How do we deal with two conflicting opinions about an Alzheimer's diagnosis?

1 answer | Last updated: Mar 28, 2016
Mblack asked...

My mother recently got two conflicting opinions as to if she has Alzheimer's or not. Which one do I believe, the team of doctors that said she does have Alzheimer's or the team that says she only has MCI?

Expert Answers

Lisa P. Gwyther, a social worker specializing in Alzheimer's services, is the author of The Alzheimer's Action Plan. An associate professor in the Duke University Medical Center Department of Psychiatry and Behavioral Sciences, she's also a past president of the Gerontological Society of America.

It's not so much which diagnosis to believe, but how you, your mother and your family respond. Specialists are careful to distinguish mild cognitive impairment from early Alzheimer's, but the differences are subtle, and some experts believe mild cognitive impairment is, in fact, very early Alzheimer's disease.

At this point, you need no more opinions, but you do need an action plan to shore up her memory and retained capacities. Take advantage of this time to encourage her to review and talk with you about her values, preferences and goals. Focus on her quality of life, not the specific diagnosis.

Mild cognitive impairment generally doesn't interfere as much with a person's capacity to function in daily life. However, many people with mild impairments or very early Alzheimer's do better with some help managing money, driving and organizing. Now is the time to encourage your mother to let you know whom she trusts and to update durable powers of attorney for health care decisions and finances. Help her use cues and reminders to limit her frustration or embarrassment related to forgotten appointments or occasions. If she has been putting off a long-anticipated vacation, help her arrange a stress-free companionable trip.

Make sure she establishes a comfortable and predictable routine with plenty of time for social engagement, intellectual stimulation and exercise. Make sure she gets regular medical care, preventive screening and a thorough review of her medications. She may need help with medication reminders or help with meal planning or preparation.

Her community may have Alzheimer's Association programs or support groups for people with early or mild memory changes. She may feel less alone, misunderstood or scared if she exchanges tips and support with others in the same boat. If there isn't a group, encourage her to stay connected to people and activities that bring her pleasure. Find ways to reduce tasks that take her too long or frustrate her. Suggest she "outsource or retire" from the tougher tasks to insure more time for fun or more meaningful, pleasant activities.

Her condition will declare itself with time. In the meantime, she and your family are wise to talk frequently about the future, while fully enjoying the present.

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