Contacting psychiatrist / psychotherapist

zilco58

Thank you for responding to my post last week about sending a portal message to my DH’s PCP in advance of his appointment with her. I am sending it today and will try to hand a copy to the nurse day of, as well. I also reached out to our retired trust advisor (now a friend) for some advice and now have a good idea how to proceed. Additional question: My DH sees both a psychiatrist and a psychotherapist, as he has longstanding mental health issues, including depression and anxiety. These go back to adolescence. He often has side effects from these meds that make distinguishing said side effects from dementia symptoms more difficult. And, of course, long term use of psychotropics are a risk factor, as well. Hopelessly complicated! My question is, has anyone tried to contact their LO’s mental health professional, similar to the PCP, when in search of a diagnosis? I fear that they would feel duty bound to report the communication to their patient/client, and that would be disastrous. Thanks for any insights. This forum is such a resource and comfort to me as I go through these early challenges.

M1

I would absolutely reach out to the psychiatrist at the very least if not both. If he/she is any good they will know that communication with the family is critical in these situations. As your DH dementia progresses the therapist will be less important as his ability to reason will go by the by. You may be there already. But if this is someone your DH trusts they could still be of help.

ButterflyWings

@zilco58 In addition to M1's advice to contact psychiatrist, I think it is fair to ask that they NOT report your concerns or question to your DH. They can explore the issue with him using "I statements", or just generally without throwing you under the bus, setting up potential paranoia for him etc. No reason for them to be unprofessional and possibly counterproductive by triggering a catastrophic reaction in him. Which it sounds like it would — and you know him best.

A foolish member of DH's professional organization who was supposed to meet with us to help identify some retirement guidance, did exactly this. He went on and on about how DH was "compromised", and "his wife was concerned". What!? I could have stayed at home and had that conversation myself if this were an appropriate approach for PWDs which we learn very early it is not. This was a social worker/interventionist managment type. Really??

DH's response was to walk out (he stormed out actually) and managed (thankfully) to find his way home somehow (not driving) almost an hour away. I was livid with the dunce whose job it was to know better, and it was not our first conversation (which DH initiated). When I finally caught up with him he was still frantic and his first words were (loudly) "YOU BETRAYED ME!!". He looked so hurt and anguished it broke my heart. All unnecessary pain for him, and setback for our urgent goals. What a colossal waste of time in hindsight. It took a while to regain his trust and this was at a very critical point immediately after diagnosis trying to exit him from work, banking, etc.

You are right to be cautious and the psych's loyalty here should be as his Dr. not his confidante or a gossip if that makes sense. Be diplomatic yet specific if you do enlist their support. I have not been impressed with the lack of knowledge about dementia, even among medical personnel. Especially if they have been seeing my LO through a certain lens for a time. They don't always respect what you see almost taking it personally that you are saying they missed something (?).

If you are his POA and HIPAA authorized representative though, they are supposed to treat you as an extension of their patient almost though. You are the client now since he can't be a reliable reporter anymore. GOOD LUCK THIS WEEK! I also have found excellent allies and professional partners in the medical field as part of DH's care team that I've helped assemble and anchor the last 6+ years. It is possible! You seem like you are on the right path. Keep breathing!

mrahope

Hi, there. I will second the excellent advice you have gotten so far. My sister (executor and POA) actually talked to my mom's psychiatrist in the months of her last illness, even though dementia was not part of her picture. He was able to advise us that when she said she was "ready to go" (which she did in a meeting with all of us and her hospice team) that this had been the case for some time and they had discussed it thoroughly. It gave us some confidence that this was not anger or depression, but a sincere wish. I so hope you can reach out in a way that's productive for you all.