When someone is having a serious memory issue. . .

[Miss Peregrine]

And you think they need to be evaluated, is there really anything you can do if they don't want to admit it?

 

This individual had grandparents on both sides with Alzheimer's. The memory issues are becoming more apparent. Examples: Asking how to get to a friend's house when that person has been there many times.

Or: Telling people they need to stay home from an event( with details why this would be the best decision)and then seeing them later in the day and asking why they weren't at said event.

 

If( BIG IF) that person actually went to the doctor, could anything really be accomplished if the person won't admit they have a problem? Could they cheat a memory test?

[gaillardia]

What I have to suggest, I don't know if it is even legal. If you know who the person's doctor is, I would start there by calling and expressing my concern. Then maybe the doctor's office could call your person to set up for a wellness appointment.

[OneStepAtATime]

Sometimes doctor's offices will have forms that family members can fill out if they have concerns in this area and the doctor can then do a sort of review of what the family member is seeing by looking at what the family member filled out.  Then the next time the person comes in for a checkup they can discuss the issues with that person.  It can backfire, though.  The person may get really angry that someone talked to their doctor behind their back.

[J-rap]

I think at some point you could get a county social worker involved, or something like that.  We did that once a long time ago for a woman who lived alone and was an alcoholic.  It was to the point where she never left her chair, and would probably have died like that.  She still refused any help, but we were able to get a social worker involved who probably got a court order to help her. 

 

But assuming it's far from the point of him/her being a danger, I wonder if you could call her doctor and express concern?  Then the next time she was in for a check-up, the doctor could check into that to the extent that she/he can.  I would think the doctor would not need to let on that someone had alerted her/him.

[Kerileanne99]

Can you call Adult Protective Services?

They have lists of resources and can assign a case worker to determine what sort of help is needed.

[Momof3littles]

Call the person's MD if you can.  They won't say much to you regarding the patient but may be able to direct you to resources.  Before you call, I would write down when you recall the onset, was it gradual or sudden, how long has it been going on, and a few incidents. I would actually write down all of the incidents you can recall, but let the doctor know some of the most concerning ones and that there have been more.  Write down any medications, write down the family history, any concerns about substance abuse, that type of thing. That info compiled into one picture also help in medical professionals knowing what the areas of concern are, and it may help them choose more appropriate diagnostic examinations that are sensitive to the areas of concern. Having a journal of sorts will be helpful to other professionals, both medical and legal IMO.  I would not wait for a regularly scheduled appt. and would call the person's MD now. Continue to journal incidents you are seeing, any other concerns that start popping up, etc.

 

You may need to pursue it legally, but I would do so for a family member if they were not agreeable to seeing a doctor.  I would call adult protective services after you call the MD.

[G5052]

Been there.  My eyes were opened to this when a doctor friend of ours pointed out that memory issues aren't just a personal quirk that doesn't affect anyone.  If their driving is affected or if they are not taking medication that is important to their health, you need to intervene.  In most states doctors have a legal obligation to do this if they're aware of it, depending on the level of impairment of course.

 

The first step is to contact their doctor.  Although medial privacy laws prevent the doctor from sharing anything, you can write them a letter with your phone number and mail or fax it to them.  Outline very clearly your concerns.  

 

Sometimes people can indeed pass the office test, but then a full evaluation may flag something.  Most memory evaluations involve a review of lifestyle, medication, more complex memory/cognition testing, and and MRI/CAT scan.

 

You might also contact the state DMV if you have concerns about their driving.  In most states you can do this such that your name can't be released unless there is a court order. What happens then various, but in most states the individual has to get an "all clear" letter from their doctor.  This is why you want to contact the doctor first, and if you do that, mention your concerns about their driving.  Memory and reasoning are very important in driving.  If an older person is found to have memory issues as part of an accident investigation, it may count against them.

 

And yes, it can backfire horribly.  I've shared here before how my life became a living h*ll after doing this (two lawsuits and effectively removed from their will), but I wouldn't change a thing.  They were regularly knocking down rows of traffic cones, blasting through red lights, ignoring crosswalks, and such in addition to getting lost in a small town where they had lived for 50+ years.

