Neuropsychology Evaluation? First Post

Melissapdx

Hello,

My mother was fairly recently diagnosed with Alzheimer's. 

We had been waiting months (it had been postponed once due to "insurance issues") for a neuropsychology evaluation which was scheduled for today. Unfortunately, the neurologist's child got sick and it was cancelled at the last moment. 

-- How important is this evaluation for understanding in which stage the person living with Alzheimer's is? 

-- For those of you who have experienced this assessment, what were/are the benefits?

I am wondering how effective/important this evaluation is because I know it will take its toll on my mother and, if not necessary, will opt to skip this test. 

She has had a brain scan and signs pointed to Alzheimer's in addition to her family noticing her memory struggles which have been going on for years. 

Thank you for any input -- I am just beginning this journey which feels quite daunting. 

Melissa

M1

Welcome Melissa.  Some people feel that its very important to have a formal evaluation, others not.  A medical evaluation to rule out other causes is certainly warranted but it sounds like she's had that. My partner never wanted to pursue formal testing, and many do find it stressful. You can get a good idea of stage by common behaviors- google tam cummings stages of dementia.

This forum can be a huge help, read a lot of threads and you will find stories that resonate with your own. Good luck...

Stuck in the middle

Melissa, I don't think my wife got any benefit from the neuropsych eval.  It angered her by making her feel stupid, and feel she was being abused for being stupid (her words).  And it will do that.  A clinical psychologist told me that they all take it as part of their education, and it makes these doctoral candidates feel like fools.  

The stage your LO is at is determined by her behavior and level of ability to perform daily activities, not a test result.  The only reason I would do a neuropsych eval again would be if I needed evidence for some legal reason, such as to claim long term care insurance benefits.

It is far more important that you and your mother see a certified elder law attorney (CELA) to make sure her medical and financial powers of attorney are in order.  AD is a relentless, progressive, ultimately fatal disease and she will need more and more help as time goes on.  She will at some point become unable to manage her affairs in her own best interest, and she needs to choose someone to manage her affairs.  Now, while she is able to choose rationally, is the time to make those decisions.

Welcome to the group.  You are correct, this journey is daunting.

Lindsay22

Hi Melissa, 

The main thing, in my journey with my mom, was actually getting a formal Alzheimer's diagnosis for her.  If you have that already I don't see a reason for further testing.  We needed that formal diagnosis to get the right kind of in-home and now MC services as well as applying for benefits through the VA.  Her PCP saying she seems to have "cognitive decline" was not enough, they wanted an MRI, bloodwork, cognitive tests etc. before they would give us a diagnosis of Alzheimer's disease. We ended up going through the ADRC which was tough on her but ultimately very good for getting a definitive diagnosis.  If she's had a scan and the diagnosis is there I don't see a compelling reason for more tests.

jfkoc

I personally think the medical exam is the most important part of the diagnosis. 

ALZ.acom at the top of this page has the information re the protocol to follow. Just review that everything was done to eliminate treatable problems that cause dementia.

DrinaJGB

My DH has had 4 NP testing sessions. The last one was just a couple of months ago with an additional diagnosis of mixed mild dementia and AD. It has changed everything.

feudman

Welcome. You can see just from this thread what a helpful site this is.

A full neuro psychological test can take 4-6 hours, but doesnt have to be done in one session. They can stop & reschedule if the patient becomes upset or agitated. We did ours in two sessions.

Such tests are important diagnostic tools, usually ordered by the neurologist seeking a dx or confirmation of one. In our case, it produced a spot-on accurate dx we likely would not have received without it. An accurate dx is very helpful in determining how to interact with your LO, what to expect generally as it progresses, and what meds will best treat symptoms. It can also reveal a lot about your LO's current specific mental deficiencies.

Not a must, I suppose, but I'm sure glad we didn't bow out...incorrect dx's are common when its NOT AD, and it's not unusual to have 2 or more types of dementia (confirmed by pathologists).

Come here often & read; I learned so much here & it really helped me be a better caregiver.

MarLee92

Hi Melissa, I too am fairly new here.  I have found this group to be so helpful and welcoming that I'm sure you'll want to come back often.  My MIL was diagnosed with Alz in August, 2021.  I had suspected for 3 years she had it, but her children kept thinking it was a sleeping issue.  It really took all the tests - especially the neuropsychological one - to convince them there was indeed a problem.  From the test, they could tell us at what stage they thought she was at and what we could expect at that level.  It really helped her children to hear this and to see the test results themselves.  I honestly didn't think my MIL would make it through the testing, only because I thought she might get frustrated or feel to anxious.  She did wonderful, it was about 3 hours total.  The thing is that where she was at with alz, she didn't remember it the next day.  I'm confused a little too about the diagnosis without an neuro. exam.......maybe somebody else can help me out, but we were led to believe that the MRI, blood work, etc wasn't enough to prove she had alz - so I'm a little curious about that.