This past week I had the opportunity to accompany a family and patient to an initial neurological examination. My patient had been experiencing small changes in memory and ability to maintain her home. Oddly enough, I had not ever been privy to an exam such as this, but only had applied some of the same evaluation tools to assess memory while doing neurological testing in the home. Clearly, the physician had performed a thorough medical record review prior to going into her office. We appreciated that fact. This physician experience was not another appointment when the clinician enters the room, glances at the name on the paper chart or laptop, and feigns some sort of greeting like they already knew the patient name and the reason for the visit. We sat across from her vast desk covered with unapologetic piles of lavender charts. A sea of others’ medical records with myriad neurological diagnoses and symptoms divided us. She began our discussion with an inquiry about why we were there and was very particular to ascertain whether my patient was aware of her memory changes and got right to the point that is was an important differentiator and imperative for accurate diagnosis.
Testing For Alzheimer’s
A litany of guided questions ensued and I recognized memory tests peppered in between casual conversation and succinct leading questions. The physician also was particularly careful to make sure the patient understood, under no circumstances, was she trying to embarrass or humiliate with her queries. The family was also questioned regarding their own take on what changes were happening and how they were manifested. A brief physical assessment was also included: walking, balancing, hand-eye coordination, tongue movement and repetition of certain phrases. The interview and memory assessment took almost one and half hours.
Discussion and a probable diagnosis were reviewed. Several diagnostic exams and blood tests were ordered to rule out stroke or other hidden/silent pathology that may be contributing to the reported symptoms. Probably Alzheimer’s dementia. The neurologist used a firm but gentle tone, different than that of the interviewing tone. She was encouraged by a probable early diagnosis that would likely be slowed by the use of Donepezil (brand name Aricept) and perhaps Memantine (brand name Namenda) as time passed. A return appointment was to be scheduled once the exams were complete.
Action Steps If You Have A Loved One Who Is Experiencing Memory Problems
If your loved one or and elder in your life is experiencing changes that are not easily explained or you have concerns you cannot quite pinpoint, please seek a neurological evaluation. Diagnosis, treatment, and support can make a significant difference as you elder ages. Safety is paramount, as is appropriate and desired medical treatment. Identifying what may be contributing to memory changes, then connecting with family and community resources, can assist your elder to age in place or in a setting that enhances the last season of their life. ElderCompass can support you and your elder as you navigate the course of aging.