[Miss Peregrine]

Can you call Adult Protective Services?

They have lists of resources and can assign a case worker to determine what sort of help is needed.

I don't think it's that serious, yet. This person is still holding down their job/ providing for their family and doesn't see a problem. Admitting to memory issues is never going to happen.

[LMV]

And you think they need to be evaluated, is there really anything you can do if they don't want to admit it?

 

This individual had grandparents on both sides with Alzheimer's. The memory issues are becoming more apparent. Examples: Asking how to get to a friend's house when that person has been there many times.

Or: Telling people they need to stay home from an event( with details why this would be the best decision)and then seeing them later in the day and asking why they weren't at said event.

 

If( BIG IF) that person actually went to the doctor, could anything really be accomplished if the person won't admit they have a problem? Could they cheat a memory test?

 

How old is the individual? Would they allow you to accompany them to their next appointment?  As far as the bolded, I think they can definitely minimize, cover, and compensate for the problem, however, if their doctor proceeds with some objective testing (i.e. MMSE or a portion of MMSE) that can be difficult to cover.

 

As others have mentioned, you can share your concerns with their doctor. Nothing in HIPPA prevents this, however,  HIPPA (and the general concept of confidentiality which existed long before HIPPA) prevents their doctor from discussing your concerns with you without their permission so it may need to be a very one sided conversation.  What their doctor chooses or is able to do with the information will depend on the situation, the relationship, community resources, and the physician's own approach. 

[Momof3littles]

I don't think it's that serious, yet. This person is still holding down their job/ providing for their family and doesn't see a problem. Admitting to memory issues is never going to happen.

 

I don't know, I actually think it is really quite serious.  I worked as a physical therapist pre-kids, and would consider what you are describing in a family member highly concerning.  I don't know the age of the person involved, but what you describe is most definitely concerning enough for an immediate phone call to the physician and I would most definitely consider doing whatever necessary to get the person examined and treated. 

 

They could burn the house down, it could be something like a medication issue, it could be something treatable and you are losing time, it could be the onset of a chronic condition.  If you wait, you lose time.  I would not wait.

 

edited to add: they could impact someone else at work, on the road, etc. and you could be looking at a lawsuit.  I would take some action.

[G5052]

Can you call Adult Protective Services?

They have lists of resources and can assign a case worker to determine what sort of help is needed.

 

In most states Adult Protective Services will only get involved if there is physical abuse or the person isn't eating, living in filth, etc.

[Miss Peregrine]

I understand about notifying the doctor but don't think it will help. I actually have done that this past year about an unrelated issue. He took no action. :/

 

If memory tests are just questions then I think this person will lie, unfortunately.

[Momof3littles]

I'm not sure what you mean about memory tests being "just questions."  There are tests that would be difficult to "fake" one's way through. 

 

Is the main issue right now short term memory?  Any flags for long term memory?  Think about that while documenting.

 

If you aren't happy with your doctor's care, ask for a referral to a geriatrician if we are talking about someone older. I'd also switch PCPs in the meantime to get the person in to see *someone* ASAP.

http://health.usnews.com/doctors/location-index/geriatricians

 

I'd even consider ER if you gain their cooperation or be crafty.

 

 

[Miss Peregrine]

I'm not sure what you mean about memory tests being "just questions." There are tests that would be difficult to "fake" one's way through.

 

Is the main issue right now short term memory? Any flags for long term memory? Think about that while documenting.

 

If you aren't happy with your doctor's care, ask for a referral to a geriatrician if we are talking about someone older. I'd also switch PCPs in the meantime to get the person in to see *someone* ASAP.

http://health.usnews.com/doctors/location-index/geriatricians

 

I'd even consider ER if you gain their cooperation or be crafty.

"Just questions" meaning the doctor asks if has trouble remembering things, with maybe a few examples and he says no. End of test.

