Should I accept the "diagnosis" of Alzheimer's from my wife's doctors?

A fellow caregiver asked...

Friends often ask me, "When was your wife diagnosed with Alzheimer's Disease?" My usual response is that AD is a diagnosis by default--through the process of elimination, all other possible causes for her behavior have been ruled out. Plus, the only definitive method of diagnosis is a post mortem brain biopsy. It upsets me to see the reaction from many that my answer is not adequate. It's usually an unspoken reaction but I often get the feeling that they don't think I've done enough to determine if she really has AD. And this makes me doubt myself, frankly. Do I accept the "diagnosis" of our primary care physician, her neurologist and a third general practicioner?

Expert Answer

Joanne Koenig Coste is a nationally recognized expert on Alzheimer's care and an outspoken advocate for patient and family care. She is the author of Learning to Speak Alzheimer's. Also, she currently is in private practice as an Alzheimer's family therapist. Ms. Koenig Coste also serves as President of Alzheimer Consulting Associates, implementing state-of-the-art Alzheimer care throughout the United States.

If, in fact, your PCP, a Neurologist, and a medical third party have all diagnosed your wife with Alzheimer's disease (AD), I truly believe you will feel relieved when you are able to accept the viability of their conclusion. There was a time not so long ago when brain autopsy was the way of confirming the diagnosis of AD. We have come a long way since then and now diagnose through an appropriate medical, psychological, and neurologic workup that includes social history and neuro-psych testing. This workup is specifically designed to diagnose AD and to also rule out other possible causes of the process that brought your wife for an initial evaluation. You alone know if you have 'done enough to determine if she really has AD' and if you have had the workup completed for AD, then rest assured you have indeed done everything possible. Try to slowly understand the disease process and walk beside her in this new world of Alzheimer's. Please take care of you.