, are you sure? she thought and then said no, lol it is 2013. Next Question: how much money is 60 nickels? She answered 300.00. He said no. Then she said 30.00. He said no. She then asked 3.00? He told her Correct! Very good. My mom was a waitress most of her life and very quick with addition and money.
Next he asked her to remember 3 words which he would ask her about later. Apple, Umbrella and Cincinatti. After 5 minutes she remembered apple only. He told her them all again and asked her to repeat again. 1 minute later she remembered all 3. Next he asked her to draw the face of the clock and the time of 40 minutes after 3. She drew 2:55. He asked if that looked right and she looked confused and started to count by 5 but seemed so confused. Finally she said I want 3:40 and he said Correct that is right. She told him, but you confused me by saying it THAT way. She drew 2:55 and he didn't say any thing about that? She spelled the word WORLD correctly forward and backward and she drew two shapes he asked her to draw exactly like he did. After all of that he said she did near perfect and he thinks she is just depressed with anxiety. She said she doesn't feel depressed.
What makes me angry is he took her at her word for most of her answers which were wrong. At the end I started to speak up. He had asked if her eyes were tested and she said no, my eyes are perfect. I said mom remember we went last week and you were told you have cataracts and need a cornea transplant? He asked about why we were there and she said she didn't know. I then said we had concerns because of driving incidences which she told a completely different story to him then what she told us last week and what actually happened. She said there were 2 incidences when there were 4 . I told him she has been telling stories/lies about money issues. I explained all her personality changes. He said when a person is depressed it can affect their memories and personalities. He said if someone gives you a list of 6 things to remember and your spouse calls to give you bad news about your son you will forget 3 things on your list. If you then leave work and are being chased by someone with a knife you will forget the other 3. So therefore with her depression and anxiety she has pseudo dementia. Since she is not driving she has no life. I explained she was acting differently while she was driving. She was still withdrawn and not at all her usual social self. I also explained when she was driving the last year she was fired from 3 jobs. Her whole life she was independent and I cannot remember her ever being fired from jobs. She usually left for better opportunities. And my last point is my mother had a very dysfunctional childhood. She lived through many hardships and she hasn;t always made the best life decisions. She married poorly several times. She raised 5 kids without much help. She had many, many reasons to be depressed through the years and never was sad. She always, always had a positive out look on life. She always said fake it until you make it. Boring people get bored. Activity creates energy. I can go on and on with all her sayings. Why now would she get depressed? This does not feel like depression. This feels like something changing her mentality and her slowly losing skills.
Has anyone else experienced totally doubting the doctor?

Thanks for reading!

 
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Old 05-01-2013, 08:15 AM   #2
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Re: My mom was tested today

Stepdig... it sounds exactly like what happened with my Mom. She had never ever been depressed in her life. She was the poster child for upbeat positive energy. Yet her first doctor assured us that what was going on with her was "just depression". He gave her an antidepressant which she forgot she had and forgot to take! Later, Mom's second doctor was telling us basically the same thing. She just needs to focus more. HUH? The class valedictorian with an incredible IQ who was able to do anything she put her mind to needed to focus. HUMMM! In the mean time she was doing much like your Mom on the MMSE (which is what he gave her). That is only a preliminary quick test to see if something might be wrong. Obviously, from the answer you gave her, she had some trouble with the test. She needs further testing....

Is there a Memory Assessment Clinic or Cognitive Testing Center in your area? I would ask the GP or Neurologist for further cognitive testing. At least a referral to a Geriatric Psychologist.

I am not sure why doctors do this. They take the word of someone that is being tested for memory issues at face value and ignore the advocate who is there with them. They allow mistakes on a test that should be done perfectly. Or they label it depression. You know better than the doctor what you have been dealing with.

Question, did he give her a follow up visit? Perhaps to come back in 9 months for a follow up evaluation? The best way to know if it is truly dementia is to have an evaluation and then a follow up evaluation in 9 to 12 months. Then they reevaluate. That way they will see the progression of the dementia. It's sad but true... this is what truly tells the story PS UMDNJ has a memory assessment. I used a memory assessment connected to our local university and that is where Mom was diagnosed. It might be worth contacting them for an evaluation

Love, Deb

 
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Old 05-01-2013, 09:49 AM   #3
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Re: My mom was tested today

Sigh. Many doctors, including neurologists do this. Really makes me want to slap them up one side of their head. In my personal instance, after neurologist proclamation all was fine, she went around proving to everyone how great her memory was by stating things like how she remembered what she had for dinner on her 14th birthday or something like that.

