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Is there a reason for 94 year old to have testing?
Tina M
Posted: Thursday, September 22, 2022 1:49 PM
Joined: 9/22/2022
Posts: 4


I have been in denial.  About a year ago my 93 year old mother was admitted to the hospital due to a fall and the physician informed me that she had dementia.  I didn't believe him. Then I went to her house and with her not there started to really notice all the ways I had been enabling her to cope.  Notes all over telling her how to use the microwave, use the stove, set the thermostat, operate the television. 

Since then she has been living in a memory care unit in an assisted living facility.  Over the past year I have been dealing with her worsening dementia.  Apparently I was still in denial.  I was positive she did not have Alzheimer's.  Well I am here to say that I just recently spent a lot of time on the Alzheimer's website and have come to the realization that it must be Alzheimer's.  

Six months ago her physician made the referral to neurology.  However they, of course, want an MRI and a CT and other testing to make a diagnosis.  I understand.  But my mother is almost 95 and very confused at this point and I am wondering if there is any reason to go further with testing and an official diagnosis.  What will be accomplished?

I already have a letter of incapacitation from the physician and all POA documents are in order.  I have been handling everything for years and as of the last year, she no longer has access to any of her finances or medical decision making, so nothing to be gained there.  

Please tell me what those of you who have been dealing with this for years think.

Thank you.


jfkoc
Posted: Thursday, September 22, 2022 1:56 PM
Joined: 12/4/2011
Posts: 21020


The only testing I would look into is the lab work which might reveal something treatable.
Tina M
Posted: Thursday, September 22, 2022 2:14 PM
Joined: 9/22/2022
Posts: 4


Thank you for your reply.  Are you speaking of regular blood and urine testing?  We keep up to date on all of the general health testing.
Iris L.
Posted: Thursday, September 22, 2022 2:19 PM
Joined: 12/15/2011
Posts: 18239


Check her vitamin B12 and thyroid levels, to start.  Low levels can mimic dementia.

Iris


Victoria2020
Posted: Thursday, September 22, 2022 3:03 PM
Joined: 9/21/2017
Posts: 1490


Hi Tina--

I think you've done a great job. You may have been in "denial" but you've got the legal stuff done [hopefully a final directive so that she isn't over or under treated depending on her wishes ] and  you've got your Mom safe in a MC home.

Would anything have been different now if you'd known 2 ,5, 10 years ago? Not really.

I'd just think of things to make her more comfortable, softly playing music that dates from her youth since her brain is probably back then  , easy to chew favorite treats if she still enjoy foods .

She is blessed to have an innately wise and loving daughter.

 


dayn2nite2
Posted: Thursday, September 22, 2022 3:21 PM
Joined: 6/20/2016
Posts: 3312


There is no way I would put someone of that age through imaging to get a diagnosis they already pretty much have and are in the appropriate setting for anyway.
harshedbuzz
Posted: Thursday, September 22, 2022 3:55 PM
Joined: 3/6/2017
Posts: 3825


Tina-

I have a dear friend who was in your shoes some 5+ years ago when my own dad was initially diagnosed in the mid stages.

Her beloved mom, 91, was slipping. It seemed worse on trips and vacations, but mostly mom had a routine of puttering around her own house until about 1pm when my friend picked her up to run errands and have dinner together. As time went on, my friend decided to move mom in with her and was gobsmacked at how badly mom functioned when she wasn't around to scaffold and set her up for success. 

She was reluctant to pursue the same diagnostic process to which we subjected my dad. (FTR, he was one of those zebras who did have a dementia/amnesia caused by a vitamin deficiency, but he also had Alzheimer's so correcting that only bought a short term return to a better baseline) Her mom's internist ran the bloodwork for vitamin and hormone issues to rule them out. 

She is already getting the help she needs, I don't see a need to subject her to further testing. 

HB
Tina M
Posted: Thursday, September 22, 2022 4:43 PM
Joined: 9/22/2022
Posts: 4


Thank you so much for sharing that with me.  I believe I knew the answer was not to do those tests but now I can move forward without adding more anguish to my plate.
abc123
Posted: Friday, September 23, 2022 4:40 PM
Joined: 6/12/2016
Posts: 2452


Hi Tina! Welcome to the forum. I think you have gotten some good feedback to your question. I would not put a PWD of that age through those types of procedures either. You seem to have some very important matters already covered. Your mother is fortunate to have you as her daughter. There are so many wise and caring people here, I'd be lost without them. Please keep posting and ask any questions you have. We support each other and truly care about each other. 

