Should I be taking my mother to a psychiatrist or neurologist?

AbusedCaregiver2021

My mother is 74 years old and detected with Dementia. I had an appt  with a neurologist back in Dec and since I cannot really tell my mother's condition which way it is progressing I would like to get her evaluated again. 

With the psychiatrist they need her consent and she is not in a state to comprehend or agree to seeing a psychiatrist. The earliest neurologist appt I am getting is June 8th!!

How often am I supposed to be showing my mom to a psychiatrist/neurologist? how will i abel to know what the medicines are doing to her??

Any guidance is much appreciated. 

dayn2nite2

I’m confused-a psychiatrist and a neurologist are both MDs, why would “ consent” be required for one and not the other?

harshedbuzz

I'm confused.

Does your mom have long-standing mental health issues or are you seeking a geriatric psychiatrist specifically for dementia care and psychoactive medication management?

IME, once a diagnosis is made, most neurologists follow up once or twice yearly. Often they will have staff administer a quick MMSE or MoCA to compare to the last visit to monitor progression against the last visit. This isn't fool-proof as the results don't always corelate with how well they function at home. A complete evaluation is unlikely unless there is some change that points to a different kind of dementia- from say Alz to FTD or Parkinson's w/Lewy Body. 

Another piece is that a hands-on regular caregiver probably has a better sense of progression as most doctors visits happen during a time of day when a PWD is likely functioning at their best. And many PWD will showtime around doctors further clouding things. My dad put on quite the show with his geripsych and was able to test almost average for his age and education on MoCA not 9 months before he passed away but at home he was hallucinating, confused his urologist for my son, and was incontinent. What the geripsych saw and what I knew were miles apart.

Are you asking about Alzheimer's medications?

HB

towhee

Hi, welcome to the forum.

What doctor should see your mom? Ideally the doctor who diagnosed her. They will have information on her previous state to compare to her current state. But, they also rely on the information that caregivers report to them to determine progression. They usually just do the short mental exam, the results of which can be problematic depending on your moms condition at that particular point in time and whether or not she does better at the doctors office than at home.

How often to be seen? In general, unless there is a drastic change, every 6 months to a year. Used to be when a doctor was prescribing a new medication they might want to see the patient back in a couple of months, but doctors do also rely on caregivers to report any medication problems, especially in these times.

How do you know what the medications are doing? You go by the observations of the people who see your mom most often for the longest periods of time, with input from occasional doctor visits. The dementia medications are not known for drastic improvements in symptoms. The best you can usually hope for is to slow the increase in symptoms down.

I would take the neurologist appt and get on the cancellation list, you can often get an earlier appt that way.

You can also read about the dementia stages, I think Tam Cummings has a good one, hopefully someone will provide a link for you. Also, if you have not, you might want to check out the book The 36 Hour Day.

LauraPaul

It is my understanding and I may be wrong but if you do not have legal guardianship of your family member then yes some medical providers require consent to do a psychiatric or even neurological evaluation.  Which seems ridiculous to me since in many cases the dementia diagnosis (depending on how far along the disease has progressed) our family members may not have the capacity to consent to anything.  I have found medical power of attorney to be helpful.  My family member...his medical providers accept this form for me to make decisions for him because they do not believe he has the capacity to make decisions for himself.  

Don't know if that helps but hopefully it will

JJ401

 since I cannot really tell my mother's condition which way it is progressing I would like to get her evaluated again.  

If  you want to know about progression, I’d go to the same doctor. But, be prepared to not learn much. In my experience, there isn’t a lot you learn at an appointment that you don’t actually know. Living with your mom gives you lots more insight than a doctor visit.

How often am I supposed to be showing my mom to a psychiatrist/neurologist?

At the December visit, when did they say to return? DH usually gets told to make an appointment for six months before we leave (but call to come back sooner if things change drastically.)

 how will i abel to know what the medicines are doing to her?

Observation is usually the only way to know what the meds are doing. The goal of the current dementia meds is to slow progress. So if things stay relatively the same all is good.

Figuring all this out is hard. Read here. Ask questions. If the local support groups are meeting again, join one. In my experience, in person talking is helpful.

easy23

My husband's psychiatrist schedules appointments every three months to handle psychiatric issues, such as anxiety.  His neurologist evaluated his dementia symptoms and prescribed memantine  I would go with the neurologist.