Is there a reason for 94 year old to have testing?

Tina M

I have been in denial.  About a year ago my 93 year old mother was admitted to the hospital due to a fall and the physician informed me that she had dementia.  I didn't believe him. Then I went to her house and with her not there started to really notice all the ways I had been enabling her to cope.  Notes all over telling her how to use the microwave, use the stove, set the thermostat, operate the television. 

Since then she has been living in a memory care unit in an assisted living facility.  Over the past year I have been dealing with her worsening dementia.  Apparently I was still in denial.  I was positive she did not have Alzheimer's.  Well I am here to say that I just recently spent a lot of time on the Alzheimer's website and have come to the realization that it must be Alzheimer's.  

Six months ago her physician made the referral to neurology.  However they, of course, want an MRI and a CT and other testing to make a diagnosis.  I understand.  But my mother is almost 95 and very confused at this point and I am wondering if there is any reason to go further with testing and an official diagnosis.  What will be accomplished?

I already have a letter of incapacitation from the physician and all POA documents are in order.  I have been handling everything for years and as of the last year, she no longer has access to any of her finances or medical decision making, so nothing to be gained there.  

Please tell me what those of you who have been dealing with this for years think.

Thank you.

jfkoc

The only testing I would look into is the lab work which might reveal something treatable.

Tina M

Thank you for your reply.  Are you speaking of regular blood and urine testing?  We keep up to date on all of the general health testing.

Iris L.

Check her vitamin B12 and thyroid levels, to start.  Low levels can mimic dementia.

Iris

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dayn2nite2

There is no way I would put someone of that age through imaging to get a diagnosis they already pretty much have and are in the appropriate setting for anyway.

harshedbuzz

Tina-

I have a dear friend who was in your shoes some 5+ years ago when my own dad was initially diagnosed in the mid stages.

Her beloved mom, 91, was slipping. It seemed worse on trips and vacations, but mostly mom had a routine of puttering around her own house until about 1pm when my friend picked her up to run errands and have dinner together. As time went on, my friend decided to move mom in with her and was gobsmacked at how badly mom functioned when she wasn't around to scaffold and set her up for success. 

She was reluctant to pursue the same diagnostic process to which we subjected my dad. (FTR, he was one of those zebras who did have a dementia/amnesia caused by a vitamin deficiency, but he also had Alzheimer's so correcting that only bought a short term return to a better baseline) Her mom's internist ran the bloodwork for vitamin and hormone issues to rule them out. 

She is already getting the help she needs, I don't see a need to subject her to further testing. 

HB

Tina M

Thank you so much for sharing that with me.  I believe I knew the answer was not to do those tests but now I can move forward without adding more anguish to my plate.

abc123

Hi Tina! Welcome to the forum. I think you have gotten some good feedback to your question. I would not put a PWD of that age through those types of procedures either. You seem to have some very important matters already covered. Your mother is fortunate to have you as her daughter. There are so many wise and caring people here, I'd be lost without them. Please keep posting and ask any questions you have. We support each other and truly care about each other. 

Sincerely,

abc123

zauberflote

Tina, please stop kicking yourself over "being in denial". Regardless of what you thought it was or wasn't, you did exactly the right things all down the line! 

Doing the blood and urine work is the least miserable of all the testing that may be proposed, and the only one that might possibly change her treatment and gain some improvement if there are hidden causes of dementia-like issues. So I agree with doing that, especially if a traveling phlebotomist can come to her place and do the blood draw.  

When my mom was almost 92, her hip broke and we had the whole hospitalization situation. The xrays alone nearly sent me round the bend. As you say, save yourself, and mom, the anguish. You have done well. Enjoy your mom and let her enjoy you. 

Michael Ellenbogen

Yes and MRI or other type of exray they recomend.

pickleballhelps

I just learned about this forum. Mostly because in talking with the nursing director of the memory unit my dad was just admitted to, I burst into tears.  Actually, I am crying AGAIN.  Moving my Dad had to be a covert and deceiving mix of events in order to get him admitted.  I have gotten mixed messages on my role in the first month. They at first told us to wait 'several weeks' to visit- let him settle in.  However, 1 week into this, the nurses called and wanted us to visit because he was so sad "devastated, hurt, angry, betrayed".  To a degree, these were his. behaviors BEFORE he was admitted. I explained this to them. They suggested I visit.  I waited, mostly on the advice from siblings.  Same call the next week so I visited.  It was awful. He was bent over most of the visit, lamenting why after all he had done for us, we abandoned him.  "why can't I come to your house" etc.  It was a difficult 2 hours.  The caregivers said he was "fine' after I left- but I was not.  2 nights ago they call me and asked me to talk dad down because he was so agitated, wanting to call the police because he is lost and can't find his wife.  The next morning we insisted on a meeting with the staff. I cannot be their strategy when they need help to manage dad.  They admitted nobody should have called me.  We pressed them on what their plan of care was.  They came up with a plan of care that includes not calling me (Im the closest child, and have been mom/dads source of help for years). My brother will take calls only in emergencies and he will contact me (the POA) if needed. We requested neuro and medical evaluation for medication adjustments.  My siblings all came (3 of them) to help accomplish dad's move for which I am very grateful. But they're going home now. I have got to get myself together because it's going to be down to me again.

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pickleballhelps

Thanks for the welcome

I can only figure out how to reply- but don't know how to start a new discussion?

MN Chickadee

Tina M, I personally would not put my 94 year old LO through the scans. I would do the blood and urine tests, since that is easy enough and quick. But at that age there is little to be done other than make her comfortable for the rest of her days.  If she had symptoms that suggested it was not Alzheimers I might go further, because dementias such as Frontotemporal or Lew Body can mean certain medications should not be used and can have very different symptoms and behaviors than the other dementias, but if it looks like regular old Alz or vascular dementia I wouldn't bother. In a younger person I would, especially early in the disease. But in the middle to end stages when they are very confused it's nearly impossible to get them to cooperate for an MRI anyway. You already have what you need for the POAs to be valid so there is not a reason there either. I would focus on comfort care and educating yourself on dementia so that you can get the most out of your remaining time and give her the best care and learn communication techniques and what to expect. Teepa Snow videos online and the book The 36 Hour Day are great places to start. 

picklball, go back to the caregivers forum and look for the button at the top that says "Add Topic." Right now you are in a specific thread and can only add a reply to the current topic. 

mommyandme (m&m)

If it was me, I wouldn’t put her through the machine testings. I did have my mom in an MRI machine almost two years ago… i wouldn’t do it again. She was 83 and early stage 6 then. She got through it and was compliant but it wasn’t comfortable for her of course. The neurologist wanted a new blood test a few months ago but when the hospice nurse tried,  it was too uncomfortable for mom and the nurse didn’t succeed, mom was scared and shouted as if she was being tortured.  

Seems like everything is in order for your LOs care and nothing will change based on results. 

Thanks for sharing, keep coming back.