I invite you to log onto the home page - www.thealzheimerspouse.com - and read today's blog. I welcome ALL opinions, and I really do want to know if I am wrong on this issue.
I don't think you're wrong at all, but as we have all told each other, maybe you should get a new psychiatrist/neurologist. Does he claim that his training is in dementia treatment? I'd report him to boards if that's the case. And also, as we have all told one another, write down what you want to tell him before you get there and get it conveyed to him.
Joan, NO, you were not wrong. Sure you are dealing with an Adult, however, that adult now has the mind & reason of a child. I guess I really don't understand how a Psychiatrist is helping when Sid tells him everything is fine. But, if you believe it does, then as others have said, write down your concerns & send them to him prior to appointment.
This pyschiatrist is trained in dementia treatment - works closely with our neurologist, who is tops in his field in Alzheimer's Disease. However, because Sid scores so well on the mini-mental, and presents so well in public, the psychiatrist, who seemed to be in a bad mood yesterday from the get-go, thinks I'm a crazy control freak, who is exaggerating the extent of my husband's memory loss and its effect on his life.
Kadee,
Our neurologist does not like to prescribe psychiatric medications. He prefers to stick with his specialty - Alzheimer's Disease, so he sends his patients to the psychiatrist down the hall for the medications. That is why we go.
I also think you should let your neurologist know how you are being treated by this person. I would find another prescriber or like you said, ask the PCP for help.
I am so sorry you have to deal with this on top of everything else.
Joan, I would NOT return to that Doctor if it were me. We caregivers have enough on our plate already without a "person of authority" heaping more fuel to the fire. I have taken my dh to 7 Doctors at various places and NEVER has one sympathized with DH, or told me to back off, etc. Our local Neuro. basically is, to quote my dh, "a pill pusher", and all he does is ask how we are doing, renews prescriptions and says come back in 6 months or whenever need be. I discussed this with our pcp, who tells me he doesn't have experience with Parkenson, how the apointments go and I would like him to continue to monitor my dh along with a generatic physician at WVU. So, we are doing so. Our pcp has known us from when he first started his practice and is in complete sympathy with me and does great with dh.
I made an apointment with the generatic physician for next month for an annual visit. While there, they will inquire into my health, as a caregiver and make suggestions, etc.
I don't understand why Sid's Neurologist will not prescribe physc meds, most Neurologists who deal with AD patients normally prescribe these types of drugs in the routine practice of Neurology. Not all Neurologists are created equal, experience treating AD and Dementia patients is a must. I have found that most PCP's don't have a clue about treating AD, dementia and strokes. Most will not prescribe the required drugs because they aren't familiar with them and don't know how to use them.
We live in a major metropolitan area and have a selection of very qualified Neurologists, my wife was diagnosed by one of the top AD Neurologists in the country. We have had issues with various Neurologists, one was a Neuro/Physc who is a very good Neurologist but has a very abrupt, abrasive personality. DW didn't get along with him at all. She went to at least two other Neurologists before we found the one we have used for the last 4 or 5 years, his office is three miles from our house. One of the Neurologists didn't recognize her AD when he saw it. INHO it takes some trial and error sifting through some of these Neurologists before we find one who understands what is involved in the treatment of AD and works well with our loved ones.
It is obvious that the Psychiatrist does not understand AD and certainly had no right to suggest that you were trying to be controlling. With an AD spouse we caregivers have to maintain a certain degree of control, after all they are not capable of deciding what is best for themselves. Our loved ones can be very good actors at time, they have the ability to fool some of the medical professionals at times. Sometimes we caregivers know more about the treatment of AD than some of the medical people we have encountered and will encounter in the future.
