Hi there. 

I don't have experience with this firsthand, but I wanted to share an article I found on Caring.com about Alzheimer's diagnosis.  If you'll click here, you'll be taken to it.  Hopefully you'll find it helpful.

Best of luck to you and your mom.  I'm so sorry her health has taken such a dramatic turn. 

The process of getting a diagnosis is exhausting, no doubt about it!..Getting an accurate one is important.  A second opinion can be helpful.  My mother was diagnosed 5 years ago.  We suspecxted she had moved to end-stage of the disease process and asked her primary care doctor to evaluate her.  He didn't feel she was end-stage but we were seeing symptoms that made me question his opinion.  I took her to a neurologist who did an extensive evaluation on her and confirmed she was in end-stage.  There are differences in Alzheimer's & Dementia but they aren't the only 2 that fall in this catagory.  There are some very good websites availabe that can help educate you...eg alz.org.  Use any resource available through agencies, church, extended family, friends etc especially since you are in without brothers & sisters to share in her care.  My heart goes out to you.

This sounds like my husband's symptoms.  He has lost 40 pounds in one year.  MDs suspect cancer, but can't find it.  He was diagnosed w/dementia 4 years ago.  He's had a series of small strokes over the past 8 years.  He has been taking the same meds as someone w/Alzheimers would.  Some days he is better than others.  So far we can leave him alone for a few hours at a time while we go to work.  Thank heavens our 18 year old is still living at home.  We can stagger our work hours so as not to leave him very long.  As far as which type of dementia...  it doesn't matter to us.  There's nothing else we can do for him but be there for him, maintain a regular routine at home and be very, very patient.  He seems to respond very well to our cats and dog.  No spoken words needed for their relationship.

HELLO THERE,

I HAVE BEEN USING THIS SITE FOR ALMOST 7 MONTHS.  AND I FIND IT TO BE EXTREMELY RESOURCEFUL.  I GET DAILY EMAILS AND I READ COUNTLESS BLOGS.  MOST OF WHICH ARE QUITE INSIGHTFUL AND FULL OF USEFUL INFO.  I HAVE THOUGHTS ON MANY OF THE BLOGS I READ BUT, I NEVER FELT COMPELLED TO REPLY TO ANYONE. HOWEVER, OUR SITUATIONS ARE SO VERY SIMILAR, I FELT YOUR PAIN & DISTRESS AND DECIDED IT WAS TIME FOR ME TO SHARE.  I TOO AM AN ONLY CHILD CARING FOR MY 77 YEAR OLD MOM.  SHE ALREADY HAD QUITE A FEW AILMENTS THAT REQUIRED MEDICATION, AND A CANE. THEN SHE WAS DIAGNOSED WITH DEMENTIA A LITTLE OVER 2 YEARS AGO. SHE TOO LOST A DISTURBING AMOUNT OF WEIGHT IN A VERY SHORT PERIOD OF TIME.  WE INITIALLY THOUGHT IT WAS DUE TO HER THYROID PROBLEM (HERS WAS 61% TOXIC & REQUIRED RADIOACTIVE IODINE TREATMENT).  MEDICAL APPTS. WERE 2, SOMETIMES 3 IN ONE WEEK. IT WAS VERY DIFFICULT AND FINANCIALLY DRAINING (SO MANY DAYS OFF OR 1/2 DAYS). HOWEVER, WE FINALLY DISCOVERED, THROUGH THE SAME BATTERY OF TESTS YOU MENTIONED, THAT IT WAS INDEED A COMBINATION OF THE TWO DISEASES THAT CAUSED THE DRAMATIC WEIGHT LOSS.  ONE OF THE IMPORTANT THINGS THAT BOTH HER PCP AND THE NEUROLIGIST EXPLAINED TO ME IS THAT DEMENTIA HAS MANY TYPES, AND ALZHEIMER'S IS ONLY 1. MOST FORMS OF DEMENTIA HAVE SEVERAL OF THE SAME SYMPTOMS (SHORT TERM MEMORY LOSS, REPETITION, CONFUSION, MOOD SWINGS, GOOD DAYS & BAD).

