I am caregiver to my 85 year old husband who has multiple health issues, including [so far] mild alzheimer's. He also has a form of sleep apnea (central sleep apnea) that causes him to periodically stop breathing several times an hour during sleep...robbing him of oxygen throughout the night, which affects his brain function.
So, I have noticed changes in his behavior and memory that I need to bring up to both his neurologist and his primary care physician. As these incidents occur, I have mentioned them to my husband, hoping he will not be surprised or feel I am trying to somehow sabotage him when I bring these up with doctors. One of his behavior changes is that he can be angered (inconsistently) and...there is the issue that his memory is getting worse and he probably won't remember any of what I will tell the doctor.
How do you other caregivers deal with bring up issues during doctor visits that you know will spark unpredictable emotions?
The sleep apnea can be addressed also, but a CPAP machine for a person with Alzheimer's doesnt usually fare too well. They dont like wearing the mask and won't understand or remember why it's necessary TO wear one consistently. That may be a battle you don't want to fight......because there will be many ahead, so choose wisely.
Since you are new to the Alzheimer's *AD* world, I suggest you read this 33 page booklet ( a free download) which has THE best information ever about managing AD and what to expect with an elder who's been diagnosed with it.
Understanding the Dementia Experience, by Jennifer Ghent-Fuller
https://www.smashwords.com/books/view/210580
This article has lots of tips & "Do's & Don't's" that may prove helpful to you as you navigate this new territory with your husband *DH*
Best of luck to you
We were blessed by his skill as a savvy interviewer.
Remember, it is NOT dishonest, nor unfair to your husband, to provide all the information YOU need the physician to have, to understand your husband’s behaviors at home that are concerning you.
You and your husband’s physician(s) need to be members of a team, helping your husband by working together.
Most doctor's now during a physical will do a Mini Mental Exam. If there are changes from the last one the doctor will notice.
Actually if the inconsistent anger issues are new you should bring them up and what better way but in the doctor's office so that if it does occur the doctor would be able to observe the change.
That seemed to work best and my husbands doctors always thanked me and told me to continue doing that, as it helped them a lot.
In all honesty, your Doctor will do the exams. Your doctor may notice some of this, and unless you are expecting some miracle medication that may help with the anger issues (which likely doesn't exist at this level without endangering his gait and his sleep patterns), there isn't a whole lot of reason to focus on these things. Alzheimer's, of all the dementia diagnoses, is a slow steady downward projectory, and these changes are expected. Some dementia's, such as Lewy's can be up, down, and all over the place. Some go in stairsteps with a plateau at every step down; but Alzheimer's is a downward steady path.
Sparking unpredictable emotions is OK, you know. Life is full of that whether we are 2 or 92, and we often react to them. Your husband may react poorly. If this is the case, let him say his piece, and then remind him "Hon, we spoke earlier today about some of the increase in anger and some of the decrease in memory. Do you remember our talking about that"? Most he can say is he doesn't remember or that you didn't or that you are WRONG. And those reactions are all in the realm of possibility and the norm.
I sure wish you good luck.
You could keep a little diary of things, but to what purpose other than to continuously remind your husband of his decline, continually discourage him? There really is no reason to do so. It will change nothing.
Because I was accompanying both my parents to these appointments, I also sat behind my folks and often resorted to writing out questions for the doctor and holding them up behind my mother where she couldn't see them.
Giving the office a couple days' notice allows the doctor to read the note well in advance and be able to have some answers ready.
If asked my step-mother will say she is just fine, "Peachy Keen". One visit she was asked if she wore glasses she said No, they were hanging around her neck.
Dealing with unpredictable emotions is part and parcel of the disease.
The other very good reason for keeping a journal is that you (and we all) may find your memory isn't quite as objective or as detailed as you might have thought it was, too. When the doctor asks what's happening, you can give a range of examples. When the doctor asks how often this occurs, or whether you've noticed any pattern to it, both you and your husband will be able to look and see.
I totally agree with Alva (and this is another reason not to burden your DH with too many everyday examples) that the time to remind him that there are concerns to be discussed is on the way to the appointment; and when in the consulting room an example formula would be: "We would like your advice on some behavioural and memory issues, please."
And at the *very* worst - if DH does kick off at the merest mention that there may be a problem, the physician will be quite able to draw appropriate inferences from that in itself. If it does happen, reassure DH, bring the conversation to a civil, orderly halt, and book another appointment.
Cognitive impairment can be caused by many different health problems, some of which can improve with treatment.
if you have access to the portal to ask questions of the doctor, you could voice your concern prior to the appointment. The anger that my husband also displayed prior to using the machine was due to being extremely exhausted which drove him to get a sleep study.
But I want to add, if your husband has an outburst at the office if you mention something in front of the doctor, that helps the doctor to see how he is behaving.
I don't want to humiliate mom and talk about her while she is right there. Giving them a note to explain what is going on or what to expect or just to let them know why I might answer for her, puts them at ease and makes the visit better.