No, Joan, you are not wrong. That's why I don't take DH to a Psychiatrist here in our small town. I've seen what they do to dementia patients here. Our PCP prescribes and monitors all meds and is fantastic with both my DH and myself. We get two "exams" for the price of one at each visit!
joan i just lost a lengthy post expressing my anger too. you must forget the 'treatment' drs for sid at this point and find a 'caregiver' dr who will work with you for this journey. nothing any dr will say to sid is going to influence his behaviour long term. you should continue your own therapy though. his job is to help you cope with AD and stay sane these next yrs while dealing with irrational and irrate behaviours. so many of us have dealt with more than one or two drs. they are correct that not all handle business the same. our neuro addresses the anti psychotic meds and has never suggested i see a psychiatrist for that. i think its a waste of time to do therapy for sid. he wont retain it anyway and the dr isnt taking you seriously so why waste time/energy. i had yrs of pschoanalogy. the drs job is to be impartial and see it from both sides. thats good if both are rational. its a waste if spouse has AD. hope you find a new dr soon that will work with you joan. you dont need to suffer insult on top of all you do. divvi
Hello Joan and all, I hesitate to comment,as many of you have SOOO much more experience than I, but one thing I do that I have found helpful is to type up a one page synopsis of behaviours and issues and fax to the doctor a week prior to appointment. This way straight talk is on the table prior to arrival. I hate talking about my husbands issues in front of him cuz his feelings get hurt. This way the doc can bring up stuff without me looking like a tattle-tale. Maybe that fax can be shared with the other dr (psych) and insight gained on their end. This disease affects everyone so individually, if this dr spent enough time with Sid, he would see the issues, rather than taking a quick "snapshot" which can be mis-leading.
I have always been a control-freak and Joan, I now believe these qualities are a blessing for our situation. These control-freak impulses keep up in tune with our spouses changes and keep them happier and safer.
I must be missing something all the way around. My husband has AD. He would not be able to remember what he had done to tell a doctor, nor would he remember what the doctor told him after the visit, SO WHY TAKE HIM AND WASTE THE MONEY????
Joan, if you go back to that a**hole, I'll be VERY ANGRY at you!!!! He had NO REASON WHATSOEVER to talk to you that way, nor to express what he did. He obviously does NOT understand AD, and should be reported!!!!
SO THERE!!!
Now, if you feel the necessity to go to one for yourself, Joan, that is a whole different ball of wax. Go with my blessing and get some relief!!!
If you get the impression that I was angry at Sid's doctor, and upset for Joan, you are correct! <grin> That doctor better be glad I don't live in Florida!!!
Joan-give me a call and I'll go with you to instruct Sid's psychiatrist in how the AD mind works (or doesn't). How can you allow Sid to suffer the consequences of his actions when he doesn't remember them. On the other hand your telling Sid that he is driving people off won't be remembered either. I reached the point with Bill that I had to let him self destruct. I felt like a rat-but there was nothing else to do. Nora
When we are dragged "kicking and screaming" into the role of "mommy" what else can we do but be controlling? I definitely agree with the comments above! I would not go back to that doctor!!! This is a learn-as-you-go disease and unless the doctor has lived it he is just "blowing smoke".
Joan, I think that conversation wins as the most stupid thing to come out of a psychiatrist's mouth. If you are just going to him for meds, then he is a med guy, 10 - 15 minutes that's all he allots. That doesn't allow time for a real conversation. He was wrong to tell you that, but indeed, what would have helped anyhow? Sid can't take in or remember what's said, and as for annoying other people, with or without your intervention, don't think it's going to stop. Seems you have false hopes.
It reminds me of yesterday. About 4 days ago, we started getting ants in the kitchen. Husband removed all from the counter & sprayed with rubbing alcohol, which I don't know if it works or not. That evening he put his dirty dinner dish on the counter. Guess what, ants returned. I told him we couldn't have food stuff on the counter. Next day he sprayed again, but put a bowl with grease in it in the sink. Ants returned. I told him again, no food stuff, it is attracting ants. This comment after meals repeated, no luck. Yesterday he bought ant traps & put them on the floor & counter. Then he rinsed off a tuna salad bowl & left lots of tuna scraps in the sink. Loads of ants ignoring the "traps" and going for the more tasty tuna.
