Sometimes the lack of understanding of dementia astounds me. I have been trying to get my dad to have a repeat blood test (which he needs due to the side effects of an antipsychotic) since February but he just refuses to leave the care home (time in a psychiatric hospital has left him quite institutionalised). We have had so many ‘no shows’ and I feel like we are messing the GP surgery about. A family member is a qualified nurse in the community and is cleared to take blood samples. We asked the Drs if they would be ok with them doing it (the carehome, nursing team at the surgery, and I was ok with this) and the Dr said it would be unethical and wouldn’t allow it. So we said he needed a nurse to go to the care home to take his blood, but the GP surgery has said that it won’t do that as he isn’t house bound, proven by the fact that he has attended appointments previously. He may not be housebound physically but he certainly is mentally at the moment.
Apologies but I need a rant about the GP surgery.
- Thread starter Yorkshire-lass
- Start date
might need to fight for housebound. he only needs a person trained in taking blood which is not necessarily a nurse but a lobotomist. im housebound and had to fight for that through chronic pain. they all come to me. i have my blood test at home. the doctor just needs to refer him. i tend to refuse to attend anything due to the pain so they cant say that i attended including vaccines etc.
I think part of the issue is that the care home is for complex needs and behaviours of concern and the staff at the GP surgery just aren’t prepared to go.
I’ll get in contact with his care coordinator after the bank holiday and see what he suggests.
Has your Dad moved into a care home away from the GP’s surgery? In which case try to register him with the one the care home use.
Who is prescribing the particular medication that needs a blood test?
Is it primary care, GP, or secondary care, hospital? Are there any shared care guidelines for the medication stating who has responsibility for any blood tests?
Your plan, to ask the care coordinator, is very sensible and I hope it all sorts.
Have a good weekend.
Who is prescribing the particular medication that needs a blood test?
Is it primary care, GP, or secondary care, hospital? Are there any shared care guidelines for the medication stating who has responsibility for any blood tests?
Your plan, to ask the care coordinator, is very sensible and I hope it all sorts.
Have a good weekend.
He’s moved into a care home and he’s registered at the GP around the corner from there.
The GP asked for repeat blood tests as a protein in his blood is too high likely caused by risperidone which was prescribed when he was sectioned in a psychiatric hospital.
I think your best chance of getting this sorted is to state clearly that your Dad is unable to leave the care home and so needs the blood to be taken by a district nurse or nurse assistant who comes to the care home. We’re very much trained not to work with family members.
How about writing direct to the particular GP who said the blood tests were necessary (ie addressing it to the GP him/herself by name, rather than just to the surgery), along the lines of “Dear Dr Bloggs, you told us on (date) that you needed a further blood sample to be obtained from Mr X as soon as possible because the protein in his blood had been too high. Because of his mental health issues, Mr X is reluctant to leave (name of his care home) to travel to the surgery to have blood taken. (Names of staff) at your surgery have told me that nobody from the surgery will attend Mr X at (care home) to take the blood sample. Please could you therefore let me know how you intend to proceed?”
Great idea from Phill - it would at least get into your father’s notes.
Must admit I’d be more blunt in my wording. Rather than ‘reluctant’ I’d say ‘unable to leave the care home due to his dementia’. Give the surgery