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My LO has been "hiding" his cognitive decline for years. I live with him and I see it; others dismiss/minimize/deny. It's progressing, and I've known for years he has some form of dementia. He recently had a short hospital stay, and failed two brief cognitive tests. I was asked by several staff "is he always this confused?" or " is this his typical cognitive function?" etc. On his discharge papers, a cognitive evaluation was recommended. I'm reluctant to pursue it, because it would be very hard on him. And at 90 with multiple health issues, I see no real benefit to having a diagnosis or label. He refuses any/all types of support or intervention anyway. I just do the best I can as a caregiver. I wondered what others' experience has been. I really can't fathom putting him through formal testing. The brief assessments done in the hospital had him flustered and cranky.😔

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You have to face reality. If he is starting with dementia, you have to prepare ahead. You can't leave it to the last minute. Dealing with somebody with dementia it's more difficult than caring for someone with a physical problem.
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Surprisingly I am more or less "with you". As a nurse I would normally recommend testing and staging. ArtistDaughter suggests the reason might be for medication, but quite honestly there are ZERO medications proven to help with dementia. He is 90 at this point. You are caring for him.
You may not be able to continue in his care should you become disabled.At that time he would likely be moved to a hospital that WOULD assess him at that time for placement. Or his care may become too difficult and then he may need placement and would be assessed then.
To my mind, at 90? I leave this in your hands and suggest you do as you think best IF that is what you wish to do. Or until someone gives me a good reason for this to be done. It sounds like the testing would be brief indeed due to your loved ones' inability to participate.
I am assuming many things here. That he does not currently drive. That you are handling banking and bills. Etc. There is much we don't learn on a brief post on forum, but if life is working for you both at this point I see little reason offhand to change it. The responses of others may change my mind, but not so far.
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A cognitive evaluation would allow a doctor to prescribe medication if it is found he has dementia. It would help you too as his caregiver to find some coping strategies directly related to his particular needs. All will likely get worse in time, but you could wait to see if he gets more interested in accepting support. It seems you are pretty well in tune with his character so far. Some people get easier to deal with as dementia continues (my mom did), but others get much harder to control. At some point a diagnosis might be needed for placement in a facility.
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