My mom has been growing more and more concerned about Dad over the past few months, and started mentioning that something was wrong about six months ago. He is getting into the habit of relying on her to explain things or help him make decisions, which is definitely not like him. He’s been noticing some changes too, and went to a neurologist yesterday.
Here’s the part that is making me mad… these are some of the questions the neurologist asked my Dad;
What is your address?
What day of the week is it?
Will you count backwards from 10?
He also had him walk down the hallway to check Dad’s balance, and did the old standby where he named three objects, asked a few more questions, and then asked Dad to repeat the three objects. I don’t think that the exam was challenging enough to display some of the difficulties Dad is having. The neurologist said that Dad was fine and the symptoms are just age related. I don’t believe him, and I think that something is wrong. The last time I went out with Dad he was different. I could tell that when I talked about things that were detailed, he couldn’t understand me. He also asked me to pay for the food that we ate (he gave me the money) and asked my opinion about what size of ice cream to order. That’s definitely nothing like what he ever would have done before!
My mom said that she thought the neurologist would talk to her individually. He had requested that she watch Dad for forgetfulness or behavior traits that are unusual so that she could give her observations at the appointment. She thinks that it would have been better to do that individually and not with Dad sitting right there, listening.
He will be going in to have an MRI. What other diagnostic tools are available? I’ve been on several websites and it looks like it’s hard to tell until things really progress. If there’s any diagnostic approach that I’m missing, please let me know.
I don’t have a relative with Alzheimer’s any more. My grandfather died from complications about fifteen years ago, though.
More recently, my father has been having problems with a condition called Normal Pressure Hydrocephalus. This is one of many conditions that can affect neurological function. So I can offer some suggestions.
First off, the diagnostic you’ve described, checking for oreintation, awareness, and short-term memory is just a quick and dirty check. It can be spoofed. (My mother has a friend who is so terrified of the prospect of getting Alzheimer’s that she practices spelling common words backwards, and counting down from 100 by sevens.) A good Neurologist should be aware of that. And from what you’re describing I think that the one your parents saw just was saying that what your mother has noticed isn’t something that would come up in the normal tests that a few minutes consult can show.
It doesn’t seem unreasonable to me to expect that a more detailed written log of specific incidents would be a better way to show the doctor that your father’s mental condition is deteriorating, than just vague incidents. It does bother me to hear that the doctor is dismissing your mother’s reports of changed behavior, though. On the gripping hand, however, if he’s following up with an MRI I’m not sure what more could be being done at this time, without a more specific diagnosis.
As for having the doctor talk to your mother outside your father’s hearing - I don’t think that’s a good idea. First off, it’s making clear to your father that he’s no longer to be trusted with decisions on his own health care. And I’d find that even more disturbing than any discussion of confusion or mental degradation I could think of, personally. Secondly, without a proper health care proxy in place, I’m not sure it’s legal for the doctor to discuss prognosis, treatments or tests for your father without him present.
Good luck. I hope that they find that your father’s problems are something treatable. My father’s NPH is responding to the shunt that was installed this August and he’s walking again, and talking, too. But it’s never pleasant dealing with someone who is going through mental decline.
My mom has it. She was diagnosed about 3 years ago, though now she is on one of the test drugs as a human guinea pig.
Keep the diary, and go back with it to the doc or a different doc. She takes the normal one [aricept?] and this experimental one that is clearing up the placques and preventing new ones from forming. She was fairly drifty up until about a year ago, when I found out she was on the experimental drug by asking my brother.
You might also encourage him to have blood vitamin levels checked, especially B12 levels. I was having memory and concentration problems last year and my doctor discovered that my B12 and D levels were low. (He also tinkered with my thyroid level, but I don’t know if that’s a common problem for men.) He put me on sublingual B12 and told me to take extra vitamin D. It made a tremendous difference. Vitamin absorbtion can be a problem for older people. Mine was cause mostly by long-term use of Prilosec for reflux, but I know I felt like I was walking around in a fog for months. I couldn’t remember names and common words and concentration was really difficult.
Thank you all for the advice. It’s funny that you mentioned B12. My Dad’s primary care doctor told him to start taking it a few months ago. Dad thinks that vitamins are just a way for the manufacturer to make money, but he does take them.
I just got off of the phone with him. He’s very intelligent; we were talking about the stock market and different things the Feds are doing and how it’s affecting the economy. He’s sharp as a tack in most ways. He does forget words more often than before. When talking about what he did yesterday, he’ll say “And then I went to… the place with your Mom after church…” (meaning a restaurant). I’ll usually just fill in with; “Oh, you and Mom went to Bennigan’s… how was it?” That keeps the conversation moving and is less embarassing for him.
I’m not sure when the MRI is going to be. Maybe that will reveal more information.
My mom died with Alzheimer’s. I’ve seen several other cases with neighbors, and friends of my parents.
It seems to me that the first thing that happens is that the patient can’t transfer information from short term memory to long term memory. This isn’t all or nothing, it creeps in over time. The short term memory allows them to carry on a conversation, but what they told you never gets into long term memory, so eventually they get to where they tell you the same things again and again every 10 minutes.
At the end of this process the long term memory becomes strictly read-only. They can tell you the name every teacher they ever had, but not what they had for breakfast, or even if they ate breakfast.