[Momof3littles]

I should add my concern is also that you and others may assume this is the onset of Alzheimer's, but there are other serious medical causes that are more treatable.  A slow bleeding subdural hematoma, a tumor, all kinds of things.  I don't know this person's age, but I would feel a sense of urgency in getting them treated.  Call the MD back again and then move onto someone else as a PCP (this should not be brushed off, really, by a competent physician IMO) try to talk the person involved into an ER visit if you must, take time to document what you are seeing but make those calls first.

 

Document any head injuries, falls, work injuries, how long symptoms have been going on.

[Miss Peregrine]

I have had various lists over the years with examples but I always lose them . Lol. Not to make light but yes I am going to be more diligent in documenting.

[Momof3littles]

"Just questions" meaning the doctor asks if has trouble remembering things, with maybe a few examples and he says no. End of test.

 

That's why IMO you need to talk to the MD before going, and if they aren't referring you for more specific testing and screening, find a new doctor, start calling specialists (like a geriatrician if appropriate for the person's age), consider neurology, whatever . But don't drop it because this MD isn't doing targeted testing and will brush you off.  If you make very clear something is going on, a competent doctor is going to do (or refer out) for more appropriate screening and testing.  When I interned in a hospital, as PTs we often screened quickly as part of our evaluation for basic memory issues (the date, current president, that type of thing).  IMO no excuse for an MD to brush off entirely and do such an easily "cheated" screening,  and not refer out or do more targeted testing, especially once you alert them to your concerns, and the length of time, progression of illness, etc.

[umsami]

Based on what you've described, I don't think this person could "fool" a memory test (mini-mental state exam or mini-cog test).  BUt it sounds like you have concerns regarding this person's PCP as well…which makes things more difficult.  Can you pressure them to administer one? Perhaps.  I really think a neurologist is your best bet, but I'm not sure how you'll get this person to see one unless you talk up medications which could slow the onset of any sort of dementia. 

[Momof3littles]

I have had various lists over the years with examples but I always lose them . Lol. Not to make light but yes I am going to be more diligent in documenting.

 

So this has been progressing over years?  Make sure that the people you call know that, as that helps out diagnostically.  If you can remember any of the "old" events, write them down if you can recall.  if not, just make sure they know this has been going on for a while. 

[Miss Peregrine]

Yes, years. He's 45.

[Momof3littles]

I would see a neurologist in that case, and encourage you to find a new PCP.  A 45 yo with memory issues should concern any competent physician enough that you get referred out for a consult. Especially at that age, and especially with a family history. That's valuable time that the person could have been on meds and so forth.

[zoobie]

I would see a neurologist in that case, and encourage you to find a new PCP. A 45 yo with memory issues should concern any competent physician enough that you get referred out for a consult. That's valuable time that the person could have been on meds and so forth.

45 is hugely concerning. It could be a result of a number of physical or mental issues. Some could be treated, some managed, but medical intervention is critical.

[Miss Peregrine]

So the examples I mentioned are not small potatoes? They both happened this weekend.

 

I am being made to feel like I am making a mountain out of a molehill by this person.

[Momof3littles]

So the examples I mentioned are not small potatoes? They both happened this weekend.

 

I am being made to feel like I am making a mountain out of a molehill by this person.

 

No, especially if it was not just this weekend that you've observed memory issues.  I've seen people get dehydrated and have bad confusion, for example, but it sounds like things are getting worse or there's an uptick?  I would be concerned for sure in a 45 yo.

[zoobie]

So the examples I mentioned are not small potatoes? They both happened this weekend.

 

I am being made to feel like I am making a mountain out of a molehill by this person.

I don't know who it is, but if it were my DH, I'd drag him to the doctor by his ears if required.

[Momof3littles]

Agree, and again, there may be treatment, it could be something managed better with meds, it could be a red flag for quite a few conditions that would possibly benefit from identifying this as early as possible.  If the weekend was particularly unusual for him, I'd be thinking of it as an urgent issue and go to the ER even.

[sheryl]

Yes, Amy, there are things to look for. 

 

My Dad was/is faced with some memory loss due to aging.  I'll share some info. I've gleaned to help you.  First of all, how old is this person?  Are they married?  In other words, is there someone else who sees this person everyday and can see a decline?  Have there been major/minor events to suspect such?