 
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Old 05-01-2013, 02:44 PM   #4
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Re: My mom was tested today

Sounds like your mom needs the full neuropsych tests, but if your neurologist won't recommend them it may be difficult to get the insurance to pay. They cost about $1000 as I recall--it is a full day's work for the tester. My husband didn't do very well on the short test the first time, although he could remember the three words. A month later he did everything right but draw the clock. However the neuropsych tests revealed a moderate executive function defect and visual-spatial problems that indicated mini-strokes, or TIAs. He has actually gotten better in some respects, but he can't play bridge anymore and you have to say everything slowly and multiple times before he "gets" it.

Last edited by Arleeda; 05-01-2013 at 02:45 PM. Reason: left out important description

 
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Old 05-01-2013, 04:29 PM   #5
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Re: My mom was tested today

One reason I recommended a research clinic is because of the prices. Mom's full day of testing was about a quarter of what you would expect to pay because it was subsidized by the research grant The information from her testing (twice) has been used in their research data related to diagnosis and medication effectiveness. So it not only helped me get her diagnosis but also helped figure out just what is going on in the early stages of this disease.

Love, deb

 
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Old 05-02-2013, 06:39 AM   #6
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Re: My mom was tested today

Once of the most important things I have learned in life is that Doctor's are not infallible. There are very few who are "spot on". The best ones are so busy they don't take new patients. We had a poor one for mom's initial test, like your mom had. The next time, we got in with a good one, who recommended mom get the 2 day test, by a psychologist. Medicare paid for it, although mom has a wonderful medigap policy, which picked up the additional 20% not covered.

 
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Old 05-02-2013, 07:59 AM   #7
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Re: My mom was tested today

I am wondering that if the first time the doctor or even a specialist refuses to diagnose the elderly, what kind of suffering the elderly has to have to go through more tests and even longer test? Being diagnosed the first time is a wonder like what my late FIL had.
If it doesn't work, how do we subject the patient to this kind of torture of being asked so many funny questions?
e.g., my sister said my Mom has seen many doctors for her other health issues that she should not be diagnosed by a neurologist again. It is traditional thought. No one dares try the diagnosis. Now the rehab. doctor insists that Mom can get well. But the first MRI on her left leg was done without contrast! Now he needs another MRI with contrast? And the doctor told her she will get well. I don't believe him. It is like he is pampering Mom.

Back to the topic, if the test for the second time or even the third time is long and bothersome, I wonder how you make the elderly go through this? It is right we don't allow the elderly to decide this thing about dementia, but we still have to make sure she doesn't go through too many tests for dementia for torture! For them the questions are challenging.
Someone in this board did say that the specialist stopped diagnosing her Mom because of her mental stress under the test.

Hugs,
Nina

Last edited by ninamarc; 05-02-2013 at 08:06 AM.

 
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Old 05-02-2013, 08:26 AM   #8
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Re: My mom was tested today

In my opinion testing for dementia is not torture. They are no more invasive or painful than testing for cancer or any other disease. It is a series of questions. It's not a biopsy, blood test, or exploratory surgery. They are bothersome because those with cognitive impairment have difficulty understanding and answering them. But that is exactly what the doctors are trying to find out when they give these test.

I truly believe that the problem lies in the fact that it is a brain condition which manifest itself in ways that are no physical. You don't see the lump. You can not test for the inflammation. You can not understand or see the physical changes that happen. What you see is the cognitive changes which manifest themselves in emotional and mental disabilities. It is layered into medical science along with mental illness.... when in fact it is a physical illness. That puts it in a category that doesn't fit anywhere in our medical system. The neurologist sends a patient with brain damage to a psychiatrist?

