Physicians & Dementia: How Much Do They Know?

I know it doesn't seem polite to bring up this topic but I want to alert dementia caregivers that every physician is not an expert on dementia.

So when you are a dementia caregiver and you have reached the point where you need professional medical guidance, who should you turn to?

Please know that I am not saying this to take pot shots at all physicians but rather I would like to remind dementia caregivers to use their instincts and best judgment when getting a diagnosis of dementia.

The obvious choice is to start with your regular family physician and request an assessment. The physician should listen to your concerns and symptoms you note carefully, ask some pointed questions and do a simple cognitive assessment that should take a few minutes. Based on the initial findings, the family physician may recommend a referral to another physician such as a Neurologist, who specializes in brain disorders, or even to a Psychiatrist. Your family physician might also recommend that your loved one be seen by either a neuropsychologist or visit a Geriatric Assessment Center, where a number of diagnostic tests be done under one roof.

I bring this subject up again because so frequently I speak to caregivers who were not satisfied with their family physician's response to the growing list of symptoms that they have noticed in their loved one. Yes, it makes logical sense to start with your family physician--after all, who knows you and your loved one better?

But do know (and don't think you are going crazy) if somehow you don't get the urgent response you are looking for. Sometimes, the physician, along with you, doesn't have the perspective of subtle changes occurring over time. They may discount the seriousness of the symptoms you describe, saying, "Hey, its just a little confusion with old age".

As a caregiver of someone who you think may have dementia, you need to assert yourself with your physician to get the diagnosis and supportive services you need. If you don't get the response you need from your family physician, you need to know that it is okay to move on to someone else!! With the field of dementia exploding around us, physicians are learning about the disease right along with us.

Trust your gut instincts and get what you need, even if you have to visit more than one practitioner.

Comments

[Paula from Caring]

This is really great advice on a topic not often talked about. It's especially relevant when you're an adult child and it's your parent. Often parents feel a duty to stick to their longtime doctor (who is sometimes aging right along with them!) even when it's perhaps not the best person to make an accurate assessment. Or else the doctor is dismissive and your parent is relieved, but no closer to a diagnosis. Sometimes you can get around that by asking for a referral to a gerontologist--your parent might be more willing to go along with seeing a "specialist" than just abandoning her "usual" doctor.

[Sue Lanza]

Paula: You are so right! Having a long time family physician would seem like only a benefit because this is someone who knows all about you. The problem comes in when they don't have the specialized expertise to really see dementia symptoms. It is so much easier to adopt a "wait and see" attitude and that can have terrible consequences with delayed diagnosis and treatment.

I have heard so frequently from others. Thanks for writing!

Sue