Sincerely,

abc123


zauberflote
Posted: Friday, September 23, 2022 6:30 PM
Joined: 10/24/2018
Posts: 1539


Tina, please stop kicking yourself over "being in denial". Regardless of what you thought it was or wasn't, you did exactly the right things all down the line! 

Doing the blood and urine work is the least miserable of all the testing that may be proposed, and the only one that might possibly change her treatment and gain some improvement if there are hidden causes of dementia-like issues. So I agree with doing that, especially if a traveling phlebotomist can come to her place and do the blood draw.  

When my mom was almost 92, her hip broke and we had the whole hospitalization situation. The xrays alone nearly sent me round the bend. As you say, save yourself, and mom, the anguish. You have done well. Enjoy your mom and let her enjoy you. 


Michael Ellenbogen
Posted: Saturday, September 24, 2022 8:15 AM
Joined: 11/30/2011
Posts: 4345


Yes and MRI or other type of exray they recomend.
Victoria2020
Posted: Saturday, September 24, 2022 12:32 PM
Joined: 9/21/2017
Posts: 1490


pickleballhelps--

Welcome to this Forum. I'm sure reading, posting, venting, sharing will help you get through this journey no one wants.

Since the MC unit admits they shouldn't have called you when your father gets upset  that is good- if it comes up again--I'd ask what should they be doing- what training has their staff had?

Timing of visits- every patient, family, MC unit is different-- you may want to experiment- a 2 hour visit seems long to me  -- maybe try shorter visits and have your exit time planned before an activity or meal so you slide out , no big leave-taking  and a staff member takes him off for the next event.

Emotions, this is hard, but our PWD don't understand complex or time based issues anymore but  feelings can stick like glue  so ( you may be doing this already) calm relaxed visits  will leave both of you better off after your visits.

 It's hard because you may want to share like you used to but your Dad can't absorb or respond like he used to-- so talking about things that give and more and more -gave -him joy in the past may help. I'm talking about a place I never saw because that's my PWD's bliss this month.

 


pickleballhelps
Posted: Saturday, September 24, 2022 2:57 PM
Joined: 9/24/2022
Posts: 2


Thanks for the welcome

I can only figure out how to reply- but don't know how to start a new discussion?

 


MN Chickadee
Posted: Sunday, September 25, 2022 9:40 AM
Joined: 9/7/2014
Posts: 1613


Tina M, I personally would not put my 94 year old LO through the scans. I would do the blood and urine tests, since that is easy enough and quick. But at that age there is little to be done other than make her comfortable for the rest of her days.  If she had symptoms that suggested it was not Alzheimers I might go further, because dementias such as Frontotemporal or Lew Body can mean certain medications should not be used and can have very different symptoms and behaviors than the other dementias, but if it looks like regular old Alz or vascular dementia I wouldn't bother. In a younger person I would, especially early in the disease. But in the middle to end stages when they are very confused it's nearly impossible to get them to cooperate for an MRI anyway. You already have what you need for the POAs to be valid so there is not a reason there either. I would focus on comfort care and educating yourself on dementia so that you can get the most out of your remaining time and give her the best care and learn communication techniques and what to expect. Teepa Snow videos online and the book The 36 Hour Day are great places to start. 

picklball, go back to the caregivers forum and look for the button at the top that says "Add Topic." Right now you are in a specific thread and can only add a reply to the current topic. 

 


mommyandme (m&m)
Posted: Sunday, September 25, 2022 10:19 AM
Joined: 2/16/2020
Posts: 758


If it was me, I wouldn’t put her through the machine testings. I did have my mom in an MRI machine almost two years ago… i wouldn’t do it again. She was 83 and early stage 6 then. She got through it and was compliant but it wasn’t comfortable for her of course. The neurologist wanted a new blood test a few months ago but when the hospice nurse tried,  it was too uncomfortable for mom and the nurse didn’t succeed, mom was scared and shouted as if she was being tortured.  

Seems like everything is in order for your LOs care and nothing will change based on results. 

Thanks for sharing, keep coming back. 


 
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