Doctors appointments help!

kmw11

I just took my mom yesterday to a new primary care. I just moved her closer to me and so we are starting from ground zero. She was undiagnosed before she left her last doctor but had taken a cognitive test and shows signs of dementia. Anyway, at this doctors appointment she told the doctor absolutely nothing. Told her she was fine and that her memory problem was just for a week a while back but everything is fine now. My mom would continually look at me throughout the appointment when the doctor would ask her questions. Every time I would encourage her to answer or say you told me you were having trouble with yada yada she would then scoff and say no im fine. I was so frustrated because before this appointment we had talked about what she wanted to say for weeks and we get there and she says nothingggg! She was terrified to be there and keeps saying how she doesn’t want the doctor to lock her away because they think she is crazy. I think the doctor can see through this but how in the heck do I get her help if she refuses and won’t talk with her about her symptoms. I know about agnosognosia but I don’t want to put words in her mouth and I’m terrified I’m doing too much even speaking at the doctors appointments. I’ve written the doctor a few notes giving her background info and changes with personality, what she can and can’t do anymore and how her walking and vision have changed. She needs to be on an anxiety medication but my mom refuses to take any medication at all. How do I get the doctor to prescribe her anything is she flat out refuses to take it?

Where is the line? Am I crossing it by trying to encourage and lead her into talking about her memory problems? Should I get guardianship? Would that help with being able to get the doctor to prescribe her medication? I already have durable poa. I was just so frustrated after the appointment.

Also if anyone has suggestions on types of anxiety meds that have worked that would be great. The doctor wanted to put her back on her antidepressant but it didn’t work with her anxiety the years she was taking it and now her anxiety it triple what it used to be do to her memory issues.

harshedbuzz

@kmw11

Your mom is no longer an accurate reporter. Full stop.

Whether she is withholding her concerns out of fear of losing independence or anosognosia, she can't be relied on to communicate a full picture to a doctor. She is no longer her advocate. That is now 100% your role now. It's also likely she will showtime with her doctors which means you will need to report her current level of function and symptoms via a patient portal or a note handed over discretely to the person who takes her vitals to pass to the doc before s/he comes in.

At all of dad's visits, I sat behind him in the doc's sightline so I could communicate non-verbally when he gave dad a chance to talk about how he was doing. The doctor not only looked for my nods and head-shakes, the one time I sent my mom with him alone that doc asked after me.

If mom lives with you, you might be able to hide medication in food or drink assuming the doctor OKs this. Was she on an SSRI (antidepressant) previously? These are generally used for both anxiety and depression; sometimes these travel together and it can make it complicated to parse out. You say it didn't work, and yet when she stopped her anxiety tripled. Perhaps it reduced but didn't entirely eliminate the anxiety piece. Maybe she'd do well on a slightly higher dose. It's hard to suggest a specific SSRI as success is so very individualized-- you may need to try a few to find the best fit.

HB

psg712

Yes to everything that HB said.

I encouraged my mom for too long to mention certain things to the doctor. She was still driving and going alone to appointments, and I didn't live nearby. When I finally faced the reality of her situation myself, I called and scheduled her an appointment at a time I'd be in town. I then sent a message through her patient portal, which she did not understand how to access, detailing a few of my concerns. I chose the ones that I knew would be red flags to a doctor, primarily issues with judgment that could cause unsafe situations for her and others.

Then we went to the appointment. He did not make reference to my message, but incorporated the MMSE and some other cognitive screening into his exam. His eyebrows raised and we left with some recommendations that did not make Mom happy, but she accepted more readily from a doctor than she would from her meddling daughter. He also provided me with an official letter stating that mom had dementia and that power of attorney should be activated for her safety and well being.

kmw11

https://alzconnected.org/discussion/comment/188479#Comment_188479

https://alzconnected.org/discussion/comment/188474#Comment_188474

Thank you both for replying. Yes she was on a SSRI Escitalopram. Yeah I’m wondering if maybe upping the dose would be good. I will try calling her doctor and see what she suggests.

I have been writing notes and giving them to the person at the front desk when we check in. We have another appointment in three weeks. Hoping my mom will be more forth coming but I know that maybe wishful thinking. I really hope she will take what the doctor says into consideration she “fired” the last one for telling her she might have dementia. My mom likes to tell everyone her last doctor was fired from her practice for how she treated her. Which is fully not true.

harshedbuzz

@kmw11

I don't think she's ever going to be more forthcoming with her doctor.

I wonder if you could play on her "firing" the last guy to get her in to see a neurologist for a complete workup as way to prove the other guy wrong. I got dad into a geri psych as a "second opinion" to get meds he needed.

HB

Amanda13Johnson

My mom no longer drives so I take her to all of her appointments. I log into the patient portal and will send the doctor messages regarding my concerns or things I would like them to discuss/bring up at her coming appointment. I always let my mom answer the doctor first and then I will give the accurate information after my mom or if my mom response is accurate I will nod my head. I would also try to sit kind of behind my mom so she wouldn't see me lol but typically my mom looks to me for the answers. (Like if she is having any shortness of breath, chest pain etc she looks at me).

But I am a RN so I know almost all of her doctors well. Just keep advocating for your mom and don't feel like you are over stepping by talking at her appointments!

catminor

https://alzconnected.org/discussion/comment/188479#Comment_188479

I will be so relieved to get my Mom set up with all new doctors and have her properly diagnosed. Her doctors in SC didn't even attempt to get past the 5 minutes of questions for the new CCC intake form we asked them to fill out for us.