I don’t need a doctor!

Barbara now seems fairly open to keeping in touch with her doctor and taking her pills. Every now and then when she has lost her keys and frantically asks me for help after she’s torn apart her room looking for them she’ll say with a smile and a laugh “Do I need to see a head doctor, Bridget? Let’s go back to the head doctor!” 😀

But, she wasn’t always that way, and I don’t expect her to stay that way.

Getting people with memory problems to see the doctor often seems like a HUGE hurdle for those who love them. It was about 3 years after I started nudging, discussing, and prodding that Barbara saw a doctor with me.

Within months after her mom died Barbara was replaced with Ms. Hyde. Okay, maybe not that extreme, but she was mean. She was irritable, pessimistic, short-tempered, and I was shocked. One of her friends from her book club contacted me out of concern for her. Barbara had gotten in a tiff with one of the members and decided just like that to leave the group she’d been with at least a decade. Soooooo out of character.

It is a bad idea to do other people’s interventions. But I had noticed Barbara’s change of character, and a noticeable forgetfulness and difficulty with certain tasks now and then so I decided to call her. “How are you Barbara? … I wanted to mention to you that I’ve noticed you seem to have a little trouble as of late remembering when we are going to meet up…Also, a friend of yours from your book club emailed me…” She responded with,

“What?! How dare they! I am done with them. They offended me beyond what I can tolerate. And what are you saying, are you saying I have Alzheimer’s Bridget? I can’t believe my family and friends are colluding behind my back. Who can I trust anymore?…”

Okay, bad. I backtracked a little and said how I want to be on her side, make sure she is okay, and as her future health care agent fulfill my duty of speaking up when I was concerned. Somehow we ended that conversation amicably. I held back though, probably about a year, while still keeping my eyes and ears open. But she was fulfilling the basic checks – feeding, dressing herself, driving without incident. Likely Barbara’s change in mood was related to depression she experienced after her mom’s death. I didn’t know it at the time, but she did go see the doctor and he prescribed Prozac and Trazodone that she took for several months.

I brought it up again in a year saying something like “Being a nurse I notice people find it very helpful when they have an advocate with them when they see the doctor. I’d be happy to be that person for you anytime.” After failing again a couple times I looked at the Alzheimer’s Association site for help. They suggest focusing on how confusion and memory problems could be due to a host of things, many of which are correctable: vitamin B-12 deficiency, urinary tract infection, poor sleep, taking a lot of medications, depression, malnutrition…etc

I tried using that hook a few times, and finally Barbara bit it! As soon as she said, “Sure, maybe you could come with me.” I was pulling up appointment times on her computer with her and securing a date.

When we made it to the doctor I learned that a year ago he had already diagnosed her with mild cognitive impairment. I am often amazed at how easily the health care system can give someone a diagnosis like that and just let the person loose – knowing they live alone or in a rural area. In my opinion the diagnosis is no more than 10-50% of the treatment plan, but western medicine seems to have an attitude that once a diagnosis is reached the job is done! But I digress.

At that meeting, her primary care doctor started her on a titration dose of Aricept (Donepezil). Donepezil is a common medication prescribed for dementia, but generally it is shown to only be effective for a couple years. She’s been on 10mg now for about 15 months. She is definitely more functional now then she was then, but there are also other factors that could contribute to her improved state which I’ll explore in another post.

If you don’t have luck with simply convincing your loved to go willingly with you to the doctor you could try writing a note to the doctor expressing your concerns and asking they have the person come in for an appointment. The doctor legally can’t talk to you about the person’s situation without his/her consent, and they are not obligated to take action based on your letter of course – but something positive could come from such an attempt. Sometimes people won’t accept help until, like most humans throughout life, they’ve hit rock bottom. In this case that might be a fall, or getting lost for an extended period of time, or a car accident. Obviously, that is not ideal, but it may happen.

Alzheimer’s Association hotline: 24/7 at 1.800.272.3900.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s