IT IS, INDEED, HIGHLY TAXING ON THOSE OF US WHO ARE THE ONLY CAREGIVER, OUTSIDE OF MEDICAL PROFESSIONALS. THERE ARE SIMPLY NOT ENOUGH HOURS IN THE DAY OR ASPRIN FOR THE HEADACHES. HOWEVER, YOU MIGHT WANT TO JOIN A SUPPORT GROUP IN YOUR AREA. MANY OF THEM ARE VERY GOOD AT TEACHING CAREGIVERS HOW TO MODIFY OUR BEHAVIOR TO BETTER FIT THE EVERCHANGING SITUATION. SINCE I AM ALSO RAISING AN 11 YEAR OLD SON, ALONE, IT SEEMS LIKE I'VE BEEN RUNNING ON FUMES FOR THE LAST 2 YEARS. I DIDN'T JOIN A SUPPORT GROUP UNTIL I DEVELOPED WHAT I CALLED 'THE SLAVE SYNDROME'. I FELT LIKE ALL I DID WAS COOK, CLEAN, MEDICATE AND CHAUFFEUR BOTH MY MOM AND MY SON AROUND. AFTER JOINING THE GROUP, I LEARNED QUITE A FEW WAYS TO BETTER MANAGE EVERYONE'S BUSY SCHEDULES, AND FIT MYSELF IN. AND SOME VERY GOOD METHODS TO TEACH MY SON ON HOW TO UNDERSTAND AND DEAL WITH GRANDMA'S CONFUSION AND HER MULTITUDE OF REPEATED QUESTIONS.  I FIND IT SO DISHEARTENING THAT THERE IS NO SURE FOR ANY FORM OF DEMENTIA.  AND I HAVE COME TO TERMS WITH THE FACT THAT I WILL SOON HAVE TO FIND A SKILLED NURSING FACILITY FOR MY MOM BECAUSE SHE WILL REQUIRE MEDICAL ATTENTION THAT I CANNOT PROVIDE AND HER HMO DOESN'T PROVIDE FOR A HOME HEALTH AIDE.

SO MY ADVICE TO YOU IS TO TRY A SUPPORT GROUP, IT SOULD REALLY BE HELPFUL. AND KEEP USING THIS SITE AS WELL AS ALZ.ORG AND OTHERS THAT YOU WILL FIND LINKS TO ON BOTH. GOOGLE THE FOLLOWING SITES IN YOUR HOME TOWN: DEPARTMENT FOR THE AGING, ELDER CARE, SENIOR LIVING AND ALZHEIMER'S SUPPORT .

SORRY IF I WAS LONG WINDED. I JUST WANTED TO LET YOU KNOW THAT ALTHOUGH YOU'RE AN ONLY CHILD, YOU'RE NOT ALONE. THERE ARE COUNTLESS RESOURCES AVAILABLE FOR EVERYONE AFFECTED BY THE VARIOUS FORMS OF DEMENTIA.

I WILL KEEP BOTH YOU AND YOUR MOM IN MY PRAYERS. MAY GOD BLESS AND KEEP YOU BOTH.

SINCERELY,

VEJ398

P.S. - THANK YOU SO VERY MUCH. RESPONDING TO YOUR POST WAS VERY THERAPUTIC FOR ME.

I understand how you feel.  My mother has Parkinson's and the beginnings of dementia.  There are good days and bad.  She perks up when other family members come to visit, but with me, it feels like she just gives up and doesn't try.  She's already in a nursing home after living for almost a year in an assisted living facility.  She started falling a lot and the last time cut her head so she went to the hospital for stitches and my sister and I decided she needed more care that the current facility could provide.  It's difficult to make this decision and Mom was upset with me for a while, but it's the best for everyone.  My prayers are with anyone having to take care of parents whether with physical or mental disabilities.  Good luck to you.

