Where do you start?

First, dementia is the umbrella. Alz, Vascular Dementia, and other cognitive impairments are subsets of dementia. Other conditions can play in as well so it's excellent that you wanting to engage her physician.

A probable diagnosis is typically made by a neuro psychologist; however, your starting point should be her primary. What worked for us is that an appointment was made with the pcp and then a day before, I walked a letter to the office, asking that it be given to the physician, indicating we were concerned about xyz symptoms. We asked that the letter be kept confidential. I believe we walked out of of that appointment with a referral to a specific neuro psychologist along with a script for a specialized driving exam. For driving, they did not pass or fail my mom for her test the first time. It was costly, so thankfully, my mom got angry and refused to give them more money for a second test. Driving stopped.

My mom made it through the first neuro psych exam taking about two hours. She did not do well and therefore, became very frustrated and skeptical. Fortunately, the test was enough to receive the probable diagnosis of mixed Alz/Vascular and she was put on medication, The written report, that she was given but did not at all understand, outlined what changes in daily living were necessary at this point, e.g., no driving, supervision with financials, supervision on medication. I was able to spring the poa's about this time.

My mom was also becoming very difficult. The key for me was taking a four hour course, at a local skilled nursing facility, on Alz given by the Alz Association. When I introduced myself, I sobbed. At the close, I left with education, understanding, and brochures on everything from legal, to respite, to physicians, to adult daycare.

Ask us more questions. The journey is long. Your mother is so fortunate to have you at her side.

Contact her doctor's office direct to get the ball rolling to get you authorized. I was able to do so by downloading a form then we brought it together during one of her doctor visits. Then I had access to the patient portal so I could communicate with her doctors. Do you (or anyone) accompany her with her to her appointments? You will also need POA to make healthcare decisions and handle her banking and legal affairs. I have to be honest, my mother's PCP was of no help managing her dementia symptoms. She went to a neurologist after a fall who just basically confirmed her dementia diagnosis… they think Alzheimers but could be mixed dementia. I asked them about medications and I was told "we don't really do that here" which I thought was really strange. We found that a geriatric psychiatrist was the most helpful managing her symptoms (confusion, delusions and agitation). If your mom is anything like mine (paranoid), you may have to tell her a fiblet to get her to go. My mom thought that getting the initial assessment was required for Medicare. With that said, she was able to draw a clock, count backwards in series of 7's and remember the four words that was given to her at the beginning of the session. After some time "the wheels came off the bus" and her cognitive reserve went down and symptoms appeared (confusion, delusional stories). That first assessment was in 2018. She is now in a nursing home (lock down because she is exit seeking). It has been a very long road and we know it will continue on even longer because she is very healthy otherwise. Mom (88 YO) can still present "well" on good days, but her symptoms are more severe and are being managed with medication. Wishing you well.