Guess what? I didn't say a thing about the tuna scraps. So what if we have ants? He apparently can't connect food to ants. Why bother continuing to mention it.
I'd either just go to that guy simply to get meds (me? I'd stay far, far away), or I'd find another med guy or a neuro who can prescribe meds. There is no psychiatrist who is going to get through to Sid, just like there is no one who can make my husband connect food & ants. That being said, he was totally out of line, unprofessional, and apparently lacking any real knowledge of AD.
Please, I am not an expert, get confused a lot about much of this stuff, but a psychiatrist specializes, I think, in mental disorders and AD is NOT a mental disorder. Altho many symptoms are the same, the causes are different, and certainly talking to Sid, asking him anything can be a waste of time--he has AD!!! I took DH to a psychiatrist once. He seemed more concerned in how I was doing then in DH and he was right. He never tried to 'analyze' DH but listened closely to what we both said. What DH said was too bizarre. He gave him meds for sleep--so that I could sleep. By then I was badly sleep deprived (I will mention that sleep deprivation is considered a form of torture--prisoners should be so lucky--HA!) The visit was very good for ME. I don't know what a psychiatrist can do to help Sid, but if you feel you must--this is not the right one, obviously. I'm not sure what you did was controlling, exactly, but you were being perfectly normal and, in his way, the man was responding the way he would with normal people--we do not live normal lives! Get another doc, for sure.
One more thing--Sid will lose friends if it comes to that. He cannot control on a permanent basis what he says and does. For a short time, yes, but his social graces may well drive people away--not ANYTHING anyone can do about that. You are trying to control that, of course, but it's just one more losing battle. Maybe he'll change, one can hope, but not because of anything you say or do--unless you drug him into a stupor. We do become 'mommy' but a small child may embarrass us and still learn. If we do not control-discipline-we will be considered a bad mommy. But when our AD adult LO behaves in an embarrassing way, we cannot really discipline, he will not learn. We have to control the situation in any way we can, but we cannot control our LO the way we can control a child. We are not resonsible for their actions when we are doing our best--and you are.
Joan What's that old saying about when you only have a hammer everything looks like a nail?? Sounds to me like your Dr. was thinking your DH had mental health issues only. If your DH only had anger management problems than,yes, by all means the right thing to do would be to let him experience the consequences of his actions .That would be sound medical advice....
But to let a person with Alzheimer's experience the true consequences of their actions would be cruel!!
Goodness, our loved ones are not capable of remembering what they did ten minutes ago, let alone are they able to discuss their behavior over several months. Without you there to tell the doctor what has been going on... a trip to the doctor is useless.
At the very least think you should consider changing doctors. In this case he was way off base.....
Go and talk to your family doctor. Tell him what is going on and ask if HE, the family doctor, will prescribe anti-anxiety and anti-psychotic meds. My husband's family doctor will do that. It came up when I asked him if he would be comfortable if my husband did not go back to his neurologist for medications because the mini-mental tests were making him sad and unhappy and the neurologist had gotten him on his dementia medications and at that point the family doctor was already controlling those meds along with all of the others.
Frankly, once they are diagnosed, and are stabilized on their medications, unless there is Parkinson or lewy body involved, they almost certainly don't need to see a neurologist. Think about it. What can they do for someone with Alzheimer's or cardio-vascular dementia?
Joan, I am outraged on your behalf. I second everyone else's motion -- you need to go to a different doctor.
