Does it make sense to skip an MRI? What are others' experienes?

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Does it make sense to skip an MRI? What are others' experienes?

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My frail FIL 89-yo in AL with various medical problems and very obvious dementia (backed up by 3 cognitive tests in the past 6 months) never had a MRI done. DH flying monkey step brother is insisting we ask doctor for an MRI to confirm diagnosis. We told flying monkey that FIL will not acknowledge he has dementia along with a bunch of other denials and we don’t bring up dementia because it agitates him. I don’t see the point. It’s not going to change anything for FIL treatment-wise. My mom’s doctor never did an MRI for her dementia either. I’m just wondering is this unusual to skip an MRI when they are elderly and frail ? I didn’t think so, but was wondering other people’s experiences.

Alzheimer's & Dementia Diagnostic Criteria Senior Health

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My understanding is that dementia is only able to be diagnosed accurately after death, with an autopsy that shows the plaques. Otherwise it’s diagnosed by behavior. If this is right, an MRI won’t help anyway. Suggest that step-brother is showing signs of mental issues himself, by not acknowledging reality.

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Step-brother and his wife like to swoop in and save the day , brag about it , never listen to anyone else’s suggestions . They always think they are right . The wife gets upset if she either does not get showers of appreciation or dare say gets corrected when she is wrong . She then plays the victim and gets husband to defend her and how her “feelings are hurt when she’s just trying to be helpful “. What is the name for this affliction ?

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I am curious how he will be able to sit still completely for the test. Tell brother that insurance will not cover it because it is not indicated and that it will cost several thousand out of pocket

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Point out to this son that nothing would change with his care if signs of dementia were not seen on the mri.

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Thanks , I did explain that in the email I sent , which I also addressed all the other issues he had concerns about . I also made it clear we will not be taking his advice under consideration anymore . If he tries again, just ignoring him . He hasn’t replied .

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NHWM,
My mother had an MRI as part of an ER-to-Hospital admission.
She didn’t understand before, and immediately after, she forgot. So, I don’t know what she was feeling.

It was during COVID, so we were not allowed to be there in the middle of the night, when it happened.

We also didn’t have any idea that she had a dementia, then. We thought that everything was because she hadn’t been taking her thyroid meds.

When she fell, a year later, and had a CT scan, we insisted that someone be with her during her waking hours. We knew that she couldn’t answer questions well.

My husband went with her that time, since I was just a few weeks out of post op from major surgery. He’s not a good reporter, so he couldn’t tell me how she was feeling then, either 🤪🤪

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Cxmoody,

Oh, gosh

I remember going to the ER so many times with my mom, mainly for falls but sometimes other things too. All of the testing done was always so stressful for mom and us.

My husband was always my calming force. He’s Mr. Chill. I was always glad when he went with me.

You’re not alone in not knowing that your mom had dementia. I know that I missed the early signs of dementia too.

I agree that our moms needed someone to be with them while they were at the hospital.

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That happens sometimes Way... my first post in April 2021 was changed and stuff was deleted

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They also corrected my punctuation in original post .Lol. I am the worst at that . I commit many crimes of grammar as well . I’m much better with numbers ( math) . 🙄😂

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Hey. The title of my question changed !

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Yes, I see that! They removed, “Stupid Question.” So, now our post in the beginning of the thread looks stupid because nobody sees the reference! LOL 😆

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There is a point that the elderly no longer want to be poked and prodded. I would not want to do an MRI why would I put an 89 yr old with Dementia thru it. Does the stepson know u need to keep perfectly still? And, is FIL this step-brothers father?

Does your DH have POA for financial and medical? If so, what SB wants means nothing. Your husband, if has POA, does not have to tell SB anything. His responsibility is to his Dad. Ignore these people. Let FIL live his life the way he wants.

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Thank you agreed . DH is POA. All of the step siblings are not FIL children . It was a second marriage at 60 years old . We were all adults when he and his second wife married .

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First, no such thing as a stupid question.

Wow it sounds like there are a lot of players here. My first suggestion would be to step back a bit from the direct contact and as his sons wife stick to what you are obviously doing well behind the scenes by supporting your husband and lovingly caring for your FIL. I know this doesn’t cut back on the players but maybe it will serve to lead by example for the other spouses.

To get to the crux of your question I agree with you and everyone else that it doesn’t seem necessary but that doesn’t help deal with your flying monkeys. Why not put beliefs aside and present it simply as the doctors decision. If the doctor felt FIL needs an MRI for some reason then do it but since the doctor isn’t ordering it he obviously doesn’t feel it necessary or helpful. First you need a doctors order to get an MRI and have it covered by insurance and while the chances may be good that insisting will get that order asking the doctors reasons for not ordering one will probably get you a better answer. If the FM’s need to hear it from the doctor fine let them choose one representative, son or daughter, to accompany DH and FIL to doctor where those questions can be answered. I would probably set it up though by asking the questions prior to the joint appointment and explaining the reasons for the subsequent appointment. That way the doctor will know to focus heavily on the drawbacks of doing unnecessary testing.

