Most memory worries never need a full evaluation. But some do, and it helps to know which is which before you spend a year fretting in the wrong direction.
A full evaluation is more than the five-minute screening at a health fair. It is a longer visit, sometimes two, with what felt like a thorough check-in, a physical look-over, lab work, and often a family member asked to describe what they see at home. At the county hospital we called it the whole picture. At the senior centre on Elm Street I call it the same thing.
If the screening at your doctor’s office raised a flag, or if the slips are changing how a day runs — meals missed, bills paid twice, a familiar road gone strange — that is when the fuller look earns its keep. If you simply cannot recall the name of the actor in that film, it can usually wait. I wrote once about what a short screening feels like, and it is a good first step, not a verdict.
The Visit that Takes an Hour
The longer visit has a rhythm to it. History first: when the slips started, what they look like, whether they are getting worse. Then the body: blood pressure, a listen to the heart, blood drawn for the usual culprits like thyroid and B12. Then the thinking part — words to remember, a clock to draw, questions about the date and the place.
Dr. Okafor, the internist I send people to, brings a spouse or an adult child in for part of it. Not because the patient is unreliable. Because memory trouble hides from the person who has it, the way a limp hides from the one walking. The family sees the shape of it.
Two Kinds of Full Workups
In my years at the pharmacy counter and since, I have watched people get evaluated two ways, and both can be done well.
The first is the memory clinic. Everything under one roof: doctor, nurse, sometimes a specialist in testing, sometimes a social worker who helps with what comes after. It is thorough and it is calm. The wait to get in felt like it could run months.
The second is your own doctor doing the workup in pieces, with referrals for the parts they cannot do — the lab work, perhaps a scan, perhaps a session with a testing psychologist. I have seen this done beautifully when the doctor knows the patient and takes the time. The pieces need someone to hold them together, though, and that someone is often you with a folder. If you want a sense of the whole road, how the doctor visits fit together lays it out plainly.
How to keep your memory steadyThe video explains what to do about memory slips after sixty.
What I Told a friend from the walking group
A friend from the walking group, who runs our walking group, asked me last spring which one her sister should choose. I told her: start with the doctor who knows her, and ask that doctor whether a clinic would add anything. A clinic shines when the picture is murky. A good family doctor shines when it is not. Either way, bring somebody, and bring the brown bag of medicines first. A medicine review before any memory label is still my first sermon, and I am not tired of preaching it.
Before you book anything or change a single habit, go watch the full video and see what it lays out first.
What It Cost Us, Give or Take
My husband and I helped a neighbour work out the cost of this two years ago, and my notes are a mess, but here is the honest shape of it.
Your number will differ. Coverage differs. But nobody I know has been able to do the whole thing for the cost of a nice dinner, and nobody should walk in surprised.
The Steps I Actually Follow
When someone asks me how to get from worry to a real answer, this is the order I give them, because it is the order I would use myself.
Write down three recent slips, with dates, on the paper calendar or any scrap. Gather every medicine, prescribed and otherwise, into one bag. Book the longest appointment the office offers and say why. Bring a person who sees you most days. Ask what was ruled out, and ask for it in writing. Give any change six weeks before you judge it.
One more thing about raising it at all: people rehearse the conversation for weeks and then say nothing. Naming the worry out loud to a doctor is easier than the rehearsal, I promise you.
If any of this sounds like your kitchen table right now, pull up a chair and watch the full video walkthrough before you change a thing.
Now go watch it, and then tell me — whose job is it to notice first, the one forgetting or the one watching?