How to Talk so the Doctor Will Listen
These days, many doctors are well educated about dementia, says Dr. Barry Clarke of Halifax, N.S., a GP who specializes in geriatrics. But they may not always recognize the signs in the 12 minutes allotted for a routine checkup. You have to make your case.
“Don’t be polite,” advises Dr. Clarke. “If we were in a social place, we would try to cover up when someone forgot something as a social courtesy. This is not that place. It’s time to be very honest and speak up.”
Specific examples help, adds Schulz. Instead of saying: “I’m just not remembering things like I used to,” say: “I’ve begun to forget everyday words – it’s like they’ve simply disappeared from my brain. Or my mom got lost doing errands in her own neighborhood.”
Dr. Sandra Black, a neurologist at Sunnybrook Health Sciences Centre in Toronto, suggests keeping a list or a journal of symptoms, along with the date they occur because somebody will ask you: “‘When did that start?’”
Timing is important, says Dr. Black, because the doctor will have to rule out other treatable causes for the symptoms–sleeping problems, a reaction to a new medication, an infection or depression.
Want help getting info ready for the doc? Print and fill out the form “Preparing for Your Doctor” on the Alzheimer Society’s website.
Drug Treatments
There’s some controversy over whether drugs used to treat AD actually work. But, like many caregivers, Persoon credits the medication her mother Patricia takes with slowing her symptoms. “She started with Exelon patches, but that didn’t seem to work so well,” says Persoon. “Now she’s on Aricept, and we really do feel it has helped.”
Medications for Alzheimer’s disease work in one of two ways, says Dr. Chambers.
- Drugs like Aricept, Exelon and Razadyne are cholinesterase inhibitors and may have more effect in the mild to moderate stages of AD. Doctors believe they prevent the breakdown of an enzyme that causes the neurotransmitter acetylcholine – a chemical messenger important for alertness, memory and judgment.
- A drug like Ebixa, by contrast, is believed to block the reuptake of another neurotransmitter, glutamate, possibly helping to preserve cognitive function and memory in the moderate to severe stages of the disease.
Doctors sometimes resist prescribing drugs for AD. In fact, according a recent article in the publication Chronic Diseases and Injuries in Canada, only about 50 percent of dementia patients are taking medications for AD.
There could be good reasons for that, points out Dr. Chambers. Most medications are only effective in the early stages of AD, he points out, and even then, they only help about half of the people who take them. They can also have some nasty side effects – especially when combined with other drugs you may be taking – and the effects wear off over time.
“They are not a cure,” says Dr. Chambers. Nonetheless, he says, your doctor should at least be willing to have a conversation about them.
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