Friends of mine in the medical profession here in the midwest have told me that if they had a serious illness or accident in Florida that they would want to be air ambulanced back here for treatment. The standard of care in Florida is problematic. Although there are many fine doctors there, many bad doctors, or greedy doctors, go to Florida. The largely elderly population is often not discerning about whether they are receiving good treatment. (I know this from personal experience with family members who fell into the greedy clutches of terrible doctors who injured them.) The cost of a medical procedure in Florida costs on average 40% more than elsewhere in the country. Are costs higher there? No, it's just that the traffic will bear it. So, a greedy or inept doctor who would not be able to make a living elsewhere can thrive in Florida. PLEASE seek a competent physician. There is NO EXCUSE for the way this inept fool treated you. You must protect yourself and find a competent doctor. At this point it may not be so critical, but it is going to be crucial in the future as the disease progresses that you have excellent care. You should not be placed in a distressing situation because of the incompetence of this so-called expert.
And I am actually holding back on how outraged I am ! ! !
Speaking of ants, they drove my DH crazy--even before AD. I love kumquats and had a mini-tree that I waited each year to give me fruit. Overnight it died! Turns out there were ants around it and DH poured something on the ground to kill the ants--it was something like gasoline he had in the garage for years. I was just glad he didn't see ants anyplace else, lots of stuff grows in the yard--especially weeds, but I was afraid to plant anything edible in that spot.
Not only is this psychiatrist WRONG, he had NO right to speak to you like that. You know that his is misinformed and it makes me wonder if some other md might have better ideas about helping Sid and you with Sid's raging and abuse!!!! PLEEEEEASE find a new doctor and picture us all pummeling this dr for you. How dare he claim to be a specialist in dementia and then do that. Our DH's and DW's have little to no sense of what is appropriate and where proper interactive boundaries are. Consequences have no meaning and therefore, no impact. You know this to be true.
Sounds like we need to bring back the slapfest topic for this clown. Joan, you get to go first, second and third. We'll all line up behind you. Looks like it'll be a very long line. Those who wish, can go back for seconds. (-:
Joan, sorry for your bad experience. What I heard in your post is that you don't want to have Sid's behavior drive away his social network. When that happens it affects you big time. From what I remember, you have a good network of of spouses and their AD spouse. That has been a life savor since you moved from up north and really had no friends down there in Florida. So, I don't blame you for trying whatever you can to try to get Sid to control his behavior for as long as possible. It is not only for him, but you and your support network. And, if he keeps it up, even the friends that take him out for outings may stop, thus you would loose some of your 'free time'.
OK, looks like I may be the odd person out but it is just one persons view. When I read your blog, what came to my mind is why did you tell his psyciatrist anything. He/she doesn't treat a dementia patient. They tend to listen to them and help guide them. His/her logic and response seemed ridiculous to me. They may of 'studied' dementia patients but you don't get it until you live with it and experience it. I guess I would say, only bring up the information you need to to his neurologist and medical doctor.
Well, I guess that psychiatrist isn't making any friends here. LOL
Charlotte - you nailed it exactly.
Diane T - You're right. The psychiatrist is there to prescribe meds. Period. But there is also a nurse practioner in that office - he is able to prescribes the meds., and Sid and I both like him a whole lot better than the psychiatrist. He lets Sid complain and listens and responds sympathetically, then asks me about Sid's "episodes" and how much medication it takes to be effective, tells me how to administer it, writes the prescription, and that's the visit.
And yes, you can "study" dementia for 100 years and have umpteen degrees in it, but unless you live with it...........you don't really know it.
I once worked with a woman who not only was one of the most knowledgable speech/language therapists I had ever met, she was one of the best hands on therapists I had ever worked with. But she never had kids of her own. We went on a field trip to see Santa at a mall- we had a group of special needs pre-schoolers. It was always our method to assign one or two kids to a chaperone. It was that chaperone's job to only watch those kids. That way we could be sure all kids were carefully watched. Mary was assigned to one 3-year old Down Syndrome child, who was the same as any active, curious 3-year old. Quick as lightening. Mary was busy talking to someone, and told the child to stay by her. side. (She had taught and practiced therapy for years, but had never taken a 3-year old to the mall.) She was talking, not paying attention to the kid, and you know what happened. I ran after him and caught him. After that, she spent the rest of the day getting whiplash keeping an eye on him. When the day was over, she was exhausted, and said she didn't know how parents did it.
