Medical disclaimer: I am not a doctor or licensed mental health professional. This post is for informational and encouragement purposes only and is based on my personal caregiving experience. If you are experiencing serious symptoms of depression, anxiety, or burnout please consult a qualified healthcare provider.
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The appointment was twelve minutes long. I had been watching my mother for months. Writing things down in my phone. Small things: the repeated questions, the wrong names, the moment she stood in the kitchen and didn’t know what she came for. And when she told me there was no problem, I almost believed her, because she said it with so much certainty.
Twelve minutes. The doctor asked her what year it was and who the president was. She got them right. He said she seemed fine for her age.
We walked out of there and I stood next to the car in the parking lot and I didn’t know what to do with what I knew.
If you have been in a version of that parking lot, this post is for you.
Why these appointments are so hard
Your loved one will often perform better in a doctor’s office than they do at home. The visit is short. The environment is structured. They know, on some level, that this is a test of some kind, and they rise to it.
You, meanwhile, are trying to describe something that happens gradually and in private. Something that does not show up in a twelve-minute cognitive screen.
There is also something painful about talking about someone’s memory in front of them. You are aware of their dignity. You do not want to embarrass them. You do not want to make them feel watched or discussed.
All of this makes it easy to leave an appointment without saying what you actually came to say.
What to do before the appointment
Write it down first
Not a vague summary. Specific incidents with approximate dates. “On March 4th she asked me three times within the same hour what day it was.” “She got lost driving to the pharmacy she has been going to for fifteen years.” “She called me by her sister’s name four times this week. Her sister has been dead for six years.”
Specific and dated. Doctors are trained to respond to documentation. A written list tells them you are not catastrophizing. You are observing. And the difference between those two things matters in that room.
Prepare a one-page summary
Four or five incidents, dated and described. Changes you have noticed over the past six to twelve months. Any family history of dementia or Alzheimer’s. Any medications your loved one is currently taking, including over-the-counter supplements.
Bring two copies: one to hand to the doctor, one to keep for yourself. When you hand something in writing to a doctor at the start of an appointment, the appointment changes. You are no longer depending on a hurried conversation to cover everything. It is all already on the page.
Request time before the appointment starts
Call the office ahead of time. Tell them you have concerns about memory changes and you would like a few minutes to speak with the doctor privately, either at the start or end of the visit. Not every office will accommodate this. Some will. It is always worth asking.
If you cannot get private time, send your written summary directly to the doctor through the patient portal before the appointment, or ask the nurse to pass it along before the exam begins.
What to say in the room
You may feel awkward saying these things out loud while your mother or father is sitting right there. That is normal. Say them anyway.
“I want to share something I’ve been observing at home, and I’ve written it down so I wouldn’t forget anything.”
“I know she seems fine right now, but at home the picture looks different. I’d like to describe what I’ve been seeing.”
“I’m not looking to alarm anyone. I just want to make sure we’re not missing anything early.”
You are not diagnosing your loved one. You are giving the doctor information they cannot get from a twelve-minute office visit. That is your job. You are the one who lives with this. Your observations belong in that conversation.
Ask direct questions
Do not wait for the doctor to offer a referral. Ask for one. “Would it be appropriate to refer her to a neurologist or a memory specialist?” “Is there a more detailed cognitive evaluation she could have?” “What are we watching for between now and the next visit?”
Write the answers down in the room. Or ask if you can record the conversation on your phone. Most doctors will agree to this.
Know the tests that exist
A brief office screen like the Mini-Mental State Exam or the Montreal Cognitive Assessment can catch some issues. But they are not the whole picture. A full neuropsychological evaluation, done by a psychologist who specializes in cognitive testing, is far more detailed. It takes several hours and can identify patterns the office screen will miss.
You can ask for a referral to a geriatric psychiatrist, a geriatrician (a physician who specializes in older adults), or a memory clinic if one is available in your area. You are allowed to advocate for more thorough answers.
“The heart of the discerning acquires knowledge, for the ears of the wise seek it out.” Proverbs 18:15
Advocating for your loved one in a medical setting is not being difficult. It is being faithful to the person God placed in your care. You are not there to make the appointment easy. You are there to make sure your loved one gets what they need. Those are sometimes different things.
If the doctor dismisses your concerns
It happens. More often than it should.
Some doctors will tell you what you observed is normal aging. Some will minimize your concerns because your loved one performed well on the in-office screen. Some will simply not have enough time in the appointment to take it further.
If that happens, you have options. Request a longer appointment specifically to discuss cognitive concerns. Ask to see a different provider in the same practice. Seek a second opinion. Request a referral in writing so there is a record that you asked.
Your concerns are valid even when they are not immediately validated.
When to push harder
Push harder when the changes you are seeing are interfering with daily life. When your loved one can no longer safely manage medications, drive, cook, or handle finances. When the changes are getting worse over weeks or months. When your gut is telling you something is wrong and you have been dismissed more than once.
Early diagnosis matters. It matters for safety. It matters for planning. It matters because there are interventions, supports, and decisions that are easier to make before a crisis forces your hand.
Your job is not to make the appointment comfortable. Your job is to make sure your loved one is seen. Fight for the early conversation, even when it is uncomfortable, even when your loved one pushes back, even when the doctor is behind schedule and the appointment feels too short.
I went back to the doctor. With a written list. With specific dates. With a direct question about a neurological referral.
The appointment was different that time.
It does not always take more than showing up prepared and refusing to leave without answers. You are their advocate. No one else in that room is doing that job.
Have you had a doctor dismiss your concerns about a loved one’s memory? Have you found something that worked?
Leave a comment below or come find us in the Called to Caregiving community on Facebook. We talk about the real stuff.
With love and faith,
Amy
Called to Caregiving
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