New(6)

Carolb4

I am the primary care giver for my mom, 87, who has never received a dementia diagnosis.  She was diagnosed as MCI about 7 years ago by her psychiatrist that we do not care for.  Which leads to my first question - should I seek a diagnosis from a Neurologist? We have many services available I suspect because her medical care is all managed through Vanderbilt in Nashville.  Her memory loss and cognition has definitely changed in 7 years. She began sundowning about a month ago and is very confused about her location, is very argumentative, doesn’t remember living/dead family members.

She is currently not taking any medication for Dementia. She tried Aricept several years ago and it made her very ill, with vomiting. 

So, should I request a referral to Neurology and ask about medications to help with the sundowning?

Rescue mom

I would highly advise asking anybody and everybody (knowledgeable, at least, you know) for a Dx and whatever help they may be able to provide. A neurologist can diagnose and prescribe some drugs, but most people find them little help beyond that. But they can often point you to others who can help. Sometimes having an official Dx makes it easier to get other help.

A Geri-psych is invaluable in finding the right drugs that can at least help calm her, if/when needed. A hospice may also be able to help. If she has a dementia Dx, hospices no longer require “death in 6 months”, they can be more flexible with dementia cases and can provide great help with mobility and incontinence, both of which are likely unless something else claims her first.

As you probably know, no drug will “cure” or stop dementia, but some drugs can help deal with some symptoms, such as agitation and sleeplessness. 

Given how confused she is, I assume she is not living alone now, and that she does not have control of her finances. (??)

You may want to start thinking about where and how you can find other caregiver help, it’s almost impossible for one person to do it all 24/7, especially when sundowning starts. Sadly, dementia is progressive. It does not get better.

Marta

In my experience, she DOES have a dementia diagnosis; otherwise, she would not have been prescribed Aricept.

After seven years of decline from MCI, you can be sure her dx. is dementia.

Now, to your question:  a geripsych doctor would be the best person to consult for dementia with behavioral issues.