 

Feb. 2014 - My Dad turned 88 just a few months before. My Mother passed away over 25 years ago and he never remarried.  He's been independent.  (All of this paints a broader picture.)   His knees are not good and he can not walking standing in an upright, erect position.  He used a cane at one point, but now he needs a walker and it's hard for him to get around.  This past winter he became housebound b/c of the long, snowy winter precip and his lack of ability to walk well.  He doesn't eat well. The elderly can suffer from dimished sensory issues (loss of smell and taste).  He doesn't get enough oxygen exchange or whatever it's called b/c he can't really get sufficient activity, let alone exercise.

 

He ended up with what the doctors believe was an infection.  Still not sure of what.  We were told uti.  Then it seems one dr. mentioned it may be an infection from a previous surgery let left a deep and long scar. 

 

He "accidentally" drank bleach at his house.  Remember the elderly can lose senses.  By the grace of God it was a small amount and he was fine.  He did end up in a hospital due to his infection.  He started hallucinating.  Drs. and nurses said the way the elderly reacts is different than someone younger.  DD and I drove up and there was 1 night I thought he was going to die.  I asked the nurses and while they can't say for sure they did say it takes the elderly longer to bounce back.  During this time they were running tests they "considered" sundowners.  Google it.  It occurs when the sun sets and evening/dark comes on.  He doesn't have that but it was considered.  After the meds were worked out and the infection cleared, he stopped hullicinating.  

 

He left hospital and went to rehab.  We were able to swing having services at his house and all went very well.  An R.N. came and checked on him once a week and others as well. One person came everyday.  It was nice as my Dad is by himself and he looked forward to those visits.   We are 8-9 hours away. 

 

When I talk with him by phone/Skype he looks good and seems like his old self.  He seems to be doing well.  

 

During this whole time which started back in Feb. or so, my sister and I were talking and visiting with assisted living/memory care facilities.  I found a good one locally and the rep there said that his concern is this -

 

adults remember things they learned as a child and practice on a daily/regular basis (maybe making a paper airplane or using a coffee maker)  But, the concern for memory issues may exist when a person was actually taught something more "recently" and they don't remember it.  Espeically with all the new, electronic equipement.  So, if a person bought a smart phone for the first time a few years ago and "knew" how to use it and doesn't now, then that may be a red flag.   And, that can carry over to using the oven, washing machine, driving a car, etc.

 

It sounds like that person may not want to "consider" an issue.  I don't blame him/her.  However, for their very safety, they should go to a doctor and ask to go to a few specialists who perform tests.  Why not rule it out.  If there is an issue, then at least s/he will know of it now to deal with it.  It sounds like they just need to be informed and the research for resources is endless.  Perhaps a hospital social worker who works with the elderly could steer you in the right direction.  This person you know may need to hear from someone they know loves them and there is a mutual bond of love and respect.  Perhaps then s/he would go.

 

HTH!

 

 

[prairiewindmomma]

Neurologist, pronto.

 

Many individuals use denial as a coping mechanism. Facing the reality that there *is* or *could be* an issue is too scary to contemplate. Especially when you are 45.

[sheryl]

Yes, a neurologist may be "one" of those specialists but I wouldn't make it the "only" one.  My dd has controlled epilespy and she did have a memory issue at the age of 8-10 and beyond.  There are just so many reasons why this may be happening and there needs to be a starting point at the neurol. office and continue on until an answer is given. 

[shage]

So the examples I mentioned are not small potatoes? They both happened this weekend.

 

I am being made to feel like I am making a mountain out of a molehill by this person.

 

The denial of memory problems is in itself diagnostic.

 

Because there are many people with memory problems who do notice and do admit.

 

If you can call the family doc/primary care provider, I would do so and ask for guidance as to how to proceed.

[LMV]

I understand about notifying the doctor but don't think it will help. I actually have done that this past year about an unrelated issue. He took no action. :/

 

If memory tests are just questions then I think this person will lie, unfortunately.