By all means, get a second opinon. We thought my 80 yr.old husband's "Dementia" was the exact diagnosis. He'd been treated with the latest medications. This has been for the last year. His background is in chemical engineering....so smart. And so active. Taught our children and grandchildren tennis and swimming. All of this dementia stuff came to a halt when he was recently diagnosed in a hospital setting when we rushed him there, thinking he'd had a stroke. During hospitalization, when he had four days of  the IV drip to hydrate him, we learned it was severe dehydration and a Urinary Tract Infection. All this was "a long time coming." Since then, while he has had the usual aging individual's forgetfulness, he also wrote out completely coherent notes to all six grandchildren! He still has follow-up appointments, but, for now, we're no longer worried the way we were before. I send you hugs and my very best wishes for finding and dealing with whatever  another opinion may offer you!

My father was diagnosed with vascular dementia around 2000, and around 2004 (when I began accompanying him to medical appointments), they began prescribing drugs associated with ALZ. However, it took three years of dancing around the subject until I cornered the doctors, who grilled me about what facility or home care plans were. I basically had to call them on the carpet, and tell them to run a SPEC scan so we know what the pathology is, so we can plan accordingly, and not expect us to infer anything. The final report on the SPEC used terms such as "consistent with patients having Alzheimers", so while nothing is for sure until autopsy, we are going with that. 

Like your parent, my dad lost nearly 40 pounds in less than a year. He also had frequent loose bowel movements (like 4-5 x daily, usually within 4 hours after eating), complained of back pain, and because his father died of stomach cancer,  we also pressed to eliminate things like cancers, blockages, GI diseases, etc. All was clear, and we confirmed spinal stenosis and disc degeneration as the cause of his back issues. So we are assuming that the weight loss is yet another progression of the Alzheimers.

He is now living with me (I lost my job last September, and since April has been my 'roommate' until I find a job - which will hopefully be before he takes the next step down. Depending upon whose scale you look at, he's somewhere in Stage 6...and friends who have dealt with this all say that the passage into Stage 7 came suddenly, after years of level symptoms in stages 6. Right now, he is okay, but driving me nuts (I've lived alone in my house, by choice, for almost 18 years so this is a major life change and stressor for me.) As long as he isn't a danger to me, my cats or my house, in addition to himself, this is the way it is. Someway, we all find ways to cope.

I can relate to all who have posted here and send my best wishes. I am the only child of my father. My mother died many years ago and my dad never remarried. I am 2,500 miles away from him. He is in a lovely retirement home and can have home health care, though it is not an assisted living facility or nursing home. I was hoping that he could remain there, and the facility staff assure me that he is not the worst of the residents.

At the moment, he is angry about not passing his driver's test. (He turned 89 the day of his test a couple of weeks ago.) He can retake the test next week, and I'm hoping that he doesn't pass it. The problem will be to find reliable transportation that can take him to church and his many doctors' appointments.

I think a key factor in taking care of someone with dementia and the multitude of physical problems experienced late in life is finding a local support system for the elderly person AND a good support system for the family member. For my dad, it's through his church. Luckily, there is a new Pastoral Care priest whose defined duties are to deal with the elder members of the church. I have not met this man, but we have been exchanging emails and he is checking on my dad and helping to find transportation. That is a HUGE relief for me!

I have attended a support group at my health maintenance organization and also at the Alzheimer's Association, in addition to emailing my friends. It's amazing how many of my friends are facing the same situations, and we have banded together to be supportive of each other. Some of my oldest friends, dating back to my high school days, have rallied around me, and I have told them of this website and others that can offer information and support. If you mention your situation to acquaintances of a similar age, you'll almost immediately find others who are going through the same things and can be enormously helpful in identifying local resources and just being emotionally supportive. Again a HUGE help! I think, as Baby Boomers, we have grown up expecting to be in control, having knowledge, etc.  But it's sure nice to have friends who can hold our hands and hearts in theirs as we journey through this uncharted territory.

