Is it necessary for Nurologist it ask same questions that upset patient everytime?

charley0419 · May 3

some of you know me as I always have lots of questions but for those of you who don’t know my situation it’s that my wife , I feel , is handling this nitemare much better then most that being said I know can change in a heartbeat . It’s 3 yrs and other then not driving or cooking anymore not doing too bad, her short memory and repeating things has gotten more frequently , working the remote and phone confuses her at times I don’t feel uncomfortable about leaving her alone for very short periods say a hour or more. Does everything else herself. So my question really is is it necessary for Nurologist to ask her same questions it time , her zip code , what day is it what month and the dreaded CLOCK drawing and 11.45 time on it. I find this does upset her alot and think it’s because she knows she can’t do. She’s on Memantine & Donelphal and I’m guessing helps but who knowns. Anyone else have this issue.

blacksparky · May 3

Sorry to hear about your dilemma with the neurologist. We have a great neurologist that after our second appointment, she told me that there really isn’t any reason for us to see her unless we wanted to or needed to ask questions regarding her medications. I really appreciated her honesty.

harshedbuzz · May 3

The short answer is that those quick cognitive assessments give the doctor a quick way to assess progression. The pattern of correct and incorrect answers can be subjective of type of dementia in certain cases if that has not already been determined.

The bigger question is whether a neurologist continues to bring value to the situation beyond getting a diagnosis.

The answer to that is going to vary based on the needs of the PWD and caregiver, what resources the doctor or clinic offer for support and whether ongoing care needs could be better met elsewhere. If a PWD is being treated with one of the new infusion medications, then a neurologist is appropriate. If a PCP provider is comfortable prescribing older oral medications, a neurologist follow up might not be best for the PWD if it involves travel or upsets them.

Dad needed more powerful psychoactive medication to be safe at home and we were fortunate to live in an area where we could easily see a geripsych for that; people who live in more rural areas might use a neurologist for these meds instead.

HB

Timmyd · May 3

https://alzconnected.org/discussion/72944/is-it-necessary-for-nurologist-it-ask-same-questions-that-upset-patient-everytime

I made it clear after the formal diagnosis from the neurologist that my DW does not want to be quizzed anymore. No more cognitive challenges !!!! The next visit the neurologist started doing it again. I asked him why he keeps doing this and and his response was that we don't have to see him anymore. He did not answer why he kept doing it. Our PCP can manage symptoms. The neurologist treated her more like a research subject than patient. This disease is hard enough without doctors making it more difficult. My advice is to move on from your neurologist and find providers who display a level of compassion and empathy that you and DW are more comfortable with.

If you do see your neurologist again I would ask them why they continue to quiz her? What is the point of it? Is the treatment plan different based upon her answers?

BPS · May 3

In our case after seeing the neurologist and getting the diagnoses and initial prescription 9 years ago I could see no value in going back over and over. We talked to my wifes PCP and he was willing and able to take care of her as needed. He could add or change medications as needed and could refer us back to the neurologist if needed. My wife is now in MC and they have a doctor that comes in there that her other PCP recommended she change to because they are in often so my wife is seen more frequently.

charley0419 · May 4

thank you all very very much for your insight as usual very helpful and think I’ll keep my next appointment and no more after.

Is it necessary for Nurologist it ask same questions that upset patient everytime?

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