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question on Physician for Mom
Hello, I'm very new here and to this situation. I appreciate all your posts, they're helping me everyday. Mom was diagnosed Christmas week and spent a week in a Psyc unit now lives with me. My niece stays with me at night after work, which allows both of us to get sleep when Mom is up and upset. It's a tag team effort here. A sister most times will come and spend time with Mom so I can run errands or catch up on chores. It's exhausting as you all know juggling all the balls in the air. Mom seems to be in stage 6. My question is do I need to change her primary care Doctor (internist) to another that might be able to streamline all her meds and may be more geared to treat what's coming next? She's currently seeing a psychiatrist and a dermatologist for psoriasis. Any suggestions are helpful,
TN. (middle/northern area)
The first thing to do is to make certain that her diagnosis is correct. There are physical problems that cause dementia that are very treatable.
You also want to know what variety of dementia she has. Yes, the meds are different.
This is usually done by a neurologist and involves cognitive testing that is hours long.
You are so close to Vanderbilt that that is where I would go. After all initial work is done your PCP can probably do follow up.
The nailing down of this is terribly inportant.
I looked at "Vandy" and would have traveled from Oklahoma.
You may have months to wait. That is not abnormal at all.
In our situation, my dad was seeing a geriatric internist He referred us to a neurologist for the dementia testing. Once that was complete, we were back in the hands of the geriatric internist for the duration of his disease. (You mentioned her doctor was an internist) My father also had a cardiologist we saw once a year, who guided his heart medications. The two doctors saw each others note and coordinated his care. But it really was the geriatric internist who handled most issues. Had I used Hospice, they would have provided their own doctor, who would have taken things from that point forward. But somehow, I really wanted the doctor I had worked with for years involved to the bitter end. And since I didn't use Hospice, it was the geriatric internist who even signed my father's death certificate.
This does get confusing since everyone is so specialized these days. But I think what's important is that you have someone you really trust, and can oversee and coordinate care.
Hello Theresa, I was primary caregiver for a mother and step-dad who both had dementia. What I found through experience, was that it is far best for the long haul to have a "team," of medical providers. Small team, but expertise can be extremely important as things move forward.
My mother had a Board certified Geriatrician as her primary MD. Unfortunately, he misdiagnosed her for type of dementia and had prescribed inappropriately which ramped things up and made behaviors far worse. There is a rather significant degree of misdiagnosis or missed diagnosis for type of dementia.
I did get my mother to an excellent Neurologist who after assessment discerned the accurate diagnosis. He then tapered off the inappropriate med and initiated a care plan specific to her dementia which was FrontoTemporal Dementia. Big difference was almost immediate.
There were some physical needs, so we had a primary care Internal Med MD as well as Neuro The Internist did all physical care needs and only Neuro was allowed to prescribe or change dementia meds. This held us in good stead during the dementia years up to and including the time of Hospice and NH care.
As an RN, I have seen both professionally and personally what a positive difference a good dementia specialist can make when dementia progresses; and an accurate diagnosis for type of dementia as noted is extremely important and key to everything else.
His Daughter,Hospice must have different rules for diff areas?I still take hubby to drs. even tho he is under Hospice and they support my decision
Hospice is under federally formatted criteria and yes; one can indeed continue to have one's own physician; many people are not aware of this. A Hospice physician must continue to certify a patient for continued need for Hospice care, but one can indeed opt for one's own MD as their provider of physician care.