What would you say if you found out that your doctor completely skipped a recommended part of your annual wellness visit? If you’re over 65, there’s a pretty good chance that she did. And chances are, you didn’t even notice, much less say anything about it. You got your weight checked, your urine tested, your blood drawn. Your blood pressure was taken, and you were poked and prodded as usual; you were asked about your diet and drinking. But it’s likely that you weren’t given a cognitive screening, even though it is a recommended part of your annual Medicare wellness visit. What is cognitive screening, and who needs it?
There are many instruments suitable for cognitive screening at a medical appointment. They are designed to identify individuals who may need further evaluation for dementia. Screening tools can offer greater objectivity than simply reports and observation of the patient. Alzheimer’s and other forms of dementia may not be recognizable in early stages, but a brief screening can tell medical staff if a deeper look is called for. Most screenings take around five minutes and can be administered by a physician or other care provider. If a screening suggests that further evaluation for dementia is called for, it can be arranged.
Of course, if someone is concerned that they are experiencing memory loss or early symptoms of dementia, there is no need to wait until age 65 to be screened. They should mention it to their doctor as soon as they have a concern.
Why aren’t doctors performing the recommended cognitive screening? It’s not because they don’t recognize its importance. Most doctors acknowledge the importance of cognitive screening in individuals over the age of 65, but fewer than half say that such screenings are a part of their standard protocol.
A communication disconnect may be the reason for this. Doctors frequently wait for patients or their families to report memory issues or ask for a cognitive screening. Patients, in turn, expect their doctors to bring up the subject of screening: over 90% of seniors surveyed thought their doctors would introduce the topic of screening at the appropriate time. After all, doctors tell their patients when it’s time to have their cholesterol or blood sugar tested; patients may expect them to take the lead on this issue as well.
There may be another reason patients don’t ask for cognitive screenings: they may fear the outcome. After all, no one wants to receive a diagnosis of dementia, or even mild cognitive decline, an early stage of dementia. A senior may be experiencing symptoms, like forgetting familiar names, that could be a sign of dementia, or not. If no one else notices or comments on these symptoms, it’s easier to ignore the possibility that they represent developing dementia. This denial, though comforting, may keep the senior from getting needed help.
Yes, your doctor should be offering you cognitive screening, but if she doesn’t, you should raise the issue yourself—even if you’re not experiencing memory loss or other symptoms of cognitive decline. Why? Although there is no cure for Alzheimer’s or other forms of dementia, early screening may be able to help you treat and slow the progression of dementia.
Researchers are becoming increasingly aware that dementia doesn’t appear suddenly. Instead, what most of us think of as dementia is preceded by years, or even decades, of a so-called “vulnerable state.”
Researchers are becoming increasingly aware that dementia doesn’t appear suddenly. Instead, what most of us think of as dementia is preceded by years, or even decades, of a so-called “vulnerable state.” Early diagnosis offers a number of benefits, including, potentially, the ability to take part in groundbreaking clinical trials.
Early evaluation also gives seniors the chance to get their business in order, in anticipation of a day when they may need help managing their finances or medical decisions. It is much easier for a senior to grant a trusted loved one a power of attorney while they are still competent to do so than for family members to have to try to seek a guardianship later, when the senior is desperately in need of help. An elder law attorney can help you plan ahead.
Of course, the downside of early screening is that patients may have to live for many years with the knowledge that they are sliding slowly into dementia. As painful as this knowledge may be, however, it carries a gift: the opportunity to focus on loved ones and cherish the time with them. Another gift is the opportunity to seek and receive support for a condition that affects so many. You may not be able to avoid being diagnosed with dementia, but you can avoid dealing with it alone.
If you or a loved one is concerned about Alzheimer’s or dementia, we invite you to contact our law office to schedule a consultation.