I know it has been awhile since I have written. I’m afraid there will be more lapses in the near future with the holidays and my winter vacation coming up. However, I wanted to fill you all in on dad’s dementia evaluation.
I took dad to see the neurologist last week. It was a 3 hour appointment and I had to ask the Assisted Living Facility staff to get dad up and ready extra early. He was eating his breakfast when I arrived to pick him up.
Dad asked what the medical visit was for and I said it was just a check up and the doctor was going to talk to him about his memory. The first physician to see dad was a woman who did the actual neuropsychologic testing. Initially she asked me to come with her and dad to the examination room where she weighed him and took his blood pressure. She then asked dad questions about his life and work history.
She asked dad what year it was and he said 2012. She asked his age and his response was also 2 years off. She wanted to know about what kind of work he did and when he had retired. He gave a pretty good explanation of his work and life history. He didn’t remember exactly when he retired, but knew it was a long time ago.
Then she asked me to leave for about an hour while she did the tests with dad. I went down to the small café to have a snack while dad was tested. I returned just moments before she came out with dad. We then waited about 10 minutes before we were called back to see the neurologist.
While we waited, the first doctor shared dad’s test results with the neurologist. Then we went back to meet with him. First the neurologist stated that he never did receive dad’s medical records that he had requested from the doctor dad was seeing before he moved to our city. I had brought in copies of the paper records that mom had in her files. But the neurologist also wanted to see the MRI from about 5 years ago and related results and they had not come. He was planning to request them again.
He also said it was difficult to do an evaluation on someone dad’s age because they have not evaluated enough people over age 90 for comparison. He said he rarely gives a new diagnosis of Alzheimer’s disease to anyone over the age of 91. But since dad already had that diagnosis, he tried to work within the constraints of age.
The neurologist told dad that he did have Alzheimer’s disease, which seemed to surprise dad, though he didn’t react strongly. The diagnosis is “mixed dementia” with a mixture of vascular dementia and Alzheimer’s disease. The vascular dementia resulted from a small stroke dad had almost 20 years ago.
He also said that dad’s hearing was so bad that it made an evaluation difficult. When it seems that dad is confused, it is difficult to tell if the confusion is due to lack of hearing the question or the dementia itself. Thus he assessed the dementia as “moderate” rather than severe.
He noted that dad had taken medications in the past, both for Alzheimer’s disease and also for depression and they didn’t help. So, even though dad seemed to have both, he didn’t think medications would be helpful at this time.
In the end, his main recommendation was to get dad hearing aids. He thought the VA would pay for them since dad is a veteran though he has not used VA services in the past. I mentioned that dad has refused to wear hearing aids in the past but dad seemed to indicate that he would try them. I don’t think dad was doing anything more than being agreeable and I doubt he would wear them. I will follow up on this recommendation after doing some research. But I am not hopeful that dad would actually wear hearing aids on a regular basis.
The doctor also said I should bring dad back in a few months and he hopes to have more of dad’s old records by that point. I told him I would not have a hearing evaluation done before we return since I go away in the winter months and I believe there is a long wait at the VA.
I wonder if any of my readers have experience with getting hearing aids for people over the age of 90. Have you had any success with this? My neighbors told me their experience was that it was too difficult for an elderly person to adjust to the less expensive hearing aids provided by the VA. They were partially successful with the more expensive hearing aids they had to purchase themselves. But even then, they often didn’t use them.
I am glad I had dad evaluated, but am not sure what difference it will make in his day to day care. We will follow up with another visit in the spring and hopefully the doctor will have received copies of dad’s previous evaluations and MRIs.
The recommendations that he sent to dad’s regular doctor were mainly to continue to monitor his vascular risks and to obtain hearing aids. Perhaps the most important part of this evaluation was to establish a baseline for any changes that might occur in the future.