What if my dad's doctor doesn't think it's Alzheimer's?
How can I get my 82-year-old father's longtime doctor to take my dad's Alzheimer's symptoms seriously? He doesn't seem to notice a big change and instead points out how great my dad's blood pressure and energy level are and urges him not to worry.
It's not unusual for me to encounter a situation in which a parent has gone to a particular doctor for years, even decades, who is now hesitant to accept that there's a dementia process going on. Social skills often are the last things to go, so if the parent seems normal during a visit, the doctor won't notice anything wrong. Sometimes, too, the parent and doctor have become very close over time -- they may even be the same age -- so a lot of dynamics are going on that can cloud the issue.
If you've obtained your dad's consent to discuss his medical files, ask to schedule a 10- or 15-minute discussion with his doctor. You could say something like, "It may be difficult for you to see what I'm seeing because sometimes Dad seems on top of things, but here's what else I'm noticing that worries me."
If the doctor keeps resisting, look into getting a second opinion. A full-scale evaluation of dementia symptoms can help to determine whether that's really what you're seeing or whether it's a thyroid problem, depression, something else, or a combination of things.
Depending on how the second opinion goes, you can ask the original doctor what he thinks about the assessment. If he's still unresponsive, switching doctors is probably in your father's best interest, if you can get him to agree to that.
Think about seeing a geriatric specialist. Just as parents often take their children to a pediatrician, it can be advantageous to have your father see someone who specializes in the medical concerns of people his age.
It's really hard to assume a parental role with your own parents, especially with issues like dementia. At some point, though, you just have to accept that roles change and summon up the courage to take a more decisive lead in your parent's care, stepping into areas you wouldn't have before.
I often advise family members in this situation to write the doctor a letter, and possibly send it to him/her via fax marked URGENT, describing specific behaviors, incidents, peronality changes (distrustfulness, disinhibition, whatever) etc., that suggest that the patient is having cognitive problems. If possible, include dates and also any similar observations reported to you by others -- the bank teller, the insurance agent, the hairdresser, the next door neighbor, etc. This is especially good if you are not authorized by the patient to consult with the doctor (because even if the doctor can't share information, you can provide it) or if you feel uncomfortable bringing these things up when the patient is present. Once the doctor has received your concerns in writing, it is more incumbent on him or her to follow up with a more in-depth examination and if necessary and appropriate, a treatment strategy.
Agree with katecic: write down the symptoms, describe the behaviors, let him know what specific behaviors have changed. I wouldn't make the letter too lengthy -
-bullet specific descriptions,
-don't give opinions;
-Be direct, and may I say again;
-be specific. The doc doesn't have much time, he may be wary of getting involved in potential generational conflicts, and he needs to have creditable information to rest his opinions upon.
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