At this time there is no cure. There is no effective treatment. It is a terminal illness with no hope at present. Yet it is also a disease that has no definitive test for diagnosis. The doctor has a simple verbal test. The patient can not draw the clock. That is something that every cognitively aware individual can accomplish. But the doctor's are unwilling to diagnose a terminal, untreatable disease on the basis of drawing a clock! Yet those of us that deal with our loved ones on a daily basis already know.

The other problem is awareness. As prevalent as it has become, so many doctors are totally clueless relative to how to diagnose and what it means. They have no clue how to help the patient or the care giver. So they say it's ok and hand out "Memory Drugs". From the time a loved ones hits mid stage dementia, their entire health protocol should be different but it's not.

That is why it is up to us, as care givers, to keep trying to get the right diagnosis and the right medical treatment for your loved ones. Sad to say, many times, we do know more than the doctors. So if you have a memory research clinic in your area, at least they understand what you are up against.

I would put Mom through that day long testing again if I thought it would help understand her dementia. I received a lengthy report specifying exactly what cognitive abilities she was deficient and which ones were still intact. Using that information I was able to communicate with her better for longer. I knew her audio processing was deficient so talking to her was ineffective. But her visual processing was still in tact so I could show her or even write her notes to indicate what I wanted to get across to her. I knew she had trouble changing her focus. So I could use that to my advantage. This is what we all need... not just the word dementia

Love, deb

 
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Old 05-03-2013, 10:47 AM   #9
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Re: My mom was tested today

Thanks again everyone. I figured I was better of trusting my instincts because I do know my mom better than the doctor and I have seen her change. I am truly angry he told her she could drive even after I told him she has had 4 driving incidences. If it was ONLY her eyes I know my mom in her right mind would have been nervous about being in another accident and sought out help.

 
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Old 05-03-2013, 01:39 PM   #10
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Re: My mom was tested today

stephdig... don't even get me started on doctors and driving! Even after a diagnosis of moderate to sever dementia consistent with Alzheimer's, Mom's primary physician told her it was ok for her to drive if she would just focus more. DUH! I explained that she had a warrant for a hit and run, had several other minor driving incidents as well. She had never had any driving incidents until dementia. So how could he say this? Because he doesn't want to be the bad guy and take away Mom's independence. I finally went back to the Memory Clinic to have them tell Mom she could not drive. In reality, the doctor should notify the Department of Motor Vehicles that Mom is unfit to drive and they should take away her license.

You can call your local Alzheimer's Association and ask for their local driving testing facility who does cognitive driving testing. They will test Mom and either give her the green light or tell her she can not drive based on her current cognitive ability. If there is one in your area this is the route to take

Love, deb

 
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Old 05-03-2013, 02:31 PM   #11
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Re: My mom was tested today

In Michigan, just recently Doctors are now required to notify the DMV if the elderly should not be driving!!

 
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Old 05-04-2013, 07:14 AM   #12
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Re: My mom was tested today

Quote:
Originally Posted by stephdig View Post
Thanks again everyone. I figured I was better of trusting my instincts because I do know my mom better than the doctor and I have seen her change. I am truly angry he told her she could drive even after I told him she has had 4 driving incidences. If it was ONLY her eyes I know my mom in her right mind would have been nervous about being in another accident and sought out help.
I personally think that the doctors are NOT caregivers. They have no idea how the patient lives day in and day out. They only offer their professional opinion in their ivory tower. It is also up to the family to do what is right.
Don't go with the doctor's foolish judgment. If you find it dangerous for Mom to drive, stop the car, take away her license. Pretend that the car is broke and etc. Do all you can to stop it. It is like someone is drunk and cannot drive. You take away the key and don't let him/her drive. You don't wait until the cops to come to tell you to stop driving.
Caregiving is like that too, don't wait for the doctor to say so and so. You are closer to your Mom so you can do what you need to do without the doctor's "permission" although it helps if the doctors are on your side.

Hugs,
Nina

 
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Old 05-04-2013, 04:48 PM   #13
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Re: My mom was tested today

What I found worked best for me - and I had my mother's medical POA so could get away with it - was to meet with the doctor when she did and then have her wait while I talked with him privately - or I went back later by myself. I never corrected her while the three of us were together unless I was directly asked. I made notes and used them to take with the doctor afterwards. Of course it helped that the doctor knew what was going on. But it just was counterproductive to do it in front of her.

 
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