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When DH was on the phone with FM. He told him doctor didn’t see a need for MRI. FM said to ask doctor to order it anyway . This flying monkey thinks he knows everything and never listens to what anyone says . We are not entertaining anymore suggestions or answering the phone anymore. DH and I are done . The only reason DH was as patient as he has been is because FIL insisted on having his income taxes prepared by this flying monkey step son . He’s a CPA and has been doing his taxes each year forever . So DH has been having to deal with the flying monkey over that , gathering all the information for him . I thought this was a mistake but DH was trying not to make waves because FIL absolutely loves these flying monkeys . That’s why I sent the stern email instead of DH . I figure let them be mad at me instead of DH . We hear FIL on the phone with these flying monkeys and he always says he misses them and loves them . DH never gets that type of affection from FIL . .In fact FIL ignored us most of the last 20 years . Next year will have his taxes prepared by someone else. The taxes are complicated. FIL has multiple investments . I believe a lot of this has to do with the fact that FIL has a substantial amount of money , which when FIL passes gets divided equally 5 ways between my DH , his autistic brother who can’t help ( not his fault ) , and the 3 step siblings. FIL made DH and this CPA flying monkey stepson (that gives us the most grief) coexecutors on his will . This flying monkey is also back up POA.

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Not unusual. Ignore the monkey and serenely move on.

One reason that they don't want to give an MRI when it's a moot point - a dementia patient may forget why they're in the machine or what it's doing. It's not a kindness to confuse and upset them. The person who is there with them has to deal with the aftermath of this.

That doesn't help anything.

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They would absolutely need to be sedated in the machine, I'm pretty sure I will be too if I ever need another one🤔

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Important question here...
Who is POA for health? That is the person that makes the final call on this.
If no one..
I would not do an MRI.
In order to do one on someone that may be resistant would result in have to have them medicated to the point where they would be compliant.
That makes them a fall risk. Medications like that also are not great for someone that has cognitive problems to begin with. And it may take a while for the drugs to get out of the system, not just hours but sometimes days.
If the results of an MRI will not change the treatment plan I see no need for it.

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DH has durable POA for health and financials . We have the ducks in a row.

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Way - you don't have to do as step brother suggests - any of it. Nor do you have to justify your own actions to any flying monkey. If the doc doesn't see it as necessary then that is enough.

I wouldn't argue or even discuss the issues they brought up. Maybe just a thank you for or even an acknowledgment of their suggestions and "they are under consideration" and then refuse to discuss them any further. Boundaries!!!!

They are trying to run the show, but in fact you and dh are running the show.
What do they know? When my sis wanted to move mother to a cheaper AL I said go ahead, but I won't help. That stopped her. She had no intention of doing the work herself. They are trying to direct you to do work for them. Don't!

I think that is the issue here, not the MRI. Anything from a flying monkey that causes you more work is suspect of manipulation! Actually anything from a flying monkey is suspect.

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Golden thank you . The same stepbrother , his wife and a step sister were enabling their mother for years. She needed assisted living for years . They tried to hire an aide , she would fire them . My FIL was burnt trying to handle his wife on his own. DH , myself , another step brother and his wife were all in agreement that the situation had to change . We and the steps that agreed with us were then left out of the conversation by the 3 enablers during Covid . FIL was not allowed to talk to DH when he called . The old woman would yell at FIL who would hang up abruptly . Last year the old woman was in and out of rehab a bunch of times . We flew down to Florida to see how FIL was after not seeing for a couple of years . FIL had lost a lot of weight etc . We told the enablers now they both need assisted living , the three of them still said No. The controlling stepbrother had gotten them to move into an independent living apartment about 3 months prior to DH and I flying down . So they were at least getting a good dinner provided and weekly housekeeping. FIL was still driving and clearly should not have been . All four corners of the car dented . Our concerns were dismissed again . Step brother throws up in our face that he had to deal with their stubbornness and he saved the day getting them out of their house. He acts like we didn’t lift a finger , when in fact he left us and his other brother and wife out of the loop during Covid because we didn’t agree with him . I was told they still dress themselves and walk so they don’t need assisted living . He even in front of us told FIL that he’s the boss and don’t let anyone tell you what to do . The old woman died soon after . We took FIL with us . We got pushback from that enabling controlling group because we put FIL in assisted living and FIL still complains how he is independent and doesn’t belong there . Flying monkey step sister is upset at the cost of AL in the North East where we all live as opposed to the much cheaper amount they were paying for independent living in Florida . She is just looking for her share of inheritance . Step brother calls the other night with a laundry list for us after his visit . He had advice and strong opinions about how to handle FIL stubborness about refusing care . My father in law says he’s independent . Step threw up in DH face how he knows how to talk to stubborn FIL because he “ dealt with all that was going on with them during Covid “ . That’s because he left us out of the loop to begin with because we didn’t agree with him . Now step wants us to tell a therapeutic lie to FIL telling him that he lives in independent living . First of all if you tell my FIL he’s independent it will just make him dig his heels in more to refuse help from the aides . Second , he’s not that far gone yet .He knows he’s in assisted living . Telling FIL what he wants to hear isn’t going to make him let the staff shower him . It was such a frustrating phone call . I was only hearing DH side of the conversation . I told DH to hang up . I then sent a stern email to the entire group saying they are out of line and not respecting boundaries and that last year they refused to listen to us that FIL was burnt and needed assisted living as well as the old woman that was in rehab, and they had enabled them for years . I called and blind copied the steps that were in agreement with us so they were aware , because the flying monkeys are going to say we aren’t addressing FIL issues . The supportive step brothers wife sent me a very nice reply . Haven’t heard back from the enablers .