Same with dementia. You haven't lived with it, you don't know it.
Pardon me, joan, with all due respect I really don't think your DH needs a psychiatrist for his mind or his meds. A neuro, if they are worth a salt, should be the one prescribing meds for a damaged brain. THIS MAKES SENSE! A psychiatrist for your DH at this time is pointless. One for you, or a good counsler, is another matter...M
I would try to get all appointments with the nurse practitioner then. That is how the dr should be, but we all how some doctors (no offense Marsh) can be - their education gets in the way of their rational thinking.
When the Psychiatrist my Dh was transferred to after Dx, changed 3 Rxs without telling me anything of the whys and wherefors, and took Dh's word that he wasn't sleeping, though I filled him in on Dhs sleep pattern, and put him on Trazadone to help him sleep all at the same appointment, I was very concerned. When I found out the reduction in the 2 psych meds were because Insurance was on his case to reduce the use of Artane( also reduced), for side effects, I began to be upset. I had to call to get the psych meds reinstated to the working level when symptoms began to break through. Hadn't had to fill the reduced Artane Rx, so that had stayed level. Took more than a month to get him off the Trazadone--His sleep went from a couple 4-6 hour sessions and a nap or 2 to 1.5-2 hour cat naps strung round the clock. At appointments I had been moved from inclusion to being ignored. Plus, the Dr. had a laundry list of tests he wanted to have Dh undergo, with no explanation of why they were needed.
I asked our PCP if he could reccommend someone else. At our first appointment, besides talking with Dh, he talked to me. Asked me how I was doing. And told me, "You, Dh's caregiver, are the most valuable tool I have in treating him. You have 24/7/365 knowledge of how he is, what's changing , and how. I can't get that in an appointment time."
That's what you need, Joan. Get another Dr. If it's going to take time to find one, see if you can deal through the nurse practioner.
As hard as it is, Sid's behavior will cause his social connections to disappear. You do need to realize this and prepare youself for it. Maintain all the connections you can, for yourself. Help him maintain to the level he can (no pressure, just simple reminders). Let (or remind) his friends know how things are going. It may help them be more tolerant of the behaviors, at least for awhile. This too is a part of the AD life.
Oh, I’d like to take a shot at this guy! He obviously does not have any knowledge of this disease at all. Just because he has a degree does not mean that he is an expert in this field. That’s obvious.
What was it we call people like this—“seagulls”? It’s because they fly in and you-know-what all over a situation that is bad enough already. This guy is a prince among seagulls. He had no cause to say anything to you that he did.
I’m sure other people will be along to write more on this topic. Maybe you should take him some of the responses and let him know that we—who are the true experts on this subject—take serious issue with both his knowledge and his behavior. It most likely wouldn’t change him, but then again, you never know.
I agree too, you need to find another doctor. My husband sees a psychiatrist who prescribes his cymbalta, seroquel and namenda. He has seen this doctor for years before the FTD came into the picture and I had never gone to any of those visits. Once the FTD started, I began going with him for his appointments and his doctor has been very understanding. He will ask my husband questions regarding his feelings--which usually will be answered with an "I'm fine". Then the doctor will ask me what I have seen and how everything is going. He always asks how I am and what kind of support I have. He also will usually ask if I need to speak to him in private about anything--he does this outside of my husband's hearing.
My husband's neurologist sees him about every 6 months and did start him on aricept and risperadal. The risperadal did the opposite of what is was supposed to and as the psychiatrist appointment was well before the neuro, I asked for a different med from the psychiatrist. I don't understand a neuro who won't prescribe the proper medications when needed.
