Visit to the Doctor

Any person who has a decline in their mental abilities should be examined by a physician. The examination should evaluate memory loss (not remembering), poor attention or confusion, loss of motivation or apathy; loss of skills in speaking, reading, writing, or doing arithmetic; or difficulty finding their way around (getting from one place to another). The physician should have training in ways to evaluate these disorders.

AWARENESS AND UNAWARENESS OF CHANGE

Some people are aware of changes in their abilities and others are not. Awareness of changes depends on the different areas of the brain where brain cells are dying. If there is any question of declining function, the person needs to be evaluated by a physician.

The person who is aware of changes in memory and thinking function often is highly motivated to see a physician to identify the health change and to follow a plan of treatment. Sometimes the aware person feels depressed over the health changes. Typically this type of depression is treatable and is temporary.

On the other hand, the person who is unaware of their own changed ability may refuse to be evaluated. Since they are unaware of change, it is almost impossible to convince them that there is any change. They may wonder why the family is making up such stories. Even faced with their own errors, such as counting change incorrectly or forgetting to turn off the water faucet, they may make a casual excuse or joke about it or become angry. These people are not in denial. In truth, they are unaware of their disability because of brain cell changes.

Sometimes they will see the physician as part of a routine physical exam or because of urging from their loved one. Some people will stay through the total clinical evaluation and others will only endure part of the evaluation before they insist on going home. Thus the clinical exam may have to be done in stages, over two or three visits.

THE DOCTORS EXAM

Preparing for the Visit

During the examination

A CHECKLIST OF THINGS TO DO

After a diagnosis of a progressive memory disorder such as Alzheimer's disease, the person and family may find the following suggestions helpful.

Material taken from: Helping People with Progressive Memory Disorders: A Guide For You And Your Family, 2nd ed." (University of Florida Health Science Center). Used with permission from the authors: K. M. Heilman, MD, L. Doty, PhD, J. T. Stewart, MD, D Bowers, PhD, & L. Gonzalez-Rothi, PhD. (1999).

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College of Public Health and Health Professions, University of Florida