Hi, new here & question about VA hospitals

marti8aApril 20, 2011

My fil is 85 and was diagnosed with Parkinsons about 10 years ago. He was also diagnosed with Alzheimers, then they said he didn't. Then they said he might, and put him on Aricept. Inlaws moved from their home town to our town almost two years ago and a neighbor talked them into taking him to the VA hospital because they were having trouble finding a neurologist here that would take a medicare patient. Fil is always tired, sleeps a lot, has memory problems, and is dizzy a lot which is why they had been seeing a neurologist in their home town.

The VA dr fil was assigned to and saw first took him off Aricept, saying he didn't need it, but mil says she can tell he is much less alert and sleeps more now. They still haven't seen a neurologist there, and every time they go to an appointment they think is with a neurologist, it's with a different kind of doctor. First it was a neuropsychologist, and this time a psychiatrist. One of us usually goes with them because mil gets nervous and can't remember everything that is said.

So this last time, the main doctor said he was going to have both of them see a psychiatrist and social worker on their next visit. Why? Because he said mil refused to do a couple of the things he recommended. She said he never told her to do them. Brother-in-law was at the appointment where he said he told her to do these things, and he says the dr never told her to do them either.

Dh thinks the VA dr is trying to get fil committed and doesn't want them to go back. But one of dh's good friends was over-medicated by this same VA hospital and he died, so dh is admittedly not a fan of the hospital.

Does anyone know why they want to keep having fil go to a psychiatrist instead of a neurologist, and why they want them both to see a social worker?

Any experiences with the VA, pro or con?

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agnespuffin

I'm guessing here, so take everything with a grain of salt.

Your fil is going downhill with both Parkinson's and some sort of dementia. He isn't going to get better.

The doctor seems to be thinking of the entire family when he suggests a social worker and a psychiatrist. The family must accept things as the are. Sooner or later, they may have to think about a Nursing Home situation of some sort. Now is the time to work with a social worker to find the best solution for the situation.

For example, your MIL and the Aricept. This is a controversial type drug. It may do the job for a while, and when it stops working, the change is more noticeable. Of course he is less alert, and sleeps more. That is what is to be expected with his condition. More medicine probably will not help. Your Mil needs to accept this. Perhaps, she is the one that needs the psychiatrist, not your fil.

A neurologist cannot be expected to work miracles with someone in your fil condition. There really isn't much point in seeing one. You know what's wrong. Parkinson's is a dreadful disease. It will get worse. Please accept my synpathies for what your dh is going to have to face. It's going to be rough.

And another thing, so what if he wants to sleep more? That's about all that left for him to do. Let him. It will make the time past more quickly for him.

    Bookmark   April 21, 2011 at 9:59AM
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sushipup1

I'm backing up Agnes on her comments. Parkinson's dementia is a different sort than Alzheimer's and the drug may not be helping.

I'll suggest that both you and your MIL look for a support group to attend. That sort of counseling may be best for you to both understand the disease more as well as give you a safe place to vent all your frustrations and fears.

Have you contacted the VA for family support groups? Or the national Parkinson's group? Locally we have a group that supports caregivers of people with all sorts of dementia or brain injuries.

But I'm not sure that the medical attention you are seeing is that inappropriate. A friend whose husband has PD says that they get a lot of the meds from the psychiatrist, because of the depression, hallucinations and other effects of the disease and side-effects of the main medications.

Here is a link that might be useful: National Parkinson's Disease organization

    Bookmark   April 21, 2011 at 1:24PM
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marie_ndcal

It depends on the VA hospital. The one in Boise ID seems to be great. My brother in law was in it before he passed away with Huntington's Disease. We did go and see him several time and he (and the hospital) were always very clean, room excellent, personal just great This was several years ago.
Friend taken to VA hospital in AZ near Cottonwood, treated so bad, discharged to crappy nursing home in Kingman AZ, lasted only few weeks. Not sure why. Another BIL was in VA hospital in Tuscon and he got good service, but he would not cooperate with either Dr/s or staff etc. Got out and really caused the family problems. Because of staffing cuts, money cuts, many of the VA hospitals are just not as good as they use to be. It is like dealing with a HMO , you take charge, you make the decisions and stand tough.DO NOT let them decide what Dr. There is always someone above and they will do anything to just medicate the person to """make""" the problem and people go away. Yes I have seen this done in some VA hospitals. Who ever goes with FIL, take a notebook, write everything down, names, titles, times, attitude, etc. If necessary record conversations. Has he had a complete medical work?
If not, make sure he does. Just keep pushing. Sorry to be so adamant, but if we do not stand up for the veterans who will.

    Bookmark   April 21, 2011 at 5:46PM
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marie_ndcal

me again. Go to a large VFW hall, or contact your state comander for the VFW and ask for the Service Officer. This is their job to help veterans out. Some are better than others.

    Bookmark   April 21, 2011 at 5:49PM
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agnespuffin

Keep in mind that someone had to graduate in the bottom half of his/her class at Medical School. Some went into private practice and some went to work in VA hospitals. He may have found one that was the absolute last in his class.

Now, years ago, I worked for a group of Neurologists. As I recall, they were primarily for dianostic work ups. I don't think they had any long term patients such as those with some sort of dementia. They may have had, but I don't remember any. After tests, etc. they would give the referring physician the results and reccomendations. Perhaps this doctor feels that a Psychiatrist would be better for medication and treatment than a neurologist.

    Bookmark   April 22, 2011 at 12:44PM
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marti8a

Thank you all. agnespuffin, you made me laugh, maybe they did get the bottom of the class guy.

I found a Parkinson's support group in my town, but they meet at 10am and fil usually isn't functioning until noon, but he can get up and dressed if he has to/wants to. Mil just needs to be convinced it is a good idea before she will try to get him to do it. I will go by myself if nothing else.

Bil has reserved the date for their next VA appointment and will go with them.

    Bookmark   April 23, 2011 at 11:42AM
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sushipup1

Go by yourself, if necessary. Some support groups are better for the caregivers, others for the patient. Not sure that any one group is best for both.

And let us know how it is. You need someone to talk to and this is a good place to start.

    Bookmark   April 23, 2011 at 10:12PM
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marti8a

I spent the afternoon with mil and dh stayed with his dad. Mil was surprisingly interested in going to the support group. It also helped that we were giving her a break from being cooped up with fil all day.

    Bookmark   April 23, 2011 at 10:41PM
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marti8a

Thought I'd update. Fil had a stroke and is now in a nursing home. His dementia has gotten worse and his personality as well. Mil started the process to get him on medicaid, and I'll probably be back with questions about that one of these days. In the meantime, I've been lurking in the background here, reading and learning.

    Bookmark   January 16, 2012 at 10:28PM
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