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Questions for a first memory evaluation

For the appointment where someone finally gets assessed, and where the person being assessed will very likely say she is fine.

This appointment is usually short and you will be told a lot at once. The single most useful thing you can do is decide, before you walk in, what you want to leave with. Not a diagnosis necessarily, but a named list of what is being ruled out, a plan for results, and a phone number that works after hours.

One thing worth knowing in advance: memory trouble has causes that are treatable and causes that are not, and the treatable ones get missed. Thyroid problems, a B12 deficiency, sleep apnea, depression, and several very common medications can all look like early dementia. A good evaluation goes looking for those. You are allowed to ask whether it did.

What to bring

  • Every medication she takes, including things bought over the counter, sleep aids, and supplements. Photograph the bottles rather than trusting a list.
  • A short written timeline of what you have noticed, with rough dates. Two or three specific incidents beat a general impression.
  • The name of anyone else who has noticed something, and what they saw.
  • Her glasses and her hearing aids. Cognitive tests punish people who cannot see or hear the question.
  • A second person if you can manage it, so one of you can listen while the other writes.

What are you ruling out today, and what would each one mean?

This is the question that separates a real evaluation from a shrug. It should produce a list of named possibilities, including the reversible ones.

A bad answer sounds like: "Let's just see how she does over time," with nothing named and nothing tested.

Which of her current medications could be making this worse?

Anticholinergics, benzodiazepines, sleep aids, and some bladder and allergy medicines can blunt memory in older adults. This is the most common fixable cause and it is easy to skip past.

A bad answer sounds like: A quick "no" without anyone having looked at the actual list you brought.

What tests are you ordering, when will results come back, and who calls me?

Results that nobody is responsible for delivering can sit for weeks. Naming the person and the date is what makes it happen.

A bad answer sounds like: "They'll be in the portal." Ask who calls if something is abnormal.

Will you write the diagnosis down for me, in the words you would use to another doctor?

You will not remember it. You will be holding a lot in that room, and the exact term matters later for benefits, for other doctors, and for what you can look up without frightening yourself.

A bad answer sounds like: "It's all in the chart." You need it in your hand before you leave.

She tells everyone she is fine. How do I tell you what I actually see without contradicting her in front of her?

This is the hardest part of the appointment and almost nobody warns you about it. Most practices will take a written note in advance or speak with you separately. Asking makes it possible to be honest without humiliating her.

Who do I call when something changes at nine at night on a Sunday?

Things change outside office hours. Knowing whether that means the on-call line, the emergency room, or waiting until Monday is the difference between a night you spend worrying and a night you spend sleeping.

A bad answer sounds like: "Call the office." Ask what happens when the office is closed.

What should I expect over the next six months, and what would make you want to see her sooner?

Gives you a threshold instead of a constant low-level fear that you are missing something.

Is she still safe to drive, and who is going to tell her?

Most families put this one off, for understandable reasons. A clinician saying it carries weight that you saying it does not, and it spares your relationship a conversation you would otherwise be having alone.

What happens next, who schedules it, and what do I do if nobody calls?

Referrals fall through. Knowing whose job it was, and by when, is what lets you follow up without guessing.

If you get nothing else written down, get the diagnosis in writing and the after-hours number. Everything else can be asked again.

One more thing worth doing on the way out: ask the front desk for a copy of the visit summary before you leave the building. It is much harder to get afterwards.

And if you get through the door with none of this asked, that is a normal appointment, not a failure. You were the one who got her there. Take what you can use next time.

Keep all of this in one placeOther appointments

These are questions to take with you, not medical advice, and nothing here is specific to your situation. Written by a family caregiver from time spent in these rooms. If something here does not fit your appointment, skip it.