Expert: Paula Damgaard - 8/5/2010

Question
QUESTION: Paula,

Hi, it's Rose again.  My father's MRI came out normal.  The neurologist said there was shrinkage of the brain, but that is normal with someone being 80 years old.  However, last night, he started up again verbally abusing our mother.  When she was on the phone with a friend, he said they should be talking with people "as a couple".  He then went to the computer for a short time, then laid down on a small sofa and fell asleep immediately.  When he woke up, he was rambling about the Phillies and something about books.  We feel the doctor is wrong, but don't know where to go from here.  Dad proudly proclaimed that we tried to get him into the loony bin and it didn't work.  This is not normal behavior, but we don't know what to do next.  He will not be tricked again to go to another doctor.

ANSWER: Hi Rose again,

having a normal MRI does not mean that he is not demented.  Far from it.  Unless the doctor is trained (and very few are) to read MRIs looking for the small differences that might show up with AD, they won't find them.  So saying there is atrophy for his age is appropriate, but doesn't rule out.  When we first starting looking at MRIs in AD patients we were looking at them to make sure that they didn't have a stroke or tumor that could be causing the dementia.  So if it was read as normal that means that he didn't have a stroke or a tumor.  NOT that he isn't demented.  

If you can't get him to the doctor for himself, would he take your mother to a doctor?  If you find someone who specializes in dementias, then you could send a note onto the doctor telling him the situation and tell your dad you need him to take mom.  You can always "meet" them there (got out of work so I could come!) and if the doctor is a real dementia specialist he will be able to tease out of your dad the information he needs to make a diagnosis.  

worth a try anyway.  Otherwise I go back to what I said previously, move your mom out.  Her safety is much more important.  If dad won't move then notify Adult Protective Services and let them know the situation.  He won't be able to hold onto to his good boy personna forever!  

I am sorry you are having such a rough time.  I wish there was more I could do to help you.

Paula

---------- FOLLOW-UP ----------

QUESTION: I cannot believe what is happening.  My sister and I had provided our father's doctor with a "heads up" list as to his behavior prior to his visit.  This doctor acted totally unprofessional during the visit and for the follow-up, but this tops it all ... his office actually sent a letter to our father to inform him of this list!  Is there a way to report this doctor?  This is now a  major set back because if our father requests to see the list, this will put our mother in danger because she had informed us of these behaviors.

Answer
Hi Rose, I would call the Medical Society in your area and speak to them.  This is nuts!  And I would never go see him again.  What is he trying to prove anyway???  

Again, I can't stress strongly enough; get your mom out of there.  Call Adult Protective Services and tell them what is going on.  Tell them what the doctor did.  You have got to protect your mom!  IF she won't go, then call the APS asap!!  They need to know that your mom is in danger.  

This doctor is so unprofessional it is scary.  Call the Alzheimer's Association in your area also and tell them what he did.  If they have any kind of contact with the area physicians maybe they can talk to him.  If not at least they will know not to refer anyone to him!

Good luck!  Paula