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He was upset that I initiated the PCP visit and mentioned the memory loss. He is frustrated with himself and asks what is wrong that he cannot remember, even tearful at times.

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Don't automatically assume it's Alzheimer's, there are so many treatable things that can cause memory problems and dealing with them sooner rather than later almost always results in better outcomes.
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DrBenshir Sep 2022
You bet! Changes in sleep, diet, exercise, proper medication and nutritional supplements have dramatically slowed my DH's cognitive decline. He still works full time and is completely independent with activities of daily living. Planning skills are weak and he is aware of being more forgetful at times, but overall life is still very good. Just because we can't cure something doesn't mean we can't cope more successfully.
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He is probably frightened and does not want to know more, but he is already noticing his own confusion and memory loss, so maybe you can appeal to the need for a test as a way to choose the best way to slow down his memory loss.

Some kinds of memory loss are normal at any age. Help him work out strategies for remembering what he can like writing things down, verbalizing something he wants to remember, and taking time to concentrate on one task at a time.
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In the future, maybe contact his doctors privately in advance of the appointment so you will not have to give the hard cold facts in front of hubby.

Did the PCP do blood work? There are some common things that can cause confusion/memory loss - like low B12 and thyroid issues, for example. Or other things that could be off - my MIL had low sodium from too much diuretic and she was out there. Now that her level is back to normal, she's back to her normal.

I pushed hard for a diagnosis for my mom because I NEEDED to know what the heck I was dealing with. If you really NEED this, ask hubby to please do it for you. Information is power and it could rule some things out. Tell him it would be good for both of you to get to the bottom of this and more information will help.
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My husband was convinced to see a neurologist and a neuropsychologist in order to determine what exactly was causing his loss of executive function. An accurate diagnosis is the only way to treat the symptoms. There are many disorders that cause memory loss and that are treatable. The only way to determine proper treatment is to get an accurate diagnosis. Seeing a neurologist is the first step in getting help.
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We started with a Neurologist, but it was not a warm and fuzzy appointment: very clinical and offering little help and little hope. (Sorry, but my husband was not convinced and left rather confused.)

A few prescriptions have been made, but we all know it isn't curable. Now, we will be seeking out a Geriatric Psychiatrist when his symptom alter his life, his driving, and his daily life or if he threatens my life and sanity: I have set two very strong boundaries that I will not endure (violence and incontinence). Being placed in care will follow immediately and I told him I will call 911 if he ever touches me in anger. As for helping him stay alert, he gets up every morning and uses LUMOSITY.

Since our goal is quality of life, not quantity, I have asked his doctor to remove any medications that dull or fog his memory. My husband does not want to end up losing his license or being put in lock down: to put those outcomes off for a while takes daily practice and alertness. If your husband is tired and confused, you might want to have him tested for Sleep Apnea. Taking brain supplements may or may not help, we're trying those and hoping, but there are no guarantees.

Quality of life is all we pray for.
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If he is aware of the memory loss he is probably frightened. As well as scared of the findings when tests are done.
Testing or not if he does have dementia of some sort the outcome will be the same. The big difference is with testing and an actual diagnosis you and he can plan for the future and he can make sure that things are taken care of before he can no longer make such plans.
If he is a planner this might be the way to approach it.
If you are a planner and he is not it is still a way to approach the need for testing.

We all know that we have a finite time on this earth. We just do not think of it everyday. If we did we would not be able to function if we were worried about our impending death whenever that may be.
To get a diagnosis that confirms that we are mortal kinda throws a damp towel on things. And with memory you are always jumping to the worst case.
I forgot to get milk when I was at the store..Do I have dementia?
I forgot where I put my glasses...do I have dementia?
I forgot that I saw this movie before...do I have dementia?
We all forget something at the store at some time...we all forget where we put our glasses.. we all get part way through a show and say, I've seen this before but once you get an official diagnosis things seem "worse".

Support him as much as you can.
To get the tests done if he would let you do it go ahead and make the appointments then just tell him that he has an appointment.
It is possible that he might be afraid to make the appointment because he is uncomfortable answering the questions they may ask. Often people with dementia are afraid that they will make a mistake and people will judge them for that.
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Some people with dementia do not know they have dementia. Try to be positive, and reassuring and in the meantime, you need to have a plan for a time when your husband may not be able to live independently. You don't mention his or your ages. While he is still able to sign legal papers, make sure all of his and your paperwork is in order. You both need to set up powers of attorney (POA) for medical and financial matters, living wills with your advance medical directives, and wills, if you have assets. You may need an attorney to assist with these legal documents. Your two basic choices if he needs assistance are in-home caregivers or moving to assisted living/memory care facility. Much depends on your finances. Speak with a local social worker if needed, to discuss your and his options. All the best to you.
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In my experience, I involved my husband’s children from previous marriage, his ex-wife who’s now a good friend with my husband, his doctors and siblings to convince him to get a memory test and an MRI scan. It literally took a village close to 6 months to get him to agree. I think it wouldn’t have taken him so long to agree if he was not a physician himself. He proved that doctors are difficult patients. Once we crossed that hurdle, life was a bit easier because we could now establish a care plan for him.

I hope you involve everyone he knows to help you convince him to get tested. Good luck.
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I agree that neurologists are not necessarily warm and fuzzy. Generally, they have more training for conditions such as seizure disorders, and not much training or experience with dementia. My mother found a neurologist herself some years ago, in the same building as her other doctor, and I'm sure this guy was good at his work, but his bedside manner was abysmal. He gave my mother a diagnosis of mild cognitive impairment, but was unable to explain to her what that diagnosis might mean for daily life. Instead, he went into detail explaining the changes in her brain observed on her MRI images--he told her that her brain is bleeding! My mother did not hear the part about tiny capillaries or white matter. All she heard was her brain was bleeding and of course she was completely freaked out. Then later logic kicked in and she said, "But if my brain was bleeding, wouldn't I be dead already?" So then she had doubts about whether the doctor was qualified and whether the entire MRI process was accurate, since she figured her brain couldn't really be bleeding. The doctor's office partner, the neuropsychiatrist, gave my mother the pencil and paper "cognitive tests" (simple enough for a grade school child), but this same neuropsychiatrist refused to actually give her the bad news, in person, that some of my mother's scores were lower. Instead, she mailed a 3-page report written in medical jargon that my mother couldn't understand, and again there was no explanation of what this might mean on the day-to-day level. Anyway, even if your husband goes for a brain scan and neurological testing, it won't necessarily be enlightening for him, and will probably make him more upset. It might give you some understanding of his condition, but you will have to really insist that the professionals answer your questions, so find someone who is willing to communicate a lot: by phone, their portal, and a face-to-face consultation appointment to discuss the results with you. In the end, they will tell you that they can see brain changes in the imaging, and these brain changes often lead to cognitive problems, but not always, and they have no idea how quickly he will get worse. Then they can prescribe memory drugs, and you can watch for side effects or improvements.
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I suggested we both get tested, he went for that. I have normal wear and tear on the brain, he has Alzheimer's.
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