3rd party care

RobertsBrown

In this case I am talking about doctors and dentists.

I accompany Diana on all office visits, and generally we can manage to do all the things practitioners want us to do.  Our last dentist visit was the first one where we flunked.  We made it through the cleaning part, but when it was time for the dental exam, Diana could not follow simple directions: Open you mouth, stick you tongue out, etc. The bottom line is that she has lost an understanding of how to move her body.  I see this with getting in and out of cars, or getting dressed, or quite a few other tasks.  She doesn't know what 'raise your hand' means, but she will get it if I mimic it while asking.

Our last eye exam was our last ever.  That was a total fiasco.

So....how are we to manage future dental exams and cleaning?  At some point do you just stop going to these things, and if so what are the consequences for health?  I suppose we could shop for dentists that use anesthesia for all procedures, but that is extremely disorienting for the patient, and may compound her natural challenges.

She is only 69.  There may be many years ahead for her, and her teeth.

M1

IIt's a hard thing to get your head around, but yes I think at some point you just stop and it sounds like you're there. My partner used to have routine medical, dental, eye, skin, rheumatology and oncology follow up so was seeing someone almost every month. No more since memory care.

toolbeltexpert

Thanks Robert his is something I will be dealing with and I am going to find out how it's gonna go.  My dw who is 68 and is in a mcf keeps saying she needs to see a dentist. It's been probably 10yrs or more since she has seen a dentist. She used to be faithful about going then, the beginning hit and she stopped, I kept encouraging her to go but now I realize back then I should have made those appointments. Now she has a molar that has lost the cap and is decaying, no pain just a jagged tooth. She brushes and flosses almost every day. They have a visiting dentist every 3 months so I signed her up for an evaluation. Probably  pull the tooth if possible and doable. But I think there will come a day when we stop, we will see if she can follow directions as that is becoming a problem.

Ed1937

At some point I think it is more traumatic on the PWD than it's worth. And that makes your job harder yet. Personally, I wouldn't do any more dental exams unless there was a clear indication that it might lead to major health problems or she was in pain. I'm sorry.

Beachfan

DH is one year in MCF, but I stopped “routine” healthcare visits about 2 years ago.  He just couldn’t process what he was asked to do and I didn’t want to agitate him further than necessary.  He has always been extremely physically healthy with good teeth; he takes no medication.  I requested that the PCP who serves the MCF only examine him once a year.  He is well into stage 6 and fading away little by little before my very eyes.  No reason to torture him any further.

Jeff86

Excellent topic to raise, for those of us whose LOs have progressed in their/our AD journeys.  

DW always took great care of her not-great teeth (although now hates having her teeth brushed).  I am still taking her to the dentist (some evidence that dental health is connected to general health) even though she has limited capacity to ‘cooperate’ with the dentist.  Fortunately, we have a marvelously patient dentist who does what he can by way of a cleaning and an examination.  It’s imperfect but better than nothing, and DW tolerates it without any apparent distress.  I plan to continue until she can’t or won’t open her mouth for the dentist.

Parenthetically, it was a missed dental appointment that put an end to DW’s driving.   The dentist’s office is maybe 5 miles away, but DW couldn’t remember how to get there and ended up lost and 20 miles away.  Never drove again.

Vitruvius

We are about where you are. My DW is 71 and has been in an MCF for three months. I can't envision taking her out for any medical appointments so we're done with those unless something critical comes up. We gave up on most regular medical appointments a year or so ago. She is nominally in good health but her dementia is progressing very fast. It became apparent that we weren't going to do anything about any recommendations from these appointments.  We tried physical therapy earlier this year based on medical recommendations to deal with her oncoming Parkinsonian symptoms, but that proved pointless as they want to "train" her with techniques which wasn't going to stick.  Eye refractions became impossible as you found because DW could not understand anything about the process, but the exams were still able to check her pre-glaucoma for which she takes eye drops. "Fortunately" she had cataracts and about five years ago had her corneas replaced with lens implants which allows her to go without glasses. She still had a minor prescription for glasses but stopped wearing them because she really couldn't understand using them anymore.

As for dental care about six months ago I realized that she might be able to have one more dental appointment at best, and I asked the dentist to do any work on things that looked marginal and they put in a new crown.  The MCF has a visiting dental hygienist and that will have to do for the duration. 

So for those of you whose LO isn't quite so far along I recommend you get any suspect medical and dental work done preemptively while you still can.