How do I bring up symptoms of cognitive decline when accompanying my husband to the doctor?

Does he use a CPAP?

Any person with "mild" Alzheimer's should always be accompanied during visits with his doctors. The reason is that the patient will have problems communicating and understanding the doctor's instructions. Since most people with dementia aren't aware that they have it, the presence of a companion in the interview is absolutely necessary to alert the doctor of his cognitive decline.

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

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.

Can you access the portal for the doctors office? If he has not set it up you can and communicate to the doctor's office in a secure manner.
Most doctor's now during a physical will do a Mini Mental Exam. If there are changes from the last one the doctor will notice.

Actually if the inconsistent anger issues are new you should bring them up and what better way but in the doctor's office so that if it does occur the doctor would be able to observe the change.

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.

You say you have discussed these things with your husband. I would discuss it right before you go to the MD. Say "I want to remind you of what we have discussed and what I will bring up at the Doctor's; that you have been having some unpredictable increases in becoming angered,and that your memory is less good than it was.
In all honesty, your Doctor will do the exams. Your doctor may notice some of this, and unless you are expecting some miracle medication that may help with the anger issues (which likely doesn't exist at this level without endangering his gait and his sleep patterns), there isn't a whole lot of reason to focus on these things. Alzheimer's, of all the dementia diagnoses, is a slow steady downward projectory, and these changes are expected. Some dementia's, such as Lewy's can be up, down, and all over the place. Some go in stairsteps with a plateau at every step down; but Alzheimer's is a downward steady path.
Sparking unpredictable emotions is OK, you know. Life is full of that whether we are 2 or 92, and we often react to them. Your husband may react poorly. If this is the case, let him say his piece, and then remind him "Hon, we spoke earlier today about some of the increase in anger and some of the decrease in memory. Do you remember our talking about that"? Most he can say is he doesn't remember or that you didn't or that you are WRONG. And those reactions are all in the realm of possibility and the norm.
I sure wish you good luck.
You could keep a little diary of things, but to what purpose other than to continuously remind your husband of his decline, continually discourage him? There really is no reason to do so. It will change nothing.

I, too, like many of others who have posted, contacted the doctor before the appointment regarding my mom, when she had Alzheimer's. ( I wanted the doc to back me up, concerning not having my mom drive any more, and the doc did just that.) I had been my mom's "chauffeur," since her cognitive skills declined, but I'd have to make excuses when my mom said she wanted to drive. This took place before patient portals were commonplace, so I wrote the doc a letter. This worked out so much better than if I had brought it up at the appointment, without previously informing the doc of my concerns. Many Alzheimer's patients will deny memory and/or behavior issues. Good luck.

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.

I bring a letter with me, write all the symptoms down and hand it to the front desk when we check in. Gives the doctor a heads up.

If asked my step-mother will say she is just fine, "Peachy Keen". One visit she was asked if she wore glasses she said No, they were hanging around her neck.

Dealing with unpredictable emotions is part and parcel of the disease.

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.

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.

Start by keeping a log of his "incidents" so that the doctors can see how pervasive his conditions are. By keeping a log, you also can show how his sleep apnea is tied to his emotional lability (easily angered) and his memory lapses. If your husband becomes angered in the doctor's office, try to calmly explain that you are trying to get him help not to label him as ___________.

I would call the doctor's office in advance. Explain you have concerns about your husband's cognition but do not want to undermine or upset him. IF your doctor can't pick up the ball from there, get another doctor. Gerontologists tend to be attuned to these problems.

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.

Some people feel fear, shame and anger when they are told that they have memory loss or dementia. You may want to see if your husband can face this, or whether it's better to speak about it privately with his doctor. If your husband won't face it, you'll have to be the one to have a Plan B, if your husband's condition deteriorates to the point where you are not able to care for him by yourself. There is equipment to help with sleep apnea, if your husband can tolerate it. All the best to you both.

Write down your area thoughts and hand to nurse to give to doctor. A good neurologist will have papers for the caregiver to fill out. You can always ask the doctor to speak with him a couple minutes in private. I did that to not bring embarrassment to the person.

Judycares: YOU must be your husband's advocate since he cannot do so for himself. It is of PARAMOUNT importance that you inform his physician that he "stop(s) breathing several times an hour during sleep." Even if spouse is irratated by this, it MUST be brought up to his physician; perhaps you can do so privately with this medical doctor.

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.

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.

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.

I used to send a written note ahead of the visit so dr/nurse could review it. If you explain things about the unpredictable emotions or anger - also give a good example. Then when you go in for the visit bring up some of the things you've also told your husband (like the stop breathing apnea thing) and see if hubby engages with the dr about what's going on or if it actually creates the anger you mentioned. You might ask about the breathing machines that could be ordered to give him more restful sleep. It's very possible he is sleep deprived and that is the source of being irritable or angered.

I have used notes to relay pertinent information. It has worked out well with the ophthalmologist, the foot doctor, the hair stylist, etc...
I don't want to humiliate mom and talk about her while she is right there. Giving them a note to explain what is going on or what to expect or just to let them know why I might answer for her, puts them at ease and makes the visit better.