 

When I was referring to memory tests I was thinking of the MMSE.  You can't really lie on the MMSE.  (You can answer incorrectly of course, which isn't exactly a lie, but that will be reflected in the score.)

 

http://www.heartinstitutehd.com/Misc/Forms/MMSE.1276128605.pdf

[Miss Peregrine]

Last night I suggested seeing a neurologist. Eye roll and denial." I was really tired." I gave a couple more example not from this weekend. No response.

[Danestress]

And you think they need to be evaluated, is there really anything you can do if they don't want to admit it?

 

This individual had grandparents on both sides with Alzheimer's. The memory issues are becoming more apparent. Examples: Asking how to get to a friend's house when that person has been there many times.

Or: Telling people they need to stay home from an event( with details why this would be the best decision)and then seeing them later in the day and asking why they weren't at said event.

 

If( BIG IF) that person actually went to the doctor, could anything really be accomplished if the person won't admit they have a problem? Could they cheat a memory test?

What can be definitely diagnosed and treated depends on the cause. Neither of these examples seems very serious to me, but very annoying, and I would be concerned. But I would also think that if the person is not a danger to himself or others and is very resistant to getting help, just monitor and journal (in a very top secret place!) examples for a year or so. If you live with this person, you might be able to keep a diary of what happens and what is going on in the person's life - lack of sleep, work stess, family conflict, and see if there is a pattern.

 

Did the grandparents with Alzheimer's have an early onset (under 65?)? If so, that would increase concern, but there are a lot of other things that can cause confusion. I doubt, from your examples, there is any way you can force an evaluation. Eventually, this will either get much worse or it won't. You just have to do the best you can and accept your limitations.

[brehon]

Last night I suggested seeing a neurologist. Eye roll and denial." I was really tired." I gave a couple more example not from this weekend. No response.

This is, unfortunately, par for the course when dealing with these types of issues and is, in fact, a symptom in and of itself. If this person is unwilling to even be evaluated for the numerous medical issues which could be causing memory loss (not just early onset dementia and/or Alzheimer's), then your options are fairly limited. If his primary care doc isn't receptive to information you are telling him/her, then you're in a double blind.

 

I think at this point the best you can do is keep a journal of these types of incidents and anything else which is unusual (behavior, eating habits, driving ability, etc) for this person. Dates, descriptions of incident, time of day, time of last meal, etc are all important. Although you can keep talking with this person about your concerns, please be prepared for this person to see it as nagging and over reacting to "minor" incidents and dig his/her heels in further. Best of luck to you; this is a hard row to hoe with loved ones.

 

If you can get this person into the primary doctor, you can specifically request the MMSE after you've explained your concerns. Doesn't mean that it will be performed, though.

[OneStepAtATime]

Memory issues, as others have pointed out, can be caused by a huge number of things, many of them easily treatable, including thyroid issues, chronic dehydration, medication, chronic sleep deprivation, weak executive function skills that are getting overwhelmed with a change in schedule/lifestyle, etc. etc.  

 

I have a family that has a history of dementia.  They are ALL resistant to any suggestion of memory issues, especially my mother, because they are terrified that memory issues mean absolutely they have Alzheimer's and with that diagnosis there is nothing that can be done and their life is over (not true but the fear is there).  

 

But because of that no one wants to actively address memory issues and it is ridiculous.  They wait until whatever the issue is had actually become a more serious problem (like thyroid problems that my mom and I both have but she waited forever to get checked).  

 

Maybe if you explain that you think there is some specific issue that needs to be checked out that could easily be dealt with?  Like maybe ask them to have a medical work up that includes their thyroid?

[VeteranMom]

Is he on any regular over-the-counter or prescribed medications?  Any other health issues currently? 

[Miss Peregrine]

Is he on any regular over-the-counter or prescribed medications? Any other health issues currently?

Yes, and I just googled the name of the drug with memory loss. It seems to be a real problem. B-12 supplementation is recommend. His Dr told him last year to take B-12. He lasted a whole week.

 

This makes me so angry. I know he could have something else going on beside the side effect but this is something easy he could do.

:/