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I am caregiver to my 85 year old husband who has multiple health issues, including [so far] mild alzheimer's. He also has a form of sleep apnea (central sleep apnea) that causes him to periodically stop breathing several times an hour during sleep...robbing him of oxygen throughout the night, which affects his brain function.
So, I have noticed changes in his behavior and memory that I need to bring up to both his neurologist and his primary care physician. As these incidents occur, I have mentioned them to my husband, hoping he will not be surprised or feel I am trying to somehow sabotage him when I bring these up with doctors. One of his behavior changes is that he can be angered (inconsistently) and...there is the issue that his memory is getting worse and he probably won't remember any of what I will tell the doctor.
How do you other caregivers deal with bring up issues during doctor visits that you know will spark unpredictable emotions?

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When I accompanied my LO to her wonderful geriatric specialist, he always had his seating arranged so that I was sort of diagonally behind her and she was between us, so that as he interviewed her, I could nod “yes” or “no” to indicate whether her answers were correct or not. I also made notes, but based on his interviews, I rarely had to provide them to him.

We were blessed by his skill as a savvy interviewer.

Remember, it is NOT dishonest, nor unfair to your husband, to provide all the information YOU need the physician to have, to understand your husband’s behaviors at home that are concerning you.

You and your husband’s physician(s) need to be members of a team, helping your husband by working together.
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The best thing to do is to bring up your concerns to his doctor privately via a note, letting him know you feel your husband may become upset by you voicing your concerns publicly. Then the doctor will take the lead during your appointment. Hopefully you have POA for dh now?

The sleep apnea can be addressed also, but a CPAP machine for a person with Alzheimer's doesnt usually fare too well. They dont like wearing the mask and won't understand or remember why it's necessary TO wear one consistently. That may be a battle you don't want to fight......because there will be many ahead, so choose wisely.

Since you are new to the Alzheimer's *AD* world, I suggest you read this 33 page booklet ( a free download) which has THE best information ever about managing AD and what to expect with an elder who's been diagnosed with it.

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

This article has lots of tips & "Do's & Don't's" that may prove helpful to you as you navigate this new territory with your husband *DH*

Best of luck to you
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I always went on the patient portal several days prior to my husbands doctors appointments, to give his doctors a heads up as to what exactly was going on with him, so they could address the issues without it seeming like I was talking about him in front of his doctors. Otherwise the doctor would have asked my husband how he was doing and his response always was "fine."
That seemed to work best and my husbands doctors always thanked me and told me to continue doing that, as it helped them a lot.
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I have quickly scanned the previous replies. I agree that you have to let the doctor know ahead of time.

But I want to add, if your husband has an outburst at the office if you mention something in front of the doctor, that helps the doctor to see how he is behaving.
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I always emailed my mother's doctor a few days in advance with issues I wanted to cover during a visit. I also let her know if Mom would get grumpy about certain topics if I brought them up, so the doctor would bring them up herself.

Because I was accompanying both my parents to these appointments, I also sat behind my folks and often resorted to writing out questions for the doctor and holding them up behind my mother where she couldn't see them.
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MJ1929 Jun 2022
I want to emphasize that you should contact the doctor's office a couple of days in advance. It is of little value for the doctor to have a note handed to him just before he walks in the exam room. Be sure your note includes the patient's name and when the appointment is.

Giving the office a couple days' notice allows the doctor to read the note well in advance and be able to have some answers ready.
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With all respect to Alva, I would strongly recommend keeping a journal - not to rub your husband's nose in what's happening but quite the opposite: so that you *don't* have to "ping" every incident that is relevant to your concerns but will still have a good clear record of the kind of thing that is happening. Each record should be a statement of fact rather than opinion or drawn conclusion; so, for example, "I asked H if he'd like ham or cheese in his sandwich and he replied that I am always nagging him," rather than "H became unreasonably angry."

The other very good reason for keeping a journal is that you (and we all) may find your memory isn't quite as objective or as detailed as you might have thought it was, too. When the doctor asks what's happening, you can give a range of examples. When the doctor asks how often this occurs, or whether you've noticed any pattern to it, both you and your husband will be able to look and see.

I totally agree with Alva (and this is another reason not to burden your DH with too many everyday examples) that the time to remind him that there are concerns to be discussed is on the way to the appointment; and when in the consulting room an example formula would be: "We would like your advice on some behavioural and memory issues, please."

And at the *very* worst - if DH does kick off at the merest mention that there may be a problem, the physician will be quite able to draw appropriate inferences from that in itself. If it does happen, reassure DH, bring the conversation to a civil, orderly halt, and book another appointment.
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Judycares Jun 2022
I'm right with you countrymouse. I've been keeping a journal since January. I record mood changes ( him and me 🙂), my reactions to his reactions, events, feelings, thoughts! Having dates and documented events has been helpful in communicating with the doctor.
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Write your husband’s doctor a discrete note. Provide the doctor with concrete examples (not your diagnosis) and ask that your husband be clinically evaluated.

Cognitive impairment can be caused by many different health problems, some of which can improve with treatment.
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I assume your husband is being treated for the apnea with a CPAP. My husband refused to recognize this and when he finally did, it was too late, The many years spent with oxygen deprivation was a main factor in his dementia diagnosis. Consistently use of CPAP machine is extremely important. My husband embraced the CPAP but unfortunately is now in a MC unit

if you have access to the portal to ask questions of the doctor, you could voice your concern prior to the appointment. The anger that my husband also displayed prior to using the machine was due to being extremely exhausted which drove him to get a sleep study.
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I send an email the day before the appointment with my concerns so I don’t have to bring it up directly at the dr appointment. 100% of the time they have read my notes and can discuss the issues directly with my parents. It has worked very well for me. Good luck.
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I discuss my husband's issues just like any other medical issues.........without judgement and with hope that the doctor will respond with solutions (which is not what we get with him). Sometimes my husband goes into denial (saying he doesn't believe the diagnosis), so I pull up his medical charts so that he can read them and see which medications have been ordered). We both know that temper tantrums are associated with Alzheimer's, so now he has bottles of CBD gummies (which he likes) and can use to self-medicate. I keep my distance so that I don't have to engage in rage. I told him I will never accept abuse or incontinence: those are my limits for placement.
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Judycares Jun 2022
We had our appointment today. I sent an email to the doc ahead of time, summarizing my observations and experiences with husband's memory, cognition, and behavior. The neurologist was very straightforward with my husband...letting him know what is being described is definitely azheimer's. Having said he was straightforward, I should also say he was very compassionate and reassuring with my husband...and supportive of me. My husband, understandably, protested that he does not have alzheimer's. That I was taking his actions "out of context"...making more of things than was there. He tried to justify his actions and explain away the cognitive and behavior episodes. I finally realized that nothing I would say would make any difference in his understanding. The neurologist wants to start him on donepil for his cognition and to see a speech neurologist that may be able to help him understand better what is happening to his brain. Both the neuro and I also tried to reinforce that he is not crazy, that his body is just sick. I hate this part of my caregiving. My husband sees my communication about his symptoms as a betrayal. The doctor reinforced that it didn't matter that my husband had "reasons" for putting his hands on me in anger...that it was never acceptable.
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