Checklist for Visiting a Neurologist

Caring for an older adult who has Alzheimer’s disease or another form of dementia requires a team approach that includes physicians, social workers, care coordinators and other specialists. It takes a dedicated care team to ensure the health and longevity of affected seniors and to help relieve stress for caregivers.

If your senior loved one has recently been diagnosed, the first step is to decide on a course of treatment. While there is no cure for Alzheimer’s or dementia, there are steps you can take that may help to delay the progression of your family member’s disease. During this time, you will likely work with a variety of medical professionals to coordinate your loved one’s care. It is important to understand the role and function of each of these specialists.

Begin by developing a strong relationship with your senior’s primary care physician. They will act as the care team’s “quarterback,” ultimately responsible for managing medications and therapies, monitoring for any conflicting treatments or side effects, and helping to assemble other specialists.

Another key member of your loved one’s dementia care team will be the neurologist. These specialists are trained in diagnosing, treating and managing disorders of the brain, nervous system and spinal cord. Many neurologists also have specialized training in one area of neurology such as stroke, epilepsy or dementia.

When to See a Neurologist

If your loved one is having problems thinking, remembering or speaking clearly, or is experiencing noticeable personality changes, it’s probably time to seek help from a neurologist. 

A neurologist specializes in diagnosing and treating disorders that affect the brain, spinal cord and nerves. They are trained to detect the signs of dementia, which may include: 

• Memory problems, including an inability to recognize familiar people or recall recent events
• Increased confusion and disorientation
• Reduced concentration or attention span
• Personality and behavior changes
• Depression, apathy or a withdrawal from favorite activities
• Difficulty performing familiar tasks or solving problems
• Poor judgment or decision-making
• Difficulty communicating or finding words

Finding a Neurologist Specializing in Dementia 

Your loved one’s primary care physician may be able to refer you to a high-quality dementia neurologist he or she has worked with in the past. You can also locate a dementia specialist with the help of your local Alzheimer’s Association or through the American Academy of Neurology’s online database. Before making an appointment, make sure the neurologist is covered by your loved one’s health insurance.

In addition to finding a physician considered to be an expert in dementia, it is also important that the physician you work with is someone you and your loved one feel comfortable around. You and your loved one should feel respected and free to ask questions. You may want to consider interviewing a neurologist to see if he or she is a good fit for your family before making an appointment. 

Preparing for a Neurologist Appointment 

Your loved one will get the best care possible if you prepare for your appointment ahead of time. The American Academy of Neurology (AAN) recommends caregivers of people with known or suspected dementia do the following before visiting a neurologist:

• Write down all the questions you would like to ask, like the ones listed in the section below. List your most important questions first.  It may be helpful to carry a small notebook or download a smartphone app that will include all your loved one’s pertinent care information in one place.
• Make a list of all medications – including prescription, over-the-counter and supplements – your loved one takes and their dosages.
• Bring along his or her medical history and other paperwork including diagnostic test and lab results, as well as imaging scans like X-rays and MRIs.
• Bring a list of your loved one’s other physicians who should have access to their neurology records.
• Ask the neurologist if there are any forms you can complete prior to your visit so you can focus, as much as possible, on keeping your loved one calm and stress-free for the appointment. 

What Does a Neurologist Do on Your First Visit?

It can take a week or several months to secure an appointment with an expert dementia neurologist. When it comes time for your senior loved one to visit the neurologist for the first time, what can you expect? 

Office visits average around 30 to 45 minutes, so ensure your loved one has had plenty of rest prior to the appointment.

The neurologist may conduct a variety of evaluations for dementia and other neurological conditions. They typically include:

• A mental status exam, which tests your loved one’s abilities to recall current events and perform routine activities
• A cranial nerve evaluation, which may include an eye test and an evaluation of their hearing and sense of smell
• A motor system exam to assess muscle tone and strength
• A sensory system exam, which tests their sensory response to things like temperature, pain and pressure
• A deep tendon exam, which measures reflex activity and assesses how tendons move
• A gait and coordination evaluation to test balance and walking abilities

Your loved one’s neurologist may also order diagnostic tests, such as a CT scan or MRI, along with blood and urine tests.

Questions to Ask a Neurologist About Dementia

It is important to work closely with the neurologist and other members of your loved one’s care team to make the best treatment and lifestyle decisions. Asking the right questions ensures you will understand your loved one’s diagnosis, all available treatment options and the benefits and risks of each, and what to expect as the condition progresses. 

Here are some questions you may want to ask a neurologist at your loved one’s first appointment, or first few appointments:

• What tests will you be performing, what do they involve and what will they tell you about my loved one’s condition?
• How soon can you share the results of these tests?
• How did you arrive at your diagnosis of dementia, and is there any possibility these symptoms could be triggered by a reversible cause?
• What type and stage of dementia is this, and how quickly does it usually progress?
• What treatment options are available for my loved one’s Alzheimer’s disease or other form of dementia? Are there any clinical trials available?
• Which treatment option(s) do you believe best fit our situation? Are there non-drug approaches that could be helpful?
• How will you determine if a treatment is effective, and how soon will you be able to evaluate the treatment’s effectiveness?
• What side effects are possible with this treatment, and how can we monitor those potential effects at home?
• When should we call you about potential treatment side effects or an apparent worsening of dementia symptoms?
• Is one treatment option more likely than another to interfere with medications for my loved one’s other conditions?
• What are the concerns with stopping one treatment and beginning another?
• At what stage of the disease would you consider it appropriate to stop using the drug?
• Is it safe for my loved one to continue to live at home/work/perform everyday activities?
• What resources can help us manage this condition?

What to Do After the Neurologist Visit

Review all information you receive from the neurologist’s office. If you can’t remember or don’t understand something you were told at the appointment, contact the neurologist to ensure you have a clear understanding of your loved one’s diagnosis and the recommended next steps. 

Depending on your loved one’s stage of dementia or Alzheimer’s disease, you may need to begin to plan for expected changes. Exploring local senior care options such as in-home care or Memory Care in an assisted living community may help you create a plan that will support their unique needs now and into the future.