Thank you for that post....I'm sure that the support network you have in place provides a great deal of mental and emotional relief. In fact, it's given me a few ideas on exploring how to formalze a support group in my town, perhaps tapping the Alzheimers.org.

By the way, you can get your father's doctors to inform your state's drivers license agency that he should no longer be driving. It takes the heat off of family members. My dad didn't pass his test, between his vision and memory issues, though he thought he did fine. Fortunately, he had to go into the hospital for a few days, and I grabbed his keys, and stalled and stalled using his need for glasses as an excuse, until he just gave up. Meanwhile, the state rescinded his privileges based on the doctor's notice. He STILL thinks he can drive - I hide my car keys in case he gets some crazy idea to try again.

CLC,

Yes, my dad's gerontologist is the one who referred him for driver re-testing. I guess that's how it works in Michigan--I am not sure that the doctor can tell DMV to yank the license. He didn't pass the written test, and, in typical fashion for him, blamed the wording of the test, not his lack of knowledge.  It is, however, a further indication for me that he doesn't process information accurately.

They also told him to get an eye test, which I believe he passed. The difficulty is that my father can be very convincing. Both his PCP and eye doctor said he had the physical abilities to drive. It's his judgement that is lacking; i.e., pulling out to make a turn when there are cars too close to him, but he thinks, "I had plenty of room." Sad thing is that he drove a lot for his job and never had any accidents. In addition, he was a safety engineer, and he thinks he still has all that knowledge. The doctor was good about saying that, as we age, we may have the knowledge about something, but it gets hard to use the knowledge correctly. (That went over my dad's head.)

Anyway, the state DMV told him he could retake the test this coming week, so we'll see.

Back to a Care Team for someone with Alzheimer's. I read online a suggested list:

• Primary care physician
• Physician specialist (gerontologist)
• Psychologist or neuropsychologist
• Geriatric care manager
• Home health aide
• Elderlaw attorney
• Clergy
• CAREGIVER emotional support system

Wouldn't it be wonderful if we could all pull all those people together? Where my dad lives, there are no geriatric care managers, so that ends up being ME! Hence, the need for emotional support!

Well, it's a journey, not one we planned, perhaps, but it certainly keeps life from being dull.

Good luck to everyone dealing with these issues.

I have to laugh because if I changed some of the words, it's sounds like my dad! He was a Navy Pilot, then the Chief of Staff for a US Congressman here in Illinois. So when his "pilot eyes" failed him, the just thought he could call up some of his friends to get him a license. (And given what's happened in this state with drivers licensing, that has about as much chance as snowfall in hell.)

Interesting about the medical forms for licensing- you should really check the website for Michigan's state drivers licensing forms. In Illinois, there is one called a Medical Report,  and is a two page form that must be completed by a doctor for things like heart, epilepsy, etc.. There is also a form for a Vision Specialist, where sight becomes a driving factor. You may want to use keywords like Medical Review or Vision Disability to search your Michigan site.

CLC,

  Thanks for the info. Yes, my dad had both of  those forms and the doctors filled them out and said he checked out OK!    He took them to his PCP and ophthalmologist. I wish he had taken the general physical one to the gerontologist who referred him for testing! That's what I mean about supposedly being physically OK to drive, but they don't check for things like judgement!

Well, if he passes, I just have to accept that and pray that he doesn't get into an accident and hurt/kill himself or someone else. 

I hear your concern..  My husband went to the Idaho DMV to renew his drivers license.  I was praying that they would give him some kind of testing, but they only asked him if he wanted a four-year licence, or an 8-year license.  He's 90 yrs-old!!!   Doctors won't force him to give it up.  I'm also praying he won't kill someone.

oh, the thought of someone driving when you're pretty sure they shouldn't be sure is frightening!  I hope you can sort it all out.

