Expert: Paula Damgaard - 12/28/2008

Question
My mother started out exhibiting signs of depression and overall health problems a little over 3 years ago. It took 2 years for my dad to get her to a psychiatrist because he first sought help from her primary care physician. The psychiatrist was concerned also about her lack of attention and put her on some ADD medications along with her Cymbalta.  She was checked for Alzheimer's, but was only diagnosed with dementia.  The scan actually showed little to no progression since a previous one a little over a year before when a lot of medical testing was done.  She was diagnosed with emphysema earlier this year and is having a lot of difficulty breathing too. At Thanksgiving, we were able to visit with her while she stayed in bed.  She was able to carry on a short conversation, knew current events in the family, recognized my sister's children, etc. In the last two weeks, she has become almost nonverbal. On the phone about all you can get out of her is a bunch of utterances and "Love you".  Dad says she is barely eating anything.  We don't know if this is the dementia rapidly causing this decline or what?  Can it suddenly take over like this?  The primary care doctor usually has a 1 - 1 1/2 hour wait in his waiting room, and she can't handle that. She has a first appointment with a pulmonary specialist in a few weeks. Do we beg to push that up? How do we get her seen by someone quickly who can determine what the problem is? Who do we turn to in this situation?  I am heading home on Monday and need answers.

Answer
Sandy, first off, a scan really doesn't show progression, what is being done for is to make sure that there isn't something else going on, like  a tumor or stroke.  It shouldn't be this rapid progression.  Sounds like she has some kind of infection going on.  I would have her checked by the primary physician, call ahead and ask them if they are behind before you bring her in, tell them that she cannot sit in the waiting room, ask them to call you and you will be right there.  

She should be seen by someone who specializes in dementia.  Either a neurologist or geriatric physician.  You can call the local Alzheimer's Association in your area and they can give you names.  

I hope that you can get her some help.  Also for your dad!  I am sure this is very stressful on him.  

I hope this helps.  Take care Paula