Joan--here is my take on your problem. Someone once told me--the most important thing your husband's doctor (neuro) can do for him is to support me (the caregiver). Unfortunately, since so little can be done for AD--the same AD meds are pretty much handed out to everyone--so the biggest impact the doctor can make is to prescribe the needed psych meds and be supportive of the caregiver. Clearly, this is not happening. The neuro won't give Sid psych meds and the psychiatrist is not supporting you. I would drop them both and get a neuro who will give Sid the psych meds and most importantly, be in your corner!!!!!!!!!!!!!!!
I also agree with MMarshall, I'm not sure why he would need a psychiatrist now.Seems to me a waste of time and effort. I would drop the psyciatrist, work with Sid's physician and get a neuro that you trust and works well with you and his physician.
I wonder why you need a neuro at all. I fired ours after the 3rd visit, and have relied on the PCP ever since. Check with your PCP and see if he/she would be willing to handle all drugs. Things like seroquel are not that difficult to handle. The AD drugs should be familiar to anyone.
Joan - if you enjoy being treated like this by medical professionals (?), move to Montana where they are in abundance. If you DON'T like it, suggest to Sid's Psych that SHE move to Montana where she will fit in just fine. There is simply no excuse for this arrogance......ya gotta believe me (and everyone else who has posted) on this one. Thenneck
My background is in Mental Health as a psychotherapist. In our long saga of trying to get help, at first I was told it was a couples issues - all the things that Joan said happened. We were new in town, so I didn't know which one to pick, so I made the rounds. They all said the same thing, I am trying to control him, he doesn't have to do anything because he knows if he doesn't do it, I will do it - duh.....Our last one two years ago was with one of the top people at out local University. He did not want to hear anything I had to say, he said I was speaking negatively about my husband. He said he would see what went on in his office. After the 7 th visit - I was very patient - he finally realized by my finally being allowed to voice it, that my husband had AD. He sat back in his chair like we had a bad virus he didn't want to catch and said he couldn't help us.
I hate to say this, but there are a lot of bad mental health folks out there. They go to school, hang out their shingle and never do any work on themselves. They are experts in everything and know it all. It is very hard to find a good psychiatrist and therapist. Joan, you can come to Tampa - we have an excellent psychiatrist. She won't see my husband alone because she knows he isn't telling the truth. She is someone that I knew when I was practicing and really liked her work.
With age, AD and other complex health issues that most of our loved ones have, it is so important to find someone that understands those dynamics as medications have to be fine tuned to be effective and safe. That doesn't always happen. Most psychiatrists - like doctors, don't know much if anything about AD. THAT IS WHY THIS SITE IS SO GOOD - WHEN THE EXPERTS ARE WRONG, WE HAVE EACH OTHER TO VALIDATE WHAT WE KNOW IS TRUE!!!!!!!!!!
We have a choice - we can pick someone till we get the right fit - if ever. Good luck
Oh, I forgot - one of the Doctors that didn't work was the one that is head of the Memory Disorder clinic at the University. She is a psychiatrist. My husband can count change and tell time. She said that he had memory problems validated by the CD of his MRI that we took to her. She said because he wasn't displaying any more symptoms that she could see in her cursory "evaluation" that we sould come back in a year and be "tested" again.
marsh, I'm with you. Once they are stabilized on the dementia meds there really is nothing a neurologist can do. My husband's family doctor will prescribe anti-anxiety drugs and anti-psychotics as needed. He is in a practice with 4 other doctors (including mine) and I think he has seen a lot of dementia, but if not, the other four probably have.
This is one of those situations where you see your own doctor, but in a pinch any of the others will see you, or set up blood tests and/or prescriptions or answer questions based on your medical records.
This seems to be a common topic-what kind of doctor should a person with AD be seeing regularly? It seems the answer varies with location (is there a neurologist close by), age, co-morbidity, and the skill (and knowledge of AD) that a given doctor has, or we are comfortable with.