There were neuropsych tests that the Gerentologist requested annually - things like judgment, memory and so on. Took about two hours and was administered by a resident at UIC Med Center.

Unfortunately, I have little faith in those quickie assessment tests, because while they may give an indication of memory, they don't convey the behavioral issues seen day to day. Unless you have a doctor who is willing to listen to anecdotal evidence, it's sometimes hard for medical practitioners to know how well or poorly a dementia patient is doing. At face, my dad was doing 'okay' on those quick little assessments done at his three month checkups, while his property taxes, bills and 5 years of IRS taxes were forgotten, along with the uncashed IRA distribution checks aging in his dresser for he and my mother. .Eighteen months and 80+ filing boxes of papers later, we had gone thru his papers and straightened things out. But boy could he draw the face of a clock!

I laughed so hard I had tears coming down my cheeks :-) because it is sooooo true about the clock and everyday things!!!! You just reinforced what we know, that we are still in the infancy stage of handling this disease process in any of its' forms and the smaller the town you live in the harder it will be to find a knowledgeable doctor.

All of the people who posted here are intelligent and their only concern is for the people they are caring for. To get a diagnosis, you'll have to go through many doctors I'm afraid. I would start with a geriatric doctor first, and make sure you "click" with them. Alz patients lose weight to begin with when the onset of their symptoms worsen; it's a hard time for them and there is no medical reason behind it. They're just scared. Period. Who would want to eat when this is happening???

Yes, they become our children. It's amazing how that works; my mother forgot my name and face, but never failed to recognize my voice. Recognize the connections you have with the person you're caring for, as this could mean the difference between a good day or a bad one, and someday it might mean the difference between life and death. Yes, I have been there.

Of course, the diagnosis is for us, and not them, as there is nothing you can do with it. And yes, still there is no sure way except post mortem. Check caregiving websites and childproof your home, as shuffling is also a huge part of the disease. Mumbling is key, as they will have bouts of trouble communicating. They isolate themselves, and do not like change in any manner. Taking them outside of their comfort zone is a challenge to not take lightly. Keep in mind that the connection from the brain to the body is broken or static, and so every day things confuse them. The best way to handle it is to think of them like a child, but give them as much control over their lives as possible. I think we all agree that their best interest is our only concern. The first thing you can do is help them live in dignity and and the last is to die with loved ones by their side. Sad but true.

Driver's Licenses: Boy, this is a tough one, as it's taking their independence away and it really hurts their pride. The only way to have it pulled is from a doctors note stating they are unable or unfit. If you cannot communicate with the doctor, find another one. Letting a loved one out on the road endangers everyone (duh). I did this with my father; it was really tough, but we didn't have to deal with an accident or someone dying because of it - thankfully. I did follow him one day and confirmed my worst nightmares; he once was the best driver I had ever known. On the other side, ensure they have access to cabs or buses (with supervision when the time comes), so that they still have some control. Your connection with your doctor is extremely important; many have a god complex, but a good one will work FOR YOU and not against. You have enough problems as it is right?

And yes, this website is great. No one judges and there are many who have walked in your shoes. We commend you and have lots of advice to get you through the dark days ahead. Someday it will come to an end, and it will be a shock for you, the caregiver, to have your life changed overnight. No one can prepare you for it, but when it's over and done, you'll remember those moments that made it all worthwhile. I call it the magic moments. They kept me going...

It might help to remember that when you fell you can't go on any longer, imagine us standing by your side giving our support and cheering you on. You are the unsung hero's, as a hero doesn't think of themselves first and they do it because it's the right thing to do.

