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Is there a value in switching to a geriatric doctor for an advanced late stage 6 alzheimer's patient or is it too late to switch quarterbacks?

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My 84 year old husband has a geriatric doctor whom I like very much. He is youngish, and will give you all the time you need. He is NOT dismissive, the way some doctors are with older patients, and I appreciate this very much. Since we are hours away from his office, he does tele health appointments which are all we really need at this stage in his dementia. He will explain all medications he might recommend, as to their pros and cons, since there is always a balance to be had between the help the medication might provide and the negatives or possible side effects. I would recommend a geriatric physician, if at all possible, since they are trained to deal with older patients, and are NOT dismissive of them because of their advanced age.
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Reply to wantmylife
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Ok, I made the call to the geriatric doctor, arranging a first call and we'll see how it goes. it may not be with the doctor, it might be with her office coordinator but its a step
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Reply to firsttimer1
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I was very thankful to have found an excellent geriatrician for my mother. She knew that the goal wasn’t to keep my almost 90 year old (when we first went to her) mother alive for another 50 years and her priorities were more realistic about what would improve her quality of life. She knew that there was no way my mother would be able to follow through with certain things and some treatments would not work if not followed properly. She also knew that my mother either forgot important details, didn’t take them seriously or was too embarrassed to mention others things and that listening to family and caregivers (with authorization of course) was very important to get the whole picture. Her ability to communicate clearly with my mother, even before diagnosing my mother with mild cognitive impairment, was much better than other doctors my mother had seen. She also ordered tests such as a urinalysis in situations that doctors less experienced in how the elderly present with different issues would not have thought of. Geriatric patients definitely do not present or respond to treatments the same way younger people do and they also have some unique issues, especially related to self care so greater experience with that set can make a big difference! As it is PCPs are getting increasingly difficult for anyone to find and it is even harder to find a geriatrician who is accepting new patients but if you can find one they can be worth their weight in gold!
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Reply to Animallovers
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Up until age 87 my mother had been literally passed thru the years from one Gp to another gp. Her advanced RA was never properly advanced and she'd always been one to say " nothing hurt, always fine".in 2023 when her falling, breaks, snf's etc. began, ( and the onset of dementia) i began to see exactly how neglected she had been thru the yrs. And in doin doc visits with her I witnessed and asked many questions and told them as much.. my mother is NOW being seen by a geriatric specialist who is mobile and sees her once a month. All issues are being addressed properly now, a huge relief. I know you said your LO had advanced alzheimers. I cannot express enough just how much doing so has helped us in my mothers care. Getting accurate diagnosis, monthly check ups etc. NOT JUST " looks good! See you in 4 months!!" My suggestion " Do find a good Geriatric Doc" its worth it..
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Reply to Littlewing65
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Our pcp recommended we look for a geriatric pcp because she was not familiar with all the nuances of aging. She helped us search for one. There was no issue with making the switch.
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Reply to DaddyDear
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Not really
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Reply to Beedevil66
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My dad was diagnosed with FTD in his mid-70s when he and my mom lived 800+ miles from me. I moved them to my town about 18 months later, because my mom was unable to cope, he was acting dangerously, and she was refusing to put him in memory care. So, my dad had to switch doctors and I found a geriatrician for him. I was very apprehensive that this Dr might not continue his Seroquel and Trazodone prescriptions, because without them my dad became WAY worse. But there was no issue whatsoever. My dad would fib and /or confabulate while in the examining room (I was there) but later the Dr would make time to talk to me separately. He was also great for things like getting a handicapped placard for me when driving my dad around.

I eventually took my dad to quite a few different specialists for his various other issues including an emergency dentist when a tooth had to be pulled. I have to say, they were all great. It isn’t easy for anyone (caretaker, patient, or doctors).

The question is why do you want to switch. What seems like maybe a different opinion or approach could make things better? I think we have the answer in your other question about hospice.

best wishes.
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Reply to Suzy23
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Suzy23 Apr 8, 2026
PS the first time I took my dad to the geriatrician, I brought letters from his previous neurologist stating his diagnosis and prescriptions.
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If the patient is comfortable with the present doctor and the doctor is competent, I wouldn't switch. My husband liked his PCP, who recently moved out of state, and strongly objects to his replacement, who asked him questions at the first visit trying to evaluate his mental conditions. Being reminded of their mental decay can be very upsetting to a dementia patient.
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Reply to AnnaKat
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I can tell you my experience with my mom's long time non geriatric doctor PCP. While he wasn't an expert geriatrician, by the time she was nearing the end of her life it was actually more important that he knew her when she was "all there". He knew what her baseline was, and that is something tough to recreate for a new doctor. So that is one thing to consider, if only because the patient may only show changes in behavior or mentation in response to an infection or other stressors.

For us this was very important, along with his willingness to prescribe her certain medicines that other doctors were not sure about. We had a long term relationship and we'd discussed the pros and cons of various meds. Going to new doctors and explaining things over and over again got tiring. Mom was also familiar with the doctor and felt comfortable with him. The office was easy to get in and out of and it was close to mom's home. There really wasn't much that could be done for my mom at the end anyway. When she went on hospice they handled all of her meds.
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Reply to SamTheManager
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Mom had alzheimers. She lived in a rural area that was under doctored.
We ended up sticking with her PCP. The real value that he offered was that he would do remote doctor appointments the last several years when she was bedbound in the home.

If you can find a local practitioner that will do remote doctor appointments there is real value in that for late stage.
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Reply to brandee
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You could try. But as with many areas of medicine, geriatric physicians probably are in short supply, and it might be hard to find one who will take on the individual (your parent?) as a patient. I think it's important for all patients (or their decision-makers) to be willing to educate themselves and not necessarily take a physician's or other health-care provider's recommendations at face value. This is true whether the physician is a general practitioner, an internal medicine physician, or a geratric physician (or anything else).
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Reply to Rosered6
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This is my opinion. PCPs/GP know a little about everything and a lot about nothing. I had a Neurologist for my Mom who did not believe in medicating if not really needed. I was lucky, in that Mom was fairly easy. She went without meds until her last two weeks when anxiety set in. Her anxiety started out humming that got louder by the day so they medicated her.

There is nothing much a doctor can do for a Dementia patient in the last stages. You can try a geriatric doctor and tell him your experience. See how it goes or try to get into a Neurologist. Mom does need something to calm her down.
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Reply to JoAnn29
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I agree with the strategy of finding an older doctor who can relate to an olde patient. I did this for my Mom and she was a very good primary BUT now she is retiring and we have to find another doc.

Medications, especially to treat cognitive or brain-related issues, can act very differently in different people. It's a guessing game. My Mom is a retired RN and she has always said that gerontologists just spend their time figuring out drug interactions in patients.

I saw your other post and had asked the question of who was with your Mom when this drug was prescribed, or if anyone was with her at all and I don't think this was ever answered. The antidote is for her to have a good care manager. Doctors can only do so much.
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Reply to Geaton777
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firsttimer1 Apr 1, 2026
I did answer it and frankly didn't like what you were suggesting.
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Have a doctor that specializes in alzheimers and elderly patients. avoid the issue i just had with her primary where he went outside his lane and prescribed a very controversial drug for someone in late stage alzheimers. Isn't it better to see a specialist doctor who focuses on the type of patient as opposed to one that typically sees younger patients
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Reply to firsttimer1
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What are you hoping to achieve for your LO by switching?
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