My husband's current neurologist prefers the psychiatrist manage psych. meds. He sees a geriatric psychiatrist who is very familiar with dementia and the interactions of various psych meds. Where we lived last, the neuro. took a more active role, but the one here is more into research. If you are not interesting, progressing rapidly, etc., he seems less interested.
The psychiatrist where we lived last had been seeing my DH for long standing depression, anxiety and panic attacks. Since we had moved there recently, he had only known my DH for a year and half. He was the one that recommended the neuro-psych exams that showed multiple problems. (But the primary dr. there we disliked).
I think it is easier to say of a given doctor (regardless of their specialty) that this doctor works for us, or this doctor does not.
I think it is VERY important that we have a good raport with whatever Doctor we are seeing. I am using our pcp mainly now, until something new surfaces and he needs to see a neuro. If anxiety, mental abuse, violence, more Parkenson symptoms show up I try to maintain a Neuro by seeing him once a year. Our pcp would prefer we see a specialist for extreme change.
because of the 'what ifs' and involving the brain. i tend to want to keep our neuro on board. if there is something serious later i dont want to start from scratch and would want to have someone who knew the history. plus the one i have i like alot and seems to listen to what i need. divvi
divvi, I don't disagree with you. Neither the neurologist nor the cardiologist has been fired because neither needed to be fired. If my husband needs to see either that still can be done. And my husband's history will still be available to all the doctors as needed through both the family doctor and my favorite hospital.
And I do agree that if what you are currently doing is working, there is no need to "fix" it. But if it isn't working, it probably is a good idea to take a really good look around at what is available. In Joan's case I'm not hearing her complain about her husband's family doctor, if he has one. In his case possibly not just a good place to start the fix, but maybe a good place to end it too.
Joan..you are absolutely correct and should not tolerate that from any doctor..You are paying him dearly for his services, and he is the one who deserves to be "educated" in treating patients. Most doctors assume that their patient is normal, and will readily discuss their symptoms, and doctors forget that dementia plays a vital part of being able to express oneself. The caregiver is the "moderator", and should be the one who can voice their opinions also, for the benefit of the patient who cannot. My dw is much the same when we make an appt for her doctor...everything is fine, and there are many things that she will not tell her doctor, and many things she forgets. I usually make a separate appointment to discuss the matter. My dw resents that the doctor talks to me, and she insists that she is the patient. I usually remain quiet, because she gets so aggitated if I intervene. Usually, I will make an appt ahead of time, and will discuss my concerns with the doctor. Then when the real appt comes up, he will use his "cues" to bring up items of concern. Of couse, Hippa laws always interfere, and I had to have a heart to heart talk with the doctor, informing him that my dw's rights were also my rights since I am the caregiver, and that I represented her wellbeing. I explained that she often forgot or did not want to speak of any problems, and that I would be her "voice". Since that time, I no longer get chewed out from the doctors, and can discuss pretty much anything I feel is relevant. You are not wrong in being upset, and you should let the doctor know how you feel. Does he not realize that he is dealing with a dementia patient???? That is sort of like expecting a paraplegic to get up and walk....I suggest that you "educate" him, and read him the riot act. If he does not accept that, then grab the yellow pages and find a doctor who is capable of dealing with AD. Show no mercy...If he cannot be professional, then by all means fire him....you have the authority to do that, and you deserve professional care... I recently attacked my dw's psychologist, who had given a "recommendation" that my dw's dementia was caused by transference, and somatization disorders, and that she had a possibility of a conversion disorder. When I told him that she had eoad, he agreed that his diagnosis was wrong, and that he now understood why she could not complete the tests that he had administered. He agreed that his evaluation that she had low response bias and low motivation was caused by the dementia, and he apologized. He told me that he had ruled out ad because my dw was too young (53 at that time). So doctors are not always accurate, and not always correct. You have to be the shining light and point out their errors... Go get them Joan!!!!!!!!!!!!!!!!!!!!!