Robin, Thanks for your words of wisdom, eloquently stated. My poor father. He got his eyes tested and they checked out OK. His GP told him his health was fine (yeah, right, with diabetes, prostate cancer, etc. etc. his health is "fine."). Today, Dad got a letter from DMV stating that due to a "medical condition," he may no longer be able to drive. Since I'm 2,500 miles away, I can't see the letter. It says that he has to go back next Monday to DMV, but he wasn't clear if that was for testing, or what. He doesn't understand what "medical condition" they may be talking about. This is a quandry I think many of us face. His gerontologist put it in the written report, which I have and which he sent to my dad's GP, that he has "dementia, probably Alzheimer's type." But the gerontologist did NOT tell my dad that. He never mentioned it during the visit we attended together. He didn't use any other words to describe the mental deterioration that is so obvious to all of us except my dad. So what are we to do? Whose responsibility is it to tell a patient that they have dementia? And how do I help my dad understand that it's his lack of judgement, not his eyesight, that should keep him off the road? It feels like every day provides more questions and fewer answers, and I know I'm just at the beginning of the process with my dad. I do appreciate this site, and others like it, and the Alzheimer's Association, and the AD support group at my HMO. But I'm struggling to learn the specifics that will help my dad.

Well, it's better to have someone close who can monitor and be hands on with his care. You can ask your dad to approve in writing that you can contact his doctor and keep updated on what's going on. And get copies of what is sent to him as well.

Being so far away lends to the disadvantage of seeing the daily struggle he's going through. And the family is usually the one to advise the patient of his failing health. It's a hard thing to do, but I feel we as children owe it to our parents to be there when they need help.

Can you advise who is close and will do the primary caregiving? Then we can address the questions as they come. Thanks.

I have all the appropriate Power of Attorney papers signed and pay all my dad's bills. We are on the phone at least two or three times a week. He lives in a lovely retirement home (not assisted living) that has a home health care agency onsite. I'm in frequent contact with the nurses and nurses aides as well as the people in the front office. I also have frequent contact with my dad's best friends and people at his church.

I get there are often as I can, several times a year. I am going to Japan for a month, but will go to see my dad the week after I get back.

It does seem like it's a doctor's job to provide a patient with a diagnosis. Since I'm not a fully trained medical person, I can't answer my father's questions that the doctor could. It seems like a cop-out for the doctor to tell everyone but the patient when there is a diagnosis! In addition, I feel the doctor did not do thorough enough testing and should have referred my dad to a neuropsychologist for more definitive testing. I have written to the doctor, sent my HIPAA Authorization and Power of Attorney paperwork, but he will not answer either my phone calls or letters.

I had distance issues as well - even 35 miles at 10pm can be a problem. There are some tools you might try, such as a fax machine or some of the new simple computers that are designed for the elderly. But those have diminishing returns as parents begin to have issues with instructions. I tried the fax (he thought it was an answering machine) and gave up. Just as I gave up with MedicAlert devices (he thought it was an answering machine.)

One thing you can look into are nanny cams. Depending upon how many rooms need to be monitored, you can use that for long distance viewing. I will probably install them in my house when I finally have to use home care regularly, it's protection for him and for me,my cats and house in the event of a less than noble home care person.

Since his gerontoligist didn't tell him about his Alzhiemers, it was left to me (multiple times) and along with his cardiologist of 20+ years, we got him to comprehend enough to express his end of life preferences to sign advance directives. But he still doesn't understand the long term pathology: one minute he thinks it's just short term memory problems from old age, another he asks when they will fix it. Which makes it imperative that you either get his Health Care POA and Advance Directives. You understand what awaits him; he does not. Try it in small doses. If you have a computer handy, take him to the ALZ.org site and walk him through the pictures in their tutorials. It may not work depending upon his temperament, but it's a suggestion.

Meiho, fire that doctor. I know it's a pain in the neck for you, but you need a team player and he/she is not. Geriatric specialists, good ones especially, are hard to find because it is not glamorous and doesn't pay as well as other medical specialties.

