Sad and frustrated!

Nanpr

Hi all, my mom just had an appointment with a geriatric psychiatrist. She has yet to be diagnosed with dementia. We were hopeful this would be the appointment that would give us some answers. Mom wouldn’t let us go to the appt, so we wrote a detailed letter of what has transpired over the last year. The nurse met with mom and must have ‘set her off’ as she did not stay for any testing. She left after 5 min. I am so discourage! I spoke with the nurse who had notes from a previous psychiatrist. She said that they think my mom has a psychotic disorder because of her hallucinations/delusions. I don’t know how she can come to this conclusion having only seen my mom for 5 min. I must add that she had a MOCA test and scored 18/30 5 months ago. She also had a brain injury from a car accident 15 years ago for which she was seen at a brain injury clinic from 2006-2011. I’m not a dr but I’m pretty sure psychotic disorders don’t show up when someone is 75 years old. Not to say there aren’t mental health issues as well, but doesn’t dementia present itself with behaviour issues, hallucination/delusions are quite common in all the research and education classes I’ve done! I’m so discouraged, as I don’t know how we’re going to get my mom the help she needs.

LaurenB

Have you attempted to contact the dr from this appointment?  I have found it helpful that our neurologist has an online portal.  There is a direct way to email them through the portal.  It allows me to communicate with the dr without my LO knowing.

Quilting brings calm

It sounds like the nurse was reading from the previous psychiatrists notes when she told you that.  Like you, I doubt she could form an opinion.  Nor could she make a diagnosis- unless she is a nurse-practitioner.  My LO only went to the intake appointment at a geriatric psychiatrists office.  She only saw an assistant of some sort.  About 30 minutes of mom expressing her feelings and then the typical 30 assessment questions.  She never really got diagnosed but the assistant told me on the way out that she probably had mild cognitive decline based on  the score.  She refused to go back because ‘talk therapy wasn’t going to help her’. 

Go back to your primary care physician.  Request him to help.  Ours is handling my LO in terms of medications and he now uses the word dementia when he discusses her situation. 

M1

Nan, I'm so sorry that happened but it's a familiar story.  She's unlikely to voluntarily let you participate and yet you must-otherwise it's like letting your child see the pediatrician alone. I'm assuming Canadian privacy laws and POA requirements are similar to those in the states? You may just have to come up with creative Fiblets to accompany her or get her to go with you. Doesn't sound like just communicating with the office ahead of time is sufficient here, unless you could get them to tell your mother that she must be accompanied for the visit-they might be willing to do that, saying that family input is required? Just a thought. 

Nanpr

Thanks for the suggestion! Unfortunately this dr does not have direct email!

Nanpr

Quilting brings calm, thanks for sharing your story! I do feel like we’re going to have to start dealing more with her family dr (in Canada like your PCP). Although, he doesn’t seem to see the decline like we do. It’s unfortunate with covid, that our Drs are rarely seeing people in person. I think he needs to start using some sort of terminology like Cognitive decline of dementia, so that my mom hears it!

M1, yes the privacy issues and POA are similar in Canada as the states. I like your suggestion of having the dr say that my mom must have someone accompany her to her appt.

This is such a difficult journey, I never thought I’d be navigating!

Iris L.

Nanpr wrote:

 I think he needs to start using some sort of terminology like Cognitive decline of dementia, so that my mom hears it!

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Even if your mom hears this, it probably won't make an impression.  70 percent of PWDS have anosognosia.  They are unaware of having dementia and become upset if you try to convince them that they do.  You will have to become proactive and learn work-arounds from the members.  

Iris L.