On this board, a recurrent theme seems to be that general practice MDs won't help caregivers getting elders "committed", and won't give a firm diagnosis of AD and 'dementia' and are loathe to sign papers that will hasten an interaction with Social Services. They're supposed to be patient advocates, as I understand it. I've run into this with a GP. Are they worried about liability, lawsuits, other time-consuming legal involvement, actual medical issues, or what? Because this is the interwebs, you don't need to be an MD to answer, and your speculation is welcome ;-)
You really need to have your elder evaluated and become a patient of a gerontology practice in order for them to get the best treatment plan for their specific type and stage of dementia and have them tested so that the gerontology
guys can have them declared incompetent and have the results to back it up. If family is squabbbling about $$ and control, a good lawyer will destroy easily a GP's credibility. You have to have a whole gerotology practice work up to do a incompetency if family is at odds on this.
Yeah I know if you are out in the boondocks, your care is limited. But you can find a practice affliated with a medical school or a free-standing gerontolgoy practice and get them into that and have the testing done so that the right meds can be prescribed it will be a godsend. By & large the dementia's on their own are a long decline and pretty manageable until the final phases with the proper medication. If they don;t have other diseases to any real extent like CHD or diabetes or a cancer and they have Lewy Body Dementia - like my mom does - they can be quite cognitive for ages although not competent. It could be a decade plus of diagnosed dementia till they are not capable of their ADL's at all.
One of the better things I did for my mom was to get her to a fairly comprehensive visit at the Benedum Center in Pittsburgh, and I got my hubby into our Longevity Center clinic here, though now he is back with a good family practice doc instead and it is working out OK, but then I often have to be in on it to nake sure he actulaly tells the nice doctor or the PT what is actually going on.
3 weeks later he was dead! I went back to that DR and told him dad was dead, face to face, I was so furious with him.. He had the nerve to tell me well that is unfortunate but one can OD on Tylenol...I told him oh no, you will not go there this time...Lithium is toxic medication and dad did not release us to have his records so we did not know what he was taking...it was your job to follow this thru...you dropped the ball...it was your damn job to know a demented hallucinating patient on a toxic med is in danger!!! To this day I hate that man just for his stupid cop out! anyway...I wonder now maybe the attorney never did get a positive response from him we weren't in on that conversation, maybe he just took our money! I swear I don't trust any of them so called PRO'S dr or lwyr!!! anyway I rant but yes he was a coward to go to battle with my dad idk why but he would not do it. but SURELY my dad is dead because he did not, and it was not pretty, he suffered!!!
I am not sure what I would have done if the pscyhaitrist and the primary docs at the assistive living had not given me the letters certifying mom's being unable to manage for herself which offically activated the DPOA I had in hand...running around to get second opinions is not easy, especially with an uncooperative patient.
And you can bet I was angry about mistakes and lapses in my mom's care, which happened, fortunately none of them with disastrous consequences, just aggravating to her and to me. I am sorry not just for your loss, but that you have such bad memories and the knowledge that it could have been handled so much better...you have every right to express your heartache here.
I do know the last night of dads life an angel was sent to me in the form of a nurse....it wasabout 10pm sunday nite, 3 days after he was transferred to "3rd floor", I was getting ready to go back to our motel for nite and a nurse pulled me aside wrapped her arms around me and said..."im not saying this but what are you really gaining here..i sed dr yesterday said 50/50..she shook her head and said honey you need to be brave and just let it go, he is not coming back! after that I had a long talk with my dad begging for guidance and to just let go if need be, "oh dear god. whoever you are, I don't want to make the wrong decision but I am compelled to confront DR first thing in AM"....I was beat and went to hotel, showered, hopped in bed and ringy dingy....they sed things were changing we mite wanna come back and we did...dad was gone by sunrise! I will forever be thankful to this nurse, who I have no idea who she is but was the only one willing to give it to me straight....she will forever be an ANGEL OF MERCY in my life!!
And it is all the families fault.
My FIL has been found with a gun held to his stomach and it was reported not only to the visiting nurses but to the police. He cut himself on the abdomen over and over with a knife when he did not get his way and lied to the nurse and was told, "ohhhh....that's okay honey, we get to feeling that way when we are dying." Problem is? He isn't dying. In fact, Hospice has been called off. He is in rehab and physicall stable.
We are told he is depressed (2 anti-depressants are doing squat), he has a paranoid disorder and that he has excessive sexual fantasies (he is 86). He has seen a psycharist and we are told to just dismiss all of it because he has a touch of dementia and to not be shocked by his outlandish behavior. The problem is, we have told them he has had this behavior for decades, has been committed once before (for one year) and they just sit and smile and say, "okay now...what are you going to do about bringing him home?"
