How do I talk to Mom’s doc about her dementia when she’s sitting right there?

So here’s my problem: I’m pretty sure Mom has dementia, but we aren’t acknowledging that openly. I want her to go to the doctor, but she won’t make appointments or keeps putting them off. The one time I managed to get her to go, Momma went in alone and didn’t remember a thing the doctor said. When I asked, the office staff replied that I wasn’t on the HIPAA release form. If I try to go in WITH Mom, the doctor doesn’t seem to understand that if Mom’s not mentally right, it doesn’t make sense to tell HER as much as me, because I’m the one who’s going to have to take care of her. But none of that matters if I can’t privately get the diagnosis from her doctor without upsetting her!

Before the visit

If you suspect dementia, consider getting Mom to sign Power of Attorney papers allowing you to act legally on her behalf when it comes to decisions about her medical care and legal matters, such as selling the house to pay for dementia care. It’s best to get this done BEFORE the diagnosis, as if you wait until afterwards, you may find yourself in a situation where someone demonstrated to be mentally incompetent signed a legal document—probably voiding it in the process!

If Mom’s doctor has online booking or a portal, log in, submit Mom’s paperwork–INCLUDING HIPAA signoffs to share the information with YOU, and set up the appointment FOR her. Don’t tell her when it is, why you’re going, or who you’re seeing.

If you don’t feel like Mom’s regular doctor “gets it” about dementia (many don’t!), then set up a visit with a geriatric psychiatrist. It’s important that you get a doctor who actually knows how to diagnose dementia in people like your Mom. If possible, talk to the doctor about Mom’s symptoms and help provide a history of Mom’s problems prior to the visit. That way you won’t have to talk about mom’s experiences IN FRONT OF HER. Keep the actual visit to JUST the test.

Meanwhile, talk directly to the doctor(s) who will be doing the diagnosis and make sure they understand that depending on the diagnosis, you’ll be Mom’s caregiver and need to know the results.

If Mom’s doc still won’t share information with you unless it’s ALSO shared with Mom, get Mom a new doctor.

On the way to/from the visit

Don’t tell Mom you’re going to the doctor. Just go. If you have to, tell her YOU have to go to the doctor, and when you get there, suggest she pop in for a checkup while you’re already at the doctor. Don’t argue, and don’t take no for an answer. Plan head with the medical practice so they know she’s coming in, pick a time when they’re least busy, let the front desk know to expect an elderly lady who probably has dementia, and just walk her into the exam room when you get there.

If you really need a distraction, head out early and stop by a fast food place for a treat. Keep things moving, though, and get her to the doctor while she’s still full of Tater Tots and vanilla ice cream.

Once you’re done at the doctor’s office, have SECOND dessert, and when you get home, talk about what a wonderful two-dessert day it was and thank Mom for coming with you to YOUR doctor’s appointment.

During the visit

Keep Mom’s direct involvement in answering questions to a minimum: just what the doctor needs to make a diagnosis. Don’t discuss troubling behaviors with the doctor while she’s in the room. Just have Mom take whatever tests the doctor wants to run and make sure the doctor knows to discuss the diagnosis DIRECTLY with you.

If Mom’s doc insists on trying to explain her condition to her, ask Mom to sit in the waiting room while you wrap things up.

If the doctor STILL doesn’t get the clue, be less subtle, and if all else fails, just walk out. You don’t have to be a victim of incredibly poor medical judgment. You can always repeat the process with another doctor who knows how to deal with dementia patients.

If at all possible, avoid traumatizing Mom with the news that she’s got dementia. There’s nothing she can do about it, and if she processes it at all, she’s just going to fret about it.

After the visit

• Make sure you have a copy of the dementia test results. This will come in handy if you need to start paperwork on court-appointed guardianship for her if for some reason you couldn’t get Mom to sign POA paperwork.

• Discuss the diagnosis and next steps in detail with Mom’s doctor. It might not be an on-the-spot thing, but make it clear that, given your mom’s diagnosis, he needs to discuss her health with you. In the early stages of dementia, it may be possible to slow down memory degradation or other symptoms with medications, and the earlier you act, the better.

• Finalize guardianship or power of attorney, as applicable. If Mom has dementia, you need to be legally able to make decisions for her as soon as possible, before she gets herself into trouble financially or otherwise.

• Prepare a plan for Mom’s care. This should involve anticipating how you’ll handle sudden changes in her safety, judgment, or ability to handle self-care that suddenly require greater medical attention, day care, or transfer to a dementia care facility. This plan should consider the value of Mom’s assets and how they’ll be dispositioned to ensure she’s in a safe and relatively content environment. If Mom’s mental decline is slow, you may be able to get her into a facility that provides “light” care early on and allows her to gracefully “age-in-place” so that when the time comes when she needs greater care, the transition is smoothed by their existing familiarity with Mom. Whatever you do, don’t wait until the last minute, because your options will be more limited and the urgency greater to find a vacant spot at a facility. Also, consider transitional care options such as nurse visits, adult day care, or a sitter who can alert you to sudden changes in Mom’s situation.

• Go out for dessert! 🙂 If you haven’t picked up on it yet, I’m a big fan of solving eldercare problems with dessert. If Mama’s happy, everybody’s happy!