One of the reasons I have demanded that a medical practitioner be involved in explaining DNR,Advanced Directives, Healthcare POA, and explanation of diagnosis is that I do not want anyone ever pointing a finger at me claiming I unduly influenced my father in any of his life decisions. I may confer with his medical specialists beforehand, but I want them to explain to him what is going on. If I then need to paraphrase to his level in their presence I will, but I also want to protect myself from any witchhunt. Sad but true.

As I've said in several of my posts, I have ALL the paperwork in place. My dad has been very cooperative in getting that done over the past several years. I showed everything to his attorney and he agreed that we have all those corners tucked in. My dad has even prepaid his funeral and literally helped build the niche in the columbarium in the basement of his church where his ashes will reside.

I've been worried about the finger pointing, but everyone I know says I've done everything I can do to this point and done it legally and in a morally responsible fashion. That's not an issue!

The primary concern right now is the driving issue. If he doesn't get his license back (which I hope he won't), I'm working on getting him transportation to church and doctors' appointments, etc. One of the ladies at his retirement home (who is relatively young and safe) has offered to drive him some places and the priest at his church is rounding up other church members. IF the state says he can continue to drive, well, there's not much I can do about that except appeal to his background as a safety engineer and encourage him to quit. It's an on-going process.

He lives in a relatively small town and there is only one gerontologist, so firing him isn't a great option until/unless I can find someone better.

I can tell that you are passionate about "getting it right" as I am, and I do appreciate your input and ideas.

Let me clarify myself; the doctor should diagnose the patient correctly and advise them directly with someone as a witness. Unfortunately, they grasp very little in the office, so the family member is usually the one explaining the diagnosis. I completely agree; fire that doctor and now. Many doctors, more often than not, look at the senior population as a lost cause (they'll die anyway, right), so why waste time? They give them pills and send them on their way. When you get involved with specialists, none of the doctors communicate. So the caretaker takes on the job as mediator as well.

Nanny cams are a necessary evil; they catch so much more than you would ever imagine and are a great tool. Any step you can take to protect the patient must be taken. To hell with anyone that stands in your way in keeping your loved one safe.

I suggest a living will that normally includes all documentation including a power or attorney, right to die with dignity (do not resuscitate) and conditions and directions if the patient can no longer be responsible or voice their concerns or needs. It is a document that almost always stands up in court. It is better than having individual documents all over the place. Have an attorney you TRUST draw up the document for you. It protects your rights as the caregiver, and gives you powers that cannot be contested in normal situations. I have a background in law and have been an executor of a trust (not a nice job) and it has helped immensely. There is no question as to the patients requests, even if they no longer have a voice.

I cannot stress enough the part your doctor will play in this scenario. Also keep a book charting the patients progress, daily routines, diet, etc. to fall back on and take that to the doctor on visits. Use a recorder during the appointment, so you can concentrate on the details and play back for confirmation.

In a small town, you might have to drive a distance or move your father closer to you to get better treatment. Believe me, you want your doc on your side. Many doctors give meds that taken together cause side affects that CAN mimic dementia or alzheimer's. I questioned my mother's meds on her first visit with a new doc. He about blew his top since some meds were duplicates.... It's like taking care of a child, but the issues are so much larger.

Legally cover your butt so you are above question and that gives you the right to review their medical records. Seniors are taken advantage of so many times, it can be stunning to watch. After my mother broke her hip (not in my care), and moved to a nursing home, I went in at 7am one day (surprise visit) and found her naked, lying in her own feces, pieces of diaper strewn around her bed; she was shaking and cold. I could have been arrested for what I did to the head nurse (and yes, I lost control). I moved her out of there the next day and put her into a private home with her own personal caregiver to bring her back to health. It disgusts me that this happens.

So be on alert, make the doctor toe the line; they work for us, not the other way around. Your voice counts - if it doesn't make sense to you, you have the right to question it until it does.