No one takes us serious so since we can't get him committed, there is the next best thing -- long term nursing home care. We don't care if it takes all his assests, his house and pension, let someone else deal with his "issues."
So no...they will not sign for them to be committed because they want to blame the family. We are not understanding enough, we should spend more time, quit our jobs, mortgage our home and live on the street. Oddly enough, I don't see these doctors doing the same thing...
Well, yeah, I had to take over because mom had, um, Dementia.
I did the research and came up with Namenda and Aricept and told him to give me prescriptions for both. After arguing with me (pointless) I got the scripts and noticed an improvement in my mom.
You don't have to fire a doctor, you just never go to them again.
After more research I found a specialist and took mom there. The experience was 180 degrees away from the obtuse GP.
I stated in another post that if you are not dealing with a specialist, then whomever you are dealing with is not the smartest person in the room. More than likely, you are.
The Internet is an amazing tool and the bane of doctors everywhere.
With it we are better informed and less likely to be relegated to a position of 'whatever the doctor says...'
You know when you're getting bs'ed. Move on to someone who gets it.
lovbob
Bob-yes I agree it is up to us to be our own advocate! I remember when sherriff called and had found dad..first thing I did was Google lithium toxicity. webpage appeared with a skull n crossbone logo on it...after reading that I knew things were not going to turn out well!
Thank you everyone for your support! That was another healing post here!!
K sorry done!!
I just realized, i am doing this for me as much as her. Ironically i left home so young because of her, not him! She was angry depressed woman who worked constantly...i had no relationship with her. she loved me i knew but we did not get along at all...when she was home and not dealing with dad's shenanigins, she would be taking out all her fustrations on me the youngest home. My dad and i had the good relationship! cause he was home more often, drinking n crazy but home, and we did get along great. I think she hated that fact not purposefully but just her only baby girl and he n I were the "buddies" that has got to hurt...anyway, once we moved out we had a much better relationship and dad n I waned. As i matured and understood more of the situation.... We still never got along great but it was much better. She was always angry and depressed, passive aggressive, and i couldn't deal with it! I had my own life now. Well 20 ys and distance i didn't see them often..holidays n bdays etc..
When i picked ma up from Nursing Home, she had changed dramatically since our last visit 8 mo ago! when i had her in my home those first few months figuring out our next move. i realized she had cocooned into a sweet loving most adorable creature on earth. I want to spend every minute i can with her...she cant be mom in words of wisdom etc...but she is still my momma and i love seeing her happy for the first time in her life!!! I don't want that part to end!!!! Oh god i am balling like a baby again...i am outta here!!! SORRY SO DEPRESSING AND OFF TOPIC!
It sounds familiar. Just keep writing it out.
I wonder how Roscoe is doing. I know that he has got it very rough.
Thinking of you Roscoe and everyone.
lovbob
As to addressing the main topic of this thread, I think docs are largely driven by trying to avoid medical malpractice - that and doing whatever Medicare will pay for. I agree that your average GP is maybe not the best equipped to handle geriatric patients, but there are very few geriatric specialists - maybe because Medicare is their primary insurance plan and Medicare pays less than private insurance. The GP who has been my parents' doc for many years will not even treat his patients if they are in a nursing home or in the hospital. So he only sees them when they are ambulatory, never when in crisis. In this way he is usually unaware that there has even BEEN a crisis, since the hospital and nursing homes NEVER send the records to their primary doc. Even if they did, I doubt he'd read them. Now that my sibs and I are caring for our parents, their doc is told a LOT more about what REALLY goes on, and the quality of their care has improved.
What pisses me off is we have to take the burden of being the advocate and researcher but that is what they get paid to be/do to know the medical field for the client or don't accept the damn business, not because of medicare...who the hell is paying me for my time..i drive a broken down jalopy with a leaking roof over our heads.... I know they don't!!!
I contacted Idk how many lawyers, by phone, explaining our story...I could not even get anyone to respond. most politely said they would not take the case..but one did get a little more graphic...
"well he was 78 and on SSI...no lost income so max allowed for pain n suffering is 250k...you will probably settle out at half that if lucky add legal fee and taxes.. your down to under 50k...its not even worth the effort, I wont do it" I am a little grey on the exact breakdown of numbers but pretty close! And so coldly matter of fact about it....I was disgusted with the whole system and just gave up! I would do it all...hahhahhha!!!!
But thank you so much for understanding...it was the most horrific experience I have ever lived thru.....I felt completely alone and failed by the world!!!