My 67 year old husband has his follow up neuro appointment next month. In June, the neuro said she considered him "borderline" for cognitive impairment but she did not know at that time what form it might be. She wants to see him every 6 months. MRI was unremarkable, but she wanted a "baseline" MRI now for future comparison.
I do not want to tell the neuro, in front of my husband, things that I have observed that may...or may not...be related to cognitive impairment. We are asking her to rule out other possibilities such as ADD, HF Autism, etc. My husband remarks to me (half jokingly) now and again that he thinks I am trying to have him "committed." He is by no means in any middle or advanced stage of cognitive impairment. But he has short "episodes" of seeming confusion, he forgets things a lot more now and before his PCP put him on Lexapro he had gotten mean and nasty. He retired early and his brain is not being exercised as it should be...and he refuses to consider a part time job. I do not want to sit there at the appointment and, in front of him, go down the list of things I have noticed, only to have him blame me later. MUST I give input for the neuro or will the testing and her talking to my husband allow her to make a properl diagnosis without my input? Or will the neuro talk with me alone at some point?
I explained the issues that I see with dad and asked him to please not mention our conversation.
at the time of dads visit the doctor asked dad questions relating to what we had spoke of, dad of course said he didn't have that issue .
I said oh wait , don't you remember dad and I spoke to you about that very thing I saw.
dad said oh I don't remember that.
if the doctor doesn't get the entire story of some ones health,
they cant make an accurate conclusion of the problem.
sometimes toes have to be stepped on to help someone who
needs it...
good luck
This was all critical with my mom who could "turn it on" and fool doctors because she was so highly intelligent. Meanwhile she was losing her car, leaving the stove on, etc., etc. Our input was critical to her ultimate diagnosis.
financial matters, drive, shop, cook, clean, do yoga with him 3-4 times a week, take him traveling, movies, opera, plays, festivals. He bathes, dresses himself ( but there are problems with that), and tells his stories and jokes. He sometimes reads and always watches the news on his iphone. He’s really slowed down and gets tired so easily, but can still walk. He wanders. I’m lucky it hasn’t digressed to the point of incontinence/bathing/ being mean. The most uncomfortable thing for me is his inhibitions about sex are diminishing, but that’s for another thread.
financial matters, drive, shop, cook, clean, do yoga with him 3-4 times a week, take him traveling, movies, opera, plays, festivals. He bathes, dresses himself ( but there are problems with that), and tells his stories and jokes. He sometimes reads and always watches the news on his iphone. He’s really slowed down and gets tired so easily, but can still walk. He wanders. I’m lucky it hasn’t digressed to the point of incontinence/bathing/ being mean. The most uncomfortable thing for me is his inhibitions about sex are diminishing, but that’s for another thread.
My husbands neuro talks very plainly to my husband, tells him everything about his disease, etc. No bedside manner whatsoever. We have our list of questions for the visit. We talk about his progression & options all together. My husband was offended early on by some of her remarks, but we know she’s the best neuro in our state, and I think she means well. In my experience, they all have interesting personalities.
I’ve read in this site how people don’t ever tell their LO they have dementia, but my husband and I talk about it, along with everything else. Less often now as his lucid times are fewer.
proven fact
Get him in a day program
Robert
The reason I say this is consider how long a doc actually sees you. They don't know the "real" you and don't see you much more than 10-15 minutes out of the day, here and there. That can be the "good" 10-15 minutes that particular day. Some people can whiz through the mini exam given to test for cognitive decline, yet can't remember they've repeated the same thing over and over in 10 minutes at home! YOU are there every day and YOU have known your husband for many years and therefore know him best and YOU have observed the changes. Clearly he isn't aware of the changes and/or isn't going to express his own possible concerns or fears.
You should provide whatever insight you have - some things you have observed may be okay, but others may assist the doc in making a better diagnosis.
You can provide this insight privately to the doctor. It could be invaluable in monitoring/assessing his condition! Tests and exams can only tell them so much, sometimes nothing really. Sometimes the tests and exams either don't detect anything, or the person can sail through them easily, but they are not able to function normally at home.
Of concern is his oversight for his mother. Is there a contingency plan in place? He has no siblings, and if he is incapacitated by ANYTHING, who will see to her? Is she capable of naming another (additional) person to handle her affairs? If not, you will need to seek out legal advice as to how to proceed.
Secondary is having POA set up for you both. In the event that he is going down the cognitive decline path, having this will allow you to sell the cars you cannot drive and manage everything financially and medically. If at all possible, there should be a backup for you as well. It is so much easier/better to get it done now, while he could still make decisions. Later will be hard enough dealing with whatever life brings your way.
We have no way to know what the future brings to any of us, so it is best to have some precautions in place. Having a will, POAs, trust(s) if needed, burial arrangements, etc set up while you are both still capable is the best you can do. We had all this done with mom/dad when dad wasn't well and then revisited it when mom developed early dementia. We are glad we did all that before it was too late! It would have been more difficult AND more expensive to have to go through the court system to get guardianship.
I am remiss in doing this for myself, but only because currently there are no funds to cover the cost (looking at negative balance by end of year! working that out as best I can.) Starting in March, the financial situation will hopefully be under control (there will be a little relief before that, but not enough to cover the cost needed) and I want to get all that sorted out, to make things easier for my 2 kids AND to ensure my cats will all be taken care of (neither of them want the cats :-( or to take care of them.)
Please do consider getting all these tasks done, but stress to your husband it is just something everyone should do (and it is!), don't bring up the other issues.