Based on this, I don’t think the tip-ot-the-tounge (not being able to come up with the word) memory lapse is Alzheimer’s…or certainly not difinativly so. Your dad has known the word resteraunt his whole life. My dad had this from his mid-50s or so, and never showed any signs of Alzheimer’s when his heart gave up in his mid 70’s.
My aunt died this past spring, and had been suffering from Alzheimer’s for several years. This was a common symptom for her. Driving her from the nursing home to our house for holiday dinners (half-hour trip), she would ask where I was working 2 or 3 times during the trip. But if you asked her about her years in Alaska during WWII, or working as a cook for workers building the DEW line, she could tell your in great detail, even down to which recipes the workers preferred.
IMNAD, and I’m sure some Doper doctors will come along to lend their wisdom, but I would get your dad to a neurologist or psychiatrist who specializes in geriatric issues.
When I was going through this with my mom, I was told that Alzheimer’s Disease could not be conclusively diagnosed without examining the brain itself (i.e., after death). The diagnosis was “dementia of the Alzheimer’s type.” There could be other causes for your dad’s dementia, and there is no test (single or in battery) that will diagnose Alzheimer’s. That means other factors should be considered.
Have your dad evaluated by someone who will look at the whole picture – the mediations he’s taking, etc.
{{{{{{{{purple haze and mom and dad}}}}}}}}
Whatever the cause, this is tough stuff to deal with. I’m happy to lend a shoulder to cry on or an ear to vent to – even if saying this requires me to end a sentence with a preposition!
It seems what your family is doing so far with regards to the specialist and the MRI is the normal way to go. I would, like someone above said, be concerned that the neurologist was so dismissive though. I’d maybe ask to be referred to someone who specializes in geriatric care who will be more versed in Alzheimer’s specifically.
My mom had most of the symptoms for the last 3 years of her 90-year-long life but the nursing home and doctors only got as far as calling it senile dementia.
My father had Alzheimer’s many years ago. My mother took care of him single-handedly, and it took an enormous toll on her health. She never completely recovered, until her own death.
A definite diagnosis is really tricky, and a different doctor can make a different diagnosis. But learn as much as you can, and help your mom as much as possible. She needs your help even more than your dad does.
But there will be surprises. One day, totally out of the blue, my father told me that he loved me. This was TOTALLY uncharacteristic of him, but his defenses and self-control were breaking down, and this came out. I don’t know whether he knew what he was saying or who he was saying it to, but it doesn’t matter.
There will be good days and bad days. Cherish the good ones.
My mother was diagnosed a few years ago. She was functional until she had a psychiatric episode and went to the hospital. The crappy psychiatrist decided she was psychotic and didn’t even consider Alzheimer’s and put her on drugs that I think made her worse. My sister and I took her to a memory disorder clinic. They did some tests and told us we could also do a PET scan which was optional but diagnostic. I said to do the scan which gave s the diagnosis.
Take your father to a memory clinic. Contact your local Alzheimer’s organization for information on one in your area. Memory clinics perform different tests and about 3 different specialists evaluate the patient. If he does have it and you get him diagnosed while he’s still in the early stages there are medications to help slow it.
I still kick myself for not taking my mother to a memory clinic about a year or so earlier when I had considered it. I was dealing with my own problems and I just figured the small things I was seeing were just her being mom but more so, telling the same thing to me several times, being all buddy buddy with strangers, she still remembered a lot of stuff that I didn’t remember so I didn’t think she could really have it.
Go to alz.org to read more about Alzheimer’s and testing. Good luck.
I’ve never even heard of a memory clinic. I’ll check it out. I thank you and my mom does, too. She is very worried.
It makes sense that mom will need even more support then dad will. There are five of us kids, but my sister and I will be the ones supporting dad’s care the most, if it comes to that. I hope it doesn’t come to that. I want to tell myself (and mom) that this is just age-related memory loss, but I have a feeling that’s not the case.
Definitely log any troubling events, questions, repetition, etc. as others have noted. Did the neurologist have him draw the face of a clock with the hands at 3:00 or something? If he produces something weird, that is another possible indicator of ALZ.
Have any neighbors or friends noticed that your dad’s behavior is altered from the last time they saw him, or maybe from a few months ago? Sometimes they notice it more if the person is not someone they are living with.
Please post and/or email if you have more to say or ask.
Yikes. That was one of the most disturbing things about my mom’s assessment. At the time, her physical problems were the reason she wanted to be in an assisted-living facility. But questions to determine cognitive status were part of the assessment, and when I saw what she drew to indicate 3:00 (or whatever it was), it was weird beyond belief.
purple haze, what your parents are going through sounds a lot like what mine faced last winter. Dad was having a hard time coming up with the correct words. He was much more hazy, less sharp. More passive all around. His primary care doctors ran several sets of tests, and whittled things down to “All we can’t rule out is Alhheimers”.
Then my parents moved to Florida for the winter, and switched to a doctor down there. It’s an area with a lot of retirees, so I’m assuming the doctor sees a lot of older patients. She did another exam, a couple more tests, and they discovered that Dad had an irregular heart beat. His pulse rate was dropping down to a scary low number sometimes while he was sleeping.
They installed a pacemaker, adjusted some medications, and most of the issues have gone away. My father is back the way I knew him.
Short answer - check around until you find a doctor that you trust. If you have doubts, keep asking questions.