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My mom had an MRI very early on when she was having TIAs but still physically and mentally sharp and we were looking for answers, I see no point in doing it once you reach a point where the information from it wouldn't change anything.

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No question is ever considered stupid. If someone falls an MRI or CT would be beneficial.

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hi way! :)
as others said, MRI isn’t always needed. and like you said, what’s the point?

keep in mind also, that tests like x-rays, MRI, CAT…
aren’t harmless. they do have side-effects, especially if done repeatedly in life (of course sometimes it’s simply necessary). the point is, if it’s not needed, don’t do it.

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If you already have a diagnosis of dementia then it's kind of a moot point unless they need to rule something else out. I wouldn't do the MRI--the behaviors and losses are what matters. My understanding is that to truly determine Alzheimer's it requires an autopsy, but since Alzheimer's follows the stages consistently most providers can give a diagnosis of 'dementia, likely Alzheimer's', without any scans, just the neurocognitive testing.
You're right to just blow off the well meaning advice of the relatives that drop by for a few hours every once in a while. You should ask them to read 'understanding the dementia experience', maybe they'll stop trying to force your FIL to do things he doesn't want to do. It's tough when they don't understand that you don't want to rock the boat with your dementia person.
https://www.smashwords.com/extreader/read/210580/2/understanding-the-dementia-experience/Medium,Arial,Black,White,One-and-a-Half

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It’s not a stupid question! 😊

My mom’s neurologist ordered MRI’s for my mom with Parkinson’s disease. Maybe it is necessary to do with Parkinson’s disease. I’m not sure.

Mom absolutely hated it. She said that the noise sounded like a freight train!

Overall, mom did okay with it. I think everyone has anxiety about having to do an MRI and they are glad when they are over. I am very claustrophobic.

I guess it depends on the individual situation. If there isn’t any point to having an MRI done, since the treatment wouldn’t be any different, why bother with upsetting him?

Your husband’s stepbrother sounds like a busybody who doesn’t think things all the way through.

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Stepbrother thinks he knows everything . His own Mom had , dementia at a younger age. They did MRI because they weren’t sure about Parkinson’s as well , she had big balance problems and shuffled her feet , It was water on her brain . FIL not showing same symptoms . FIL has a trick knee and his legs are weak, muscle atrophy .

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My mother’s MRI was fine.

It didn’t give us a CLUE as to what in the world was wrong with her.

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Was your mom upset about having to have a MRI done?

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No, not a stupid question. There are no stupid questions.

"Similar to CT scans, MRIs can show whether areas of the brain have atrophied (shrunk).
Evidence of shrinkage may support a diagnosis of Alzheimer's or another neurodegenerative dementia but cannot indicate a specific diagnosis".

Above taken from the first internet search I found.

Sounds like Mr Monkey wants MRI *proof* to assist his own thinking process/acceptance.

I get that people vary with their trust in a diagnosis... Many want to see hard evidence.

Personally I would NOT subject my LO to a costly & awkward test without good reason. It would have to be a VERY good reason if a frail person eg the test result offered good BENEFITS to the frail person.

Would it? No.

Behaviour & symptom management will be the same, MRI or not.

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Yup. That’s what I thought .

And yeah I just couldn’t come up with a title for my question . Lol.
Next time I’ll just title it “question “. 😂

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A brain MRI is traumatic for an elder, especially with dementia. It's loud and noisy, claustrophobic and won't empirically prove disease ANYWAY. I'm with you. Avoid it as I did w my dad who had a brain tumor which was inoperable yet docs insisted on an MRI every few months. I said nope and refused to repeat the trauma he went thru originally. Fwiw, my mother died w advanced vascular dementia and her MRI was normal! 😑

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Thank you lealonnie.
Flying monkeys came out to visit FIL last week while DH and I were away . They spent 3 hours with him after not seeing him in nearly a year and left us a laundry list . Mostly based on things that FIL forgot were already done .
They were all smug saying they “ made him sit in the lounge.” They think DH and I should also force FIL to go to activities too . FIL insists he doesn’t belong with the old people . Only comes out of his room to eat. He’s fine in his room with his TV, books , puzzles , tablet . I shot out an email they are not to “ make FIL sit out in the lounge”. The AL is his home and he has the right to refuse activities , refuse to sit in the lounge and stay in his room .

Does it make sense to skip an MRI? What are others' experienes?

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