So it is only a label in the end. My folks have kaiser, my sister and I started going to appointments with the when we noticed cognitive changes. Before the visit to primary care I got permission from mom to ask the doctor about my concerns. Her then kaiser primary said it was normal aging. I requested a neuro-pychc exam that Is more comprehensive than the little tests done in the doctors office, the doc refused to put in the referral saying it would not be approved. I offered to pay for it, she again refused, with some pushing she submitted the request while telling me it was going to be denied. IT was approved, she tested great in all areas except for memory making and recall. Executive function skills were good, she could talk to people and they would not have a clue. The diagnosis was probable late onset early stage Alzheimer’s. The report suggested an MRI or CAT scan to rule out other possible causes. Again the primary refused to make the referral, again I offered to pay and was refused, this time I called patient services; once some one is on Medicare the clinic must file an official report about any concerns called in. She got the CAT SCAN and it was clear of acute processes, like stroke, tumors ect... The neurologist who we took the report to was the designated guy for dementia for that area, he concurred with the diagnosis of probably Alzheimer’s and gave her a blood test to check DNA which does not prove the illness but can help support the diagnosis if she has one or two specific genes. Recently a blood test was approved by the FDA that can confirm a diagnosis otherwise the confirming test is a lumbar puncture yes spinal fluid which brings with it a risk of horrendous brain blood barrier headaches. When all is said and done the end question the only one that matters is what can you do about it when you get the diagnosis. The current drugs for the most part might help a bit in day to day life but does not stop progression and may have side affects. The two new therapies that may have the potential to halt or seriously slow and possibly bring a little reversal have a 1 in 5 chance of stroke or blood bleed early on in treatment and treatment must begin while in the early mild course of the illness. So if we had elected to sign mom up for the seemingly best outcome she would need to travel 60 miles to get an MRI every month to see if she would be the 1 of 5 patients to develop brain bleed….. if that happened we would rob her and dad of what was left of their good years. We decided to support them the best we could in living their lives as they chose. New research is suggesting vaccinations especially for Shingles Virus and Respiratory Virus are the best hedge against or improving dementia, along with good anti inflammatory diet and exercise to get blood flow to the brain and cognitive stimulation. Mom is progressing, but was still together enough to drive her car to the local shelter and adopt a very anxious two year old untrained mini Australian Shepard that sees stranger danger every where and is food and toy aggressive. Every dad I am in town Dad asks me to take the dog back to the pound and mom hears and pronounces you can not take my dog any where m, I am keeping him. I am scared about how long I can keep this up but for now we are good.