I am wondering what type of doctor everyone uses. My mom was doing okay until she had to go to the hospital one month ago. I took home someone I barely recognize. Since this nightmare has started I have been told to see a geriatric doctor, a neurologist, a geriatric psychiatrist, and hospice. Needless to say just getting her anywhere is nearly impossible. My head is spinning and I don't know which is the correct choice. Any opinions would be greatly appreciated.
What do you mean that she saw a geriatric doctor and was not happy. Who was not happy? The doctor or your mother?
If she has dementia, she may not be happy with any doctors. My cousin didn't like the primary care doctor at first, because she told her she had to go into ALF, since she was not able to take care of herself, but I kept reminding my cousin that she was a good doctor, who was looking out for her. I praised the doctor and always talked about what a great reputation she had. Plus, she was very nice. We were able to get my cousin to agree to go to AL.
My cousin did have dementia to the point that she was not able to make decisions about what doctors she needed to see. She had the judgment of a 5 year old, so I made those decisions. Thank goodness, I had her Durable POA and Healthcare POA, that had been signed years previously.
Since my cousin was only 62 years old, I had to rule out causes for her dementia. I didn't know if she had a brain tumor or something, so I had her evaluated by a Neurologist who did exam and ordered MRI. It ruled out other causes for her dementia.
She also had to see orthopaedic doctors due to her multiple falls and fractures. She has since been released.
She sees a foot doctor to cut her nails, since she's diabetic.
Her regular doctor is now a geriatric doctor. They do monitor her meds in order to keep her comfortable. We don't do cancer screenings, as she has a terminal illness. I've read a lot about recommendations from the American Cancer Society and other professional medical organizations, so I feel comfortable with that.
She will soon be seeing a dentist for oral surgery, but that is only because there are no other options. I've explored them. I'm just trying to keep her comfortable.
Since she now has severe dementia, my goal is not to take her to numerous doctors or have many tests. It's palliative care for her, since that is what she always said she wanted and what she chose for her mom in her final years.
You need to get her overall health evaluated. If you've been pleased with her regular pcp, take her back to her/him and ask for a comprehensive physical a review of her mental status and medications. You might want to call the doctor's office beforehand and ask if they are willing to do this; and for them to set aside time, both for the exam and to discuss the results with you.
Bring up the question of whether hospice is appropriate; some doctors are afraid to broach this topic.
I'm hoping you already have a HIPAA release so that information can be shared freely with you.
My experience with my elderly mother, with chf, pleural effusions, stroke and dementia, is that less is more. TED hose and elevating her feet work on the edema; we try to avoid diuretics because they mess with her electrolytes. She gets scheduled pain meds, not "on request" because she always answers "no" to are you in pain, but weeps that "it hurts" 5 minutes later. She is on antidepressants and antianxiety meds because they allow her to be calm and out of psychic pain. She is on minimal doses so that she is not drowzy.
Lastly, I will fight to keep her out of the hospital from here on in. She has a fatal disease called dementia, and hospitalization only makes that worse. There's nothing that her nh hasn't been able to treat, so far.
And do look into medical transport, they are a godsend.
I suggest starting with a geriatrician, for PCP. He or she can refer to specialists, such as a neurologist, if that is called for.
Describe the changes in her.
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He's seen 4 PCPs, two of whom were not the least bit thorough and only treated for whatever my father's condition was at the time. They didn't do anything voluntarily, such as blood work or routine screening.
Two others, one a PCP and the other an internist, started off being thorough, although both saw medications or preparations other than natural remedies as the first line of treatment. Dad's cardiologist does not; in fact he won't even prescribe pain meds. He's the kind of doctor we want.
I've decided the next PCP will be a geriatric specialist; I'm tired of doctors who don't understand the differing needs of seniors. I'm even going to find a geriatrist for myself; I too am tired of even female doctors who don't understand the needs of older women.
Angela, for CHF, I would see a cardiologist. A geriatric doctor would be a good choice as well, for issues that aren't cardiac related.
I'm wondering who recommended hospice; has your mother been given a terminal diagnosis and if so, is it because of the CHF?
Judging from the collection of docs you've been recommended to, I'd say your mom has had something serious happen, like a stroke or broken hip and she possible developed dementia?
I think I'd start with a good geriatrics doc, although it's got to be someone relatively easy to get to. Use medical transport sometimes called an ambulette. If she's eligible for hospice, they can coordinate her care.
Recently I switched my Dad over to the urgent care doctor who's office is less than a mile from the house, who also takes in regular patients, and he's not a geriatric doctor.... I like the fact that I can take Dad over to the doctor any time without an appointment.
It all depends on who you feel comfortable with and who understands elders. The urgent care doctor my Dad has is no nonsense when it comes to my Dad like telling him do NOT go outside to shovel [Dad is 94].