Geriatric Doctor vs. Neurologist - Your experiences

RunningWorried76

Two years ago when we realized things were not right, we took mom to a neurologist, and got the diagnosis after many tests. One of the impressions I got is that neurologists (or maybe just this one, not trying to stereotype all neuros) are more of "this is what's wrong, there's no cure for this condition, come back for a follow up." We never followed up, mainly because mom lived far away. Now that she's with me, I will schedule a follow-up.

Looking to also set up an appointment with a Geriatric Doctor soon, as someone recommended that to me. Curious to see what experiences/tips you have about this?

Also, Geriatric Psychiatry might be in the works.

smbren

I had the same question in the beginning.  I went with a geri psych who specializes with dementia.  

In my research (some on this site), I learned that many neurologists are seen on a schedule once diagnosed (every 3 or 6 months) just to get a prescription refilled.  But they don't offer much more to you.  A geri psych with the speciality is able to send her out for scans or a consult with a neurologist if needed, but a geri psych, in my opinion, will help you through this much better.  

In today's world, it is quite easy to research doctors in your area.  I had it narrowed to 3.  I then talked with my primary care doc and friend, one of them he immediately said no (I didn't ask why, it was such a fast no that it was shocking!).  The other two he said he would recommend.  

LicketyGlitz

We have only had experience with geriatric psych doctor, Running, and they have absolutely been the most helpful person on my mom's care team.

Dr. Susan specialized in medications that could help ease some of the worst of dementia's manifestations. She has always been so kind to Mom and I during office visits - Mom couldn't verbalize much but I was able to let her know what was going on. She was an angel when medications were prescribed - working with us to find the right med for Mom, the right amount, and the right time of dosing. Even a year later when dementia progression would be changing she'd pop back in our lives and reassess what Mom was taking and what might work better, or what might not be needed at all.

Good luck with whatever you choose! But I sure can't say enough good things about our geri psych experience.

harshedbuzz

We had all 3 for dad.

Dad's neurology appointments went very as your imagined- cutting edge diagnostics to help fine tune the diagnosis which can impact treatment to a degree as well as inform around what to expect down the road. Dad's neurologist was affiliated with a university teaching hospital's memory center which offered an array of resources, supports and services. We didn't make use of these because of distance, but the social workers that were part of the team were helpful a number of times. dad loathed the neurologist who reminded him of his diagnosis as well as banned him driving and managing money. FTR, dad had mixed dementia including one related to alcohol abuse which required abstinence so discussing "lifestyle changes" and consequences was appropriate early on.

Most of dad's regular care was overseen by a family practice PCP as the gerontologist in the group practice wasn't currently taking patients. He was new to my parents and fine, but when dad went into the MCF we chose to have his PC overseen by their contracted gerontologist rather than take dad out. Because he oversaw patients at a handful of MCFs, his hours were not carved in stone so I never did meet the man. He generally connected with us over the phone to discuss care. He took a much more palliative approach to dad's care than his former PCP- given dad's reduced life expectancy, he weaned dad off a couple of medications he felt weren't benefitting dad or that had a potential for side effects. 

Like Lickety, the geriatric psychiatrist was the single most important member of the team after my own mother. Dad always had a difficult personality which dementia magnified; he likely had some untreated mental illness most of his adult life. I fully expected to have to sneak up behind him with chloroform on a rag to get him in to see a geripsych but he loved those appointments- he felt heard, respected and as if someone was trying to help him. Prescribing psychoactive medications is something of a dark art and these doctors are the specialists with the most expertise in the area. 

HB