Which type of specialist (neurologist, psychiatrist, gerontologist or family doctor should a dementia patient see for diagnosis and follow-up)?

3 Tips for Today


  1. Buy whatever kids are selling on card tables in their front yards.
  2. Treat everyone you meet as you want to be treated.
  3. Admit your mistakes.


 Question:  “Which type of specialist (neurologist, psychiatrist, gerontologist or family doctor should a dementia patient see for diagnosis and follow-up)?


Answer:  My suggestion would be (if possible) to do the following:

a.      Have a neurologist specializing in dementia do the initial evaluation, workup and diagnosis.

b.      Have the same neurologist do all the follow-up visits. If this is not possible then the second best option would be to have a good gerontologist for follow-up.

c.      Have an open and understanding psychiatrist in the wing in case the patient develops pyschiatric symptoms such as depression, anxiety, delusions, etc. However, the primary provider may also be willing to do this. I am very fortunate. My particular neurologist is a world reknowned Dr. who is a dementia expert and does ongoing research in the field. He prefers to have a psychiatrist handle any emerging psychiatric symptoms/problems.

d.   An internist or family doctor can best be utilized to follow through with any and all physical/medical problems.


This seems like the patient would need a lot of physicians for his/her care. But I think it provides the best overall care and treatment.


Let’s continue with my story. Yesterday I finished my post discussing my diagnosis of Bell’s Palsy in June 2007. So after 6 weeks of steroids and an antiviral agent, I thought all was well and I returned to work at the hospital. I continued to have intermittent tremors and some trouble concentrating. But I covered the attention span and concentration issues fairly well (so I thought). Others around me commented on how hard I was working and that I was doing a good job. The Doc later told me I had enough cognitive reserve to be able to cover and to compensate so that I appeared and acted normally.


In mid-September 2007, I again drove to work on a Monday morning as usual. I remember moderating a morning meeting at 8:15. At the end of the meeting the last thing I remember was that I asked a question to the participants. “But why aren’t we going over these papers?” Little did I know we already had done that. They rushed me to the local emergency room. For the next few months I remember very little. I have vague dream-like memories of being in several hospitals, getting tests and seeing many Drs. Finally in October 2007, I was diagnosed with Lewy Body Dementia at the University of California San Francisco (UCSF) at the Aging and Memory Center.


Tomorrow………..my reactions and how this new diagnosis altered my life forever.


Dr. David


2 Responses

  1. Hey David! we knitters miss you out here! It is so interesting to me to finally know what happened to you and why you guys were gone so fast! I sat here and just teared up and I wish i could do something to help! I do think this blog will help – even to read back and help yourself remember.
    Lots of love from California (to you and to pam!)

  2. I’m gad you’re blogging! I’m blogging about my experience of caregiving at: http://livingwithlewybody.blogspot.com/ Everybody told me that I needed to make sure to keep time for myself separate from caregiving. I said so far that is easy for me, but what is hard is to find myself in caregiving. I find the blog helps with that. I hope blogging for you can be a way to find yourself even as you lose your old self.

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