Brand new. Need help.

clive

I can't get my DW to go to a doctor, much less to get a diagnosis. She refuses to talk about the possibility of her getting D. It runs in her family. She is very functional but showing personality and memory changes over the last several years. How do I trick her into going to a doctor then getting the doctor to perform diagnoses without her knowing I was involved. Thank you.

JulietteBee

Of note, all personality changes and memory loss doesn't not mean the person has dementia, but I totally understand your correlation and concerns.

If your wife has a PCP, sign up for a patient portal. Most offices are now electronically linked to hospitals, pharmacies, diagnostic centers for ease of patient care.

Once signed up, send an email to her doctor via the portal. Tell him/her your concerns and ask if the office could call and tell your wife that you need to do an insurance mandated wellness visit. At that appointment he can at least do a mini-cog test to see her baseline and take it from there.

All the best going forward. For you and your family's sake, I hope it is just a vitamin B12 deficiency or hypothyroidism which are both reversible. 🙏🏽

H1235

If you are not able to set up a patient portal I would just bring in a letter explaining what is happening to the doctors office. You might just set the appointment up and then tell her it’s for insurance purposes or anything else that might get her in (blood pressure check, check out that mole etc.), even tell her they call to set the appointment up. In my opinion you need to completely stop talking about dementia. It will only upset her. The number one rule you will see often here is never try to reason with a person with dementia. I’m attaching a staging tool. It might help you recognize symptoms you didn’t realize were symptoms.

DBAT.pdf

ladyzetta

Clive. Please don't talk to her about dementia, she will deny it. I'm also a bit forgetful and maybe changing with age. There is no way I would agree i have dementia. If this is a big concern, your doctor will help you figure out how to get your DW, in for a check up. Our insurance had retired doctors who came out to homes and checked on things, like drawing the clock and asking questions. This test was done on both of us, so my DH, dementia was noted, before the diagnosis. I hope this helps.

clive

https://alzconnected.org/discussion/comment/249273#Comment_249273

clive

Thank you so much for your reply. You are my 1st ever social media contact. I'm an old Luddite when it comes to smartphones (even cell phones) but I had to relent and purchase this smartphone secretly so I could do this to learn and help my DW. No. I don't talk to her about dementia as of 3 years ago when she" bit my head off" when I tried to get information about her 3 family members who died with dementia. Her mother died of Alz a terrible death. I've talked to 2 doctors that I see and they weren't very helpful. I live in an area that doesn't have the best doctors. She would never allow a doctor to come to our house. It's a long story. Thank you very much again.

harshedbuzz

@clive

Hi and welcome to the digital world. And to this place.

It's possible your wife has already developed anosognosia and is unable to recognize the degree to which she is cognitively impaired. Often, a PWD will admit to the occasional memory lapse as normal for their age but isn't able to see the losses around empathy, executive function, personality changes, or problem solving. To mention these losses could feel like gaslighting to her or in the context of her family history threatening.

Do you know for certain that her family members had Alzheimer's as opposed to some other form of dementia or some combination of dementias?

The medical piece is complicated as well. My parents split the year between a place with abysmal medical care and one that was only slightly better. The marginal quality and lack of continuity allowed my dad to go undiagnosed for almost a decade. I really feel for the spot in which you find yourself.

Do you have the legal pieces in place, like a DPOA that allows you to make decisions on her behalf? In the end, that is every bit as critical now as a diagnosis.

Does she generally avoid medical care? Does she have a regular PCP who knows her? There are strategies for getting a LO to the doctor that others have used successfully. If she has a PCP who treats a chronic condition like blood pressure, perhaps you could reach out behind her and explain what is going on— list symptoms, behaviors, duration and frequency, etc— and ask for the basic testing to rule out some other treatable condition. (Dad had mixed dementia— one was eminently treatable but wasn't tested for in 10 long years)

Some folks get their LO to the doctor by creating a therapeutic lie, aka fiblet, that requires them to have a reason to go. Fiblets like, "you'll need to see the doc for your BP refill", "or we need to have our Medicare annuals or we'll lose our coverage" or even "I'm worried about this symptom I'm having; would you come with me to the appointment for moral support?". If you haven't reached out to the doc about your concerns, and even if you did, bring a short list of your concerns to slip to the nurse at check-in so you don't have to throw your wife under the bus during the appointment. Sit behind her so you can discretely signal the doc nonverbally when she starts misreporting her history.

If you can't trick her into the doctor, you have 2 options. You could wait until she has some other medical issue and is hospitalized for that and ask for a neurology consult; this may not be a real Hail Mary but it can work. Another option, which generally only works for aggressive PWD in areas that are reasonably well-served medically, would be to have her transported to the ED as a danger to herself/others if she's upset and carrying on. Use your new phone to record her behavior because she'll likely calm down and refuse to go. You may need proof of her behavior to be successful with this strategy.

Good luck.
HB

clive

Wow! You've given me a lot to absorb. I hope to reconnect with you on this after I study this some more. Thank you.