Time for Doctor Change?

Wilted Daughter

Sigh!!!!!

Mom's primary left the practice last month and new NP, after 1 phone appt., doesn't seem equipped or medically knowledgeable about treating Vascular Dementia. I asked what was her medical experience with Dementia to which she responded with a story about her grandmother and stories shared by her mother???? She doesn't appear to know the meaning of stages aside from mild or severe which are both relative to her grandmother.  When I requested re-evaluation to assess the progression after an incident in the summer (mom fell hit her head) her response was to refer to an Independent Living Agency (we already have input from them...Dementia). 

She's not helpful on treatment options (said there is no treatment for Dementia) and diagnosed mom as having mild cognitive impairment because of her knowledge of blood glucose numbers (not checked for accuracy) and what mom does 3xs daily for YEARS.

It took approx. 6 years to get mom diagnosed, I'm not 'reinventing the wheel' to bring a new doctor up to speed. The time is right to search for new doctor (new insurance, previous doctor left the practice...). 

Managing dementia/doctors etc. is draining.

jfkoc

I understand the sigh. 

You are going to need someone on your team that can help. How about finding a neurologist?

SusanB-dil

well darn!  How frustrating!  You shouldn't need to teach her what it's all about... just sayin'.

Agree - find someone else...  and jfkoc good suggestion with neurologist.  

mommyandme (m&m)

Seems like new NP isn’t up to this challenge.  Sorry you have to get a new medical partner for your mom.  Not an easy task.

Lindsay22

Who did her testing when she was diagnosed? A neurologist? I would just ask the current practice for a referral to have a new MRI and testing done while you look for a new PCP.

Wilted Daughter

Good suggestions. I can always count on you all to provide good/sound information. The initial course of action was Memory Services agency (Neuropsychologist/LICSW) evaluation with follow up referral by PCP for MRI which was recommended by the neuropsychologist. I can call the neuropsy... tomorrow and schedule re-evaluation (appt probably schedule out into late summer or early fall). It's a two sided approach written evaluation then referral for MRI. To avoid delay, wanted to schedule MRI first but we'll see what happens with tomorrow's calls.

Thank you 

Stuck in the middle

A gerontologist might be a good choice if you can find one.

Marta

If looking to measure progression, your own assessment will tell you more than MRI. 

MRI does not diagnose dementia or its progression.   Mom already has her diagnosis.

Any significant consequences of last summer’s fall will already have manifested. 

Medical providers use only mild, moderate, or severe stages. The elaborate description of stages we use on these boards is for caregivers;  it’s a shorthand way to communicate our loved ones’ condition. 

Is your Mom on memantine and/or a cholinesterase inhibitor?  Is she on BP, cholesterol, and blood thinner meds?  These are the treatments for vascular dementia. 

Good luck. 

Wilted Daughter

She is not treated for VD that's the problem.

Since the last post, I scheduled re-evaluation with neuropsy...booking in fall 2022. That office suggested referral to neurologist, which was requested. I also scheduled appt with a PCP in the same office who notes "...geriatric patients..." in her profile. 

The initial MRI showed that mom has VD (...flow of blood to brain...). The initial neuropsy... eval reported alz type dementia...the two exams/reports were put together for noting her medicine records, which simply lists Dementia. Need that changed to VD for a baseline for treatment or reevaluations. 

Some medical professionals are fully aware of the dementia stages, treatment for symptoms, etc. based on training, experience, research, specialty etc. You really have to be cautious in the world of false information/misinformation as it can negatively affect someone who uses the information to make a decision. But I guess we don't know what we don't know. 

Thank you...bye for now!