In my experience, and those of others who have been through this
cyber-spot, doctors are slow to diagnose Alzheimers. Nearly 50 percent
of all people over age 85 have Alzheimers. This diagnosis can help you
make a better choice in selecting a nursing home when the time comes,
but it should not pose a serious bar to finding placement. In the
assisted living center where my mom lives, 95 percent of the residents
have some form of memory loss, whether they have been diagnosed with
Alzheimer's or not.

I didn't know today's date either until I checked the calendar, but does
he know the month and year?

Your father has not spoken on a telephone in 50 years? Never used a
touch-button phone? Even if he did not write the household checks on a
regular basis, he does not know how to write one? Even a child of 10 who
has never written a check has a rudimentary knowledge of what goes where
from seeing checks.

Sometimes the early stages are the hardest to sort out. My dad has not
been diagnosed, but everyone who knows him sees his decline. It's hard
to separate out when is his inability to listen to other people's
reasonable explanations his lifelong stubborness and when is it a sign
of the loss of reasoning ability that is part of all dementias,
including Alzheimers.

From what you report about your dad, he very well could have early
stage Alzheimers or one of the many similar diseases. I would suggest
you learn as much as you can about dementia. With two parents that age,
the odds are good that at least one will develop it. Now that your dad
has been diagnosed, has he been placed on Aricept? It can really help
slow down the progression of the disease if you get it started early enough.

My advice to you would be: Stop fighting the diagnosis. It's not going
to create the problem you fear with nursing home admission. Instead, it
may open the door to other resources through the Alzheimer's Association
and other groups. Feel free to post any questions you have here, and
we'll all pitch in and help you along the way.

Songbird

Your dad needs to be properly tested.   There are certain tests that
would reveal whether it is just "normal" forgetfulness, or if it is
something more serious.   Another issue that is VERY important is that
there are illnesses that look just like alzheimers but are not, and
are REVERSIBLE!    NPH (normal pressure hydrocephalus) and thyroid
problems are two of them.   It would be awful to not know what is
causing his symptoms, especially if they were something treatable and
reversible.   If you need to get a new doctor, shop around and find
someone who will take your concerns seriously.

Songbird gave you good advice.   Be ready for the possibility that it
is alzheimers and get all your paperwork in place and your diagnostics
in place before you proceed further.   Most important of all, you will
need an elder law specialist attorney to get POA and health care proxy
and whatever else may be needed in case he really does have
alzheimers.   It is important to do that now before the problem gets
worse, and alzheimers always gets worse, never better.

Anger and rage are not at all unusual in early stage alzheimers, but
that doesn't mean he can't be an angry person anyway and not have
it.   My mother in law got deeply depressed.   She'd always been a
good looking woman and always was spunky and sassy and all of a sudden
she was depressed, not bathing, not eating, angry too much of the
time, paranoid, and just not herself.

It is all too easy to write off these little personality changes and
think it is normal aging.  Better to get him tested and know for sure
what is going on.

Don't be afraid, everything that is born oneday dies, and all of us
will come to a place in the road where the journey will end, and
nobody knows what form that may take.   In truth alzheimers is a nasty
illness, but so are they all.   The good news is that today there are
medications that were never available in the past that can help
restore missing brain chemicals to help preserve the person's
personality a lot longer.   Take care and let us know how it is going.

Best Regards,
Evelyn

Angie, I'm not sure what you mean about a diagnosis of Alzheimer's
affecting nursing home placement. You should be aware that dementia is
the most common reason for nursing home placement. Frail seniors who
are intact cognitively can very often be successfully managed at home,
looked after by family or by hired caregivers. Its when a progressive
dementia enters the scene that the care becomes too overwhelming and
demanding to manage outside institutions. About 50% of 85 year olds
will have some cognitive impairment from some cause. It does matter to
know the cause, because some are treatable and even reversable, and
others can at least slowed down to buy the person a better quality of
life for longer.

You describe him as forgetful, hoarding, unaware of the current date,
unable to use a phone or write a check, and having behavioural
outbursts.  When a doctor is doing cognitive testing, the process is
usually quite comprehensive. They usually do a full physical and blood
tests to rule out all sorts of ailments that can affect cognition
(thyroid problems, anemia, hypoxia, all sorts of things. They usually
do a brain scan of some sort to rule out strokes, blockages, tumours
etc. They also do extensive cognitive testing that has been used and
tested on a large population so they have reason to be able to rely on
the results (i.e. a normal adult who is functional should be able to
score relatively well).

What you describe does not sound like a person who can manage on his
own. At the moment, your mum (whatever her flaws and faults) is
holding things together. If she was not there, he clearly could not
cope independently. Is this not a good thing to know? Might it not be
a good idea to be able to try some of the new medications that might
improve his mental status or preserve it longer, and perhaps calm some
of the angry outbursts? If your mum becomes ill for any reason, you
will be dealing with your father's care, and the more information you
have, the better, even if its things you don't want to hear or accept.
And yes, she may also be impaired, whether from brewing dementia or
mental illness, but that is neither here nor there. Her condition has
no bearing on his, other than with respect to her ability to cope with
running a home. Be completely realistic. If your mother was
incapacitated, you would be looking after him full time either in your
home, or you would have to place him. Could you cope with him alone at
home? If he does have AD, it will progress.

You make it sound like the label of dementia will cause some sort of
stigma. Don't you think that a care facility wouldn't do its own
assessment on his needs when he was admitted and adjust the supports
offered as appropriate? Better that they start off on the conservative
side and then allow more independence, than start off too free
wheeling and have him walk out the door and get lost. Nothing worse
than saying he's peachy fine, and finding out he's got more problems
than you might have realized, and have a care facility say they can't
deal with him.

M.