Just my opinion, but I think a neurologist would be a better choice of physicians to see first because dementia is a disease in the nerves of the brain that affects how the brain works. Psychiatry deals with an intact brain where the thought process go haywire. The neurologist will rule out other possible causes and have neuro-psychological testing done which is done by a psychologist. That being said, it won’t happen if you can’t get her there. My husband is quite cooperative so I can’t speak much along those lines. You can make an appointment and tell her that you need her to go with you. She won’t know it’s for her until they call her name and you can tell her they want her to bring you back for the appointment. Yes, sometimes we have to twist the truth when dealing with dementia. Another way is through ER. They may admit her to a phych ward, but that’s ok. They can do the tests and get a neurologist to evaluate her.
I am interested in seeing what others say about: 1. the type of physician to see. & 2. How to get her there.

I agree with @A myALZteam Member: you don't want or need to start with a psychiatrist.

Most people start with a Primary Care Physician, who will do a physical exam and a basic cognitive test, and if the basic cognitive test shows that more is needed, the PCP will then make a referral to a Neurologist. That's how it went in my husband's case; and the Neurologist then ordered an MRI and made a referral to a Neuropsychologist for testing.

You might consider telling her that a Vitamin B-12 deficiency causes symptoms that look like (but aren't) Alzheimer's or Dementia, and you love her, so you just want her to get basic bloodwork done, to rule out a Vitamin B-12 deficiency or other physical problem. (Maybe try something like this: "You were sitting outside in just your underwear, and that's not like you! I love you and I want to make sure that you don't have a Vitamin B-12 deficiency causing this change in behavior.)

I finally used that approach with my own husband, who is a retired doctor, knew too much, and really didn't want to confirm that anything was going on! He hadn't seen a doctor or had bloodwork done in 5 years, so I finally insisted on the bloodwork, and spoke with the Primary Care doctor, to let him know what was going on.

At some point, you will absolutely NEED to have a doctor on board, for medication, to get a referral for Hospice care, etc. If the only way you can get the ball rolling is to get her to an Emergency Room, please don't feel guilty. You will be helping her, in the long run.

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A myALZte...

Hi Steve, Going through the diagnostic process is really challenging, and it really is up to you and your wife and an assessment of whether or not you feel she can handle the process. For my Mom, it involved an MRI (so having to lie still in a loud environment for 20-30 minutes), a round of neuropsych tests that took about 4 hours and two appointments with a neurologist (one to do an assessment and one to receive the diagnosis.) We got her diagnosed quite early in her illness, so she was able to manage it, but further on, she would not have been able to concentrate enough to participate in the process. There is now also the possibility of doing a spinal tap for diagnosis, but I don't know much about that, as it wasn't available when we were going through it. Some neurologists or PCP won't diagnose a specific type of dementia because it is so hard to be definitive- ALZ is really a diagnosis of exclusion meaning that they look for what it isn't, as opposed to what it is. The further your loved one progresses into dementia, the less it might matter that you know exactly what the diagnosis is because it really is a day to day dealing with behaviors, which are really varied from person to person. The only exceptions I think there are to this general rule is if someone has Lewy-Body Dementia (testable with a PET scan) or Frontal-Temporal Dementia (FTD). These two types of dementia are more rare than ALZ, and early on, can present like ALZ. But as they progress, they will have different presentations, including intense aphasia and mood disruption.

If you and your wife decide to go through this process, the best place to start is probably her Primary Care Physician to start the referral process. Good luck - I hope you get the information you are looking for!

Ken and I started with his primary care physician. After testing, he started him on Arisept and referred him to a neurologist. At his appointment she tested him and did a physical check. Then she referred him to the U of MN for a neuropsych evaluation. The neuropsychologist called a week or so later with an evaluation. He has mixed dementia- Alz/vascular. Ken was not aware of the reasons for these appointments. He would have refused to go. Now I usually tell him that I have an appointment. He always wants to come with me.

My dad went to a neurologist to get tested. I would say make an appointment with one. Check with the primary doctor if he knows a good one to refer you to. I took my dad to his primary doctor and then the neurologist was next. It took a while before he could see my dad. Good Luck!