I thought some of you might want to use these simple at home testing that have been published from JohnsHopkins for dementia. i especially like the CLOCK DRAWING TEST as this one is being widely used for early detection for drivers licensing renewals in the elderly in some places. if your loved one is 'seemingly' still able to drive you might want to do this test and have them draw a full faced clock with hands marking "11:10" on it. you can read about this if you google my heading listed above, low tech screening tests for dementia and go to the johnshopkins website and search this listing. it may be an easy upfront but non professional way we can see how our loved ones are doing cognitively speaking, of course its only for personal use and if you suspect less than desired results ask their dr for input about the results. anyway, i thought it was very interesting and of course my DH couldnt get past drawing the circle..thats telling alot.:) i also like the other test about the coins and giving change for a dollar. each of these tests listed specifically challenges certain memory areas. Divvi
divvi, my husband's doctor gave him that test both one year ago and 6 months ago. Because there was the possibility that he didn't understand what was wanted I actually coached my husband into drawing the clock face. A year ago he could do it. 6 months ago he no longer had any idea of what I was talking about. Even after I showed him the kitchen clock.
Starling thats exactly what concerns me too - who is to know WHEN exactly they can pass from one 'knowing' moment to the not knowing' moment? couldnt this happen while they are driving? i know i had to do something asap when my husband was flying his plane for the last time and when the tower told him to land runway 6 he landed on the grass inbetween two runways..he was lucky, and so was i being able to call it quits then and there before something bad happened. my skin crawls just thinking about that. i saw this topic was discussed in preonset too. if i were in the early stages i would be having mine draw clocks constantly and give me change for a dollar constantly..:) take care, divvi
My husband, like many (most?) AD patients, is very sensitive to stress, which can make his symptoms much worse in the blink of an eye. Long before I realized he had a problem, I saw the stress of an unexpected driving situation cause him to make a potentially dangerous decision, on three different, and widely spaced apart, occasions.
I don't think it's possible to determine from such an incredibly simplistic test "when" an AD patient passes from being a safe driver to an unsafe one. They pass back and forth, depending on many different factors, some of which are unpredictable.
We all know that AD symptoms come and go. In the early stages, our LOs are fine one day, doing very badly the next, and then snap out of it again, leaving us wondering if they're really sick or it's just our imaginations.
They gave my husband the draw a clock and how many quarters in a dollar questions/tests today. He failed both of them. The clock had multiple hands and no numbers.
He hasn't been able to make or use change for a long time. The folks at WAWA are honest and he always gives them full dollars. He always came back with the same change until one of the papers changed its prices and then it would stay the same again. Change has been going into jars for quite a while. I'm pretty sure that started not because the change was heavy in his pocket, but because he no loner understood what the different coins were called or what they were worth.
If the change thing is an early symptom, then I've finally got one from before his accident and pacemaker. Those jars originate from quite a while ago.
I just asked my Dh the no ifs ands etc and he can't do it. He can draw the clock perfectly.He has lost most of his language and short term memory. He basic math skills are perfect. He can play cribbage, but can;t remember his color or whose turn it is. He cant use an ATM, doesn't understand income tax, bills, like utilities ,phone etc {lucky him} Go figure!!!
Now that I'm thinking about it, my husband was also asked who I was at the doctor's office. He didn't give my name. My daughter was in the room and he did say her name. When the policeman asked him for his middle name he couldn't answer the question.
I know he can't use an ATM, but he has paid for gas with the Debit Card within the last couple of weeks. And I doubt if he understands bills. I've been paying them for the last 35 years.
I too was paying the bills forever. Now he thinks I'm stealing the money and can't understand that there are bills and living expenses that have to be paid. I was surprised to learn that he has forgotten his PIN number. He's had the number for years. He has no idea what a credit card is or that a debit card can be used for anything other than withdrawls from the bank.He also knows how many quarters in a $1. Thd doc said that he's all over the place and that is right. No test can measure where he's at. I still can't believe that DH agreed to stop driving, it was such a big issue last fall.
My DH knows nothing about money these days, and in many ways I am grateful for that. I have been accustomed to telling him when our investments go up and down, but now I've learned to be careful about any of that, since he doesn't understand the significance of it anyway. I started using his PIN number when we married, so I know he's had it for years, but he wouldn't know what that is now. Sometimes this feels lonely, but the advantage is there is no argument about what to do with finances. What a carefree life our spouses could have if they didn't have any of these worries and also didn't have AD!
My husband is also all over the place with the mini test, and quite honestly, it depends on what day he takes it. the last time, he remembered the 3 words. The doctor was amazed, and I was kind of disheartened, because I'm not makeing this stuff up. I felt like 'am I the one who's crazy'?' but of course, 5 minutes later he didn't even remember having been to the doctor, so go figure. I'm afraid the minitest isn't that useful.
While at the docs DH was asked to draw a box type shape. He struggled with it, and I think for a moment even doc was surprised. He talks a good talk and has really been able to hide symptoms for so long. I hadn't tried any of these mini tests at home. Frankly I find learning about new "lost" skills is sort of depressing for me. My DH is still verbal ( in fact he often makes sounds or repetitive nonsense words around the house) but recently has had to ask me the meaning of words. It still stops me dead in my tracks when in the middle of a simple sentence he asks me what do I mean or what is that word.I know many of you have said this and certainly been through it... but because my husband still looks substantially the same and isn't seriously medically ill .. I still have moments of expecting him to understand and to act the way he used to ... to show concern or something..... this is such a lonely disease for all of us.... My husband who spent a lifetime working with computers, can no longer find his e-mail .... I know it seems like a small thing , but it breaks my heart to see each new thing he can't do......
Chris, with my husband, I think it not only depends on the way he's feeling on a particular day, but also who is giving him the MMSE. His neurologist is rather brusque, makes it very clear that he's BEING tested, and he gets all defensive and flustered and the test goes down the tubes. Other doctors -- his PCP and a couple of the neurologists at the ADRC -- are gentle, encouraging, a little playful. He relaxes, thinks it's kind of a silly game but what the hey, and so he does much better.
Isn't it strange that we agonize over our spouses being sick, and yet when they do well, we worry that the doctors might think they're not? I'd give anything for my husband to be well, but I have the same reaction you do when he's having a good day and seeing a doctor who doesn't know him and how he can be on his bad days.
Sunshyne...........Yes , there preformance is better the more comfortable they are.... but I have found that the more frustrated my wife is the more confused she gets..... I think that a lot of Docs try and frustrate them as I think this enables them to detect AD in an earlier stage.... Just my thoughts........... Dan
dandee, you are right. And in my husband's case the doctor tried to exhaust him. And sure enough he began to fail some of the questions that he should have been able to get right on that first visit.
I was shocked that time at the wrong answers, but those are the questions he can't get right even when he is at his best these days.
Interesting thought, Dan, and quite possibly some people do that. I know my husband's PCP doesn't, sweet man that he is, and I'm SURE the people at the Research Center don't. Stressing the participants would be another uncontrollable variable.
Actually, the more I think about it, the more I suspect you are giving credit where credit isn't due. I don't think the doctors are that clever ...
Understand, I'm not into trashing the medical profession -- my own father was a GP, and a wonderful doctor. I've simply never seen anything suggestion to do that in any of the reading I've done, or heard anything like that in all the talking I've done with the researchers at the Center.
Plus a lot of doctors don't seem to understand that stress can have an affect on AD symptoms. I'd have thought it was a foregone conclusion, but apparently many doctors think patients have "steady" symptoms -- i.e., they function at the same level all the time until they start to decline, and the decline is steady, too. This is what my husband's ex-neurologist believes -- emphasis on the "ex" -- and I've seen posts from others whose ADLO doctors felt the same.
Very interesting thought, though, the more I mull it over. I wonder if it might not be possible to design a stress test for early detection of mental problems, just like they do for detecting heart problems. Hmmmm...
Sunshyne...... I alway just assumed that frustrating was part of the enitial test to determin AD....... When my W was diagnoised in July of 06 I remember vividly how upsetting it was to me to witness the exam because I could tell the Neoru. was intentionally frustrating her and how shocked I was at how her frustration magnified the memory loss to a degree I who live with her had not seen,, so after the exam he took me aside and told me he suspected AD and also appoligized for how he had to ask the question but said frustration brings out the memory loss....... Since then I have only seen her in that frustration like situation when I went to the DOT to renew Dee;s drivers license ( for I.D. only ) and the babe behind the counter thought she was uncovering a caper and started shooting question at Dee ..... Those 2 situations I can remember so vividly cause you see your loved one so helpless.......... Not one of us spouses deserve to go thru some of the heartbreaking thing we all see...... Bless us all.... Dan
One of the few things my DH remembers is that he doesn't want to go to that doctor (neurologist) anymore, so I switched to a geriatric specialist. I liked the Neuro, but he told Dh not to drive anymore, and that he remembers. he does etter on the mini test with the geriatrist, but I feel she's not getting a true picture. Maybe a little frustration is not such a bad thing.
Dan, I'm surprised the neurologist allowed you to be present during the testing. That's usually a no-no.
Also, the more I think about it ... there are different types of tests / questions designed to probe different types of problems / different regions of the brain that are affected. Even the MMSE is designed to do a lot more than just test short-term memory. If administered by someone who is thoroughly trained, it can provide insight into the different regions of the brain that are affected, and can sometimes even be used to help distinguish between AD and other disorders such as Parkinson's and vascular dementia.
If the doctor deliberately frustrates and upsets the patient, then I don't think s/he will get the full picture. I know when my husband reacts negatively to the doctor, he basically clams up, and it's my understanding this isn't unusual.
And one time, when one of the doctors did upset my husband to the point that he demanded to stop and go home, I had a discussion with several of the doctors at the Research Center about "attitude". My husband was a high-level exec before he developed AD, used to a lot of respect (and kowtowing) and he considered the tester to be condescending and insulting. I thought that if they spent a little more time explaining what they were doing and why, he would be interested in the theory behind the test, and willing to "go along" even if he didn't care for the doctor's attitude. They told me that there were limits as to what they could say, or else the test might be compromised, but would try to keep in mind what I was telling them about his personality. The same doctor who had upset him so badly then tried to administer the test again, and was delighted that he cooperated, went through the entire test (it was a couple of hours long, and very tiring), and felt she'd learned something new about factors that can affect the outcome of the test.
Plus, I think a lot of people who don't have a disease per se would not do well on a test if the doctor deliberately provoked them.
In short, I think your wife's neurologist was perhaps using ... ah ... unusual tactics not in routine use and never really tested to confirm that they are helpful.
Sunshyne, I'm the one who thought that the first visit included some frustration, on purpose. Dan was just saying that he, also, had seen something like that.
And I also was in the room during the exam. And this time around so was my daughter.
Of course, my husband never got the kind of testing that a lot of your LOs got. Because he came to the neurologist from a Cognitive Therapist who had been seeing my husband for 6 months, and who had written extensive reports, there was no need for that kind of testing. Most of what was done on the first visit was confirming what was already known by another professional. My husband did get a CAT scan (no MRI because of pacemaker) and blood tests. Ultrasounds had already been done by the Cardiologist and the Neurologist had that information too.
I think some of the time getting the patiend tired out and even frustrated gets you past the attempts at hiding what is really going on.
I am not a professional so I of course can;t give an opinion as to what is right or wrong..... when it comes to neurological evaluations..............
Chris...... Yes my wife also begged me to never take her to him ( neauro ) again and I have not.... She see a lady GP that her father had AD and Dee is very comfortable with her .... Maybe they ask not to go back because of the frustration they felt at the time of the exam....... Dan
When my husband went to the cognitive half day testing he told me later that he was fed up with the lady testing and when he came back from the bathroom he just 'checked' ANY box on the test without reading the question just to get to leave! that is why he got a much higher score during the first 2hr of test then basically had 'severe dementia' reported on the end...he didnt even try to anser the last half of test...so i guess it does reflect on who administers the test and how they are frustrated. divvi..and ps the first round of tests prior to the neurocog tests said NO alz or dementia and drs report stated job and stress related! so the early tests proved nothing as he did exceptional on most of that. so i was quite stressed when the second round of testing sometime later stated vascular dementia.
We went to the neurologist this morning. My husband was SHOCKED that we were going so far away. Why didn't we just go to the family doctor's office which is almost around the corner?
Once again I was in the room when the testing was being done. He literally did the mini-mental this time. I saw the paper. It might have been the larger version of the test. Or he might just have tried a bunch of alternate questions to get a good test. He did the clock face or rather he didn't do it. Not even the circle this time around. He did the two figure drawing; or at lest he tried. My husband actually got the year right, but nothing else in that area - not the day, season or month.
I asked for the score at the end. He scored 11 which was higher than I expected. I thought we were into single digits.
Okay, being new what's the mini test? Is it the clock drawing and remember 3 things? My hubby had a "base" line test followed by a year test. The test showed "mild cognitive impairment"...and doctor put hubby on Aricept 3 weeks ago. I never got the test scores which I assume there are....clue me in plz...I sometimes feel like I have the disease too because I am so stressed out...thx...lullie
Lullie, Maybe it would be best to tell us what type of doctor diagnosed/examined your husband and what sort of testing did he have? There are a lot of doctors that will diagnose and prescribe dementia, Alzheimer's, mild cognitive impairment, etc. Some of them have the expertise and run the appropriate tests, and some do not. The clock drawing, remember 3 things is part of that testing.
I had my spouse seen by a neurologlist and tested by a psyscholgolist. Between the two they both determined it "mild cognitive"....but my gut feeling is to call the neuro. guy and get a copy of the test and scores and then schedule an apt. to an elder law attorney.....what ya think?
I don't think you need the test result to see the attorney. You can probally set things up the way you want and have him go in for signing. With mild result that may work. We tried a new one about 4 years ago and when we went in to sign the attorney wanted to make sure he knew what he was signing and when DH said he didn't understand about "A Trust" the attorney would not proceed. He said our older Wills were really ok to continue to use. Had I had it to go over I would have picked up the forms and took them to a Notary to be signed. In our case, we are only dealing with me as spouse for 53 years and 3 children. No other people like stepchildren or previous wives, etc.
Welcome to my website. I hope you have had a chance to look at the home page - www.thealzheimerspouse.com. On the left side, there are many, many resources. I would suggest starting with "Newly Diagnosed/New to this website"; scroll through the "previous blogs" for topics that interest you; if your husband is under 65, look at the EOAD (Early Onset) section; there are sections on "finding a memory disorder clinic" in your area; finding "drug trials" in your area; Understanding the Dementia Experience" is an excellent resource.
The message boards are full of spouses who understand each other's struggles, but I would also encourage you to log onto the home page every day for daily news updates, the latest information, and of course, my daily blogs. The blogs have been on hold for a few days, while I enjoy my son and daughter-in-law, who are visiting from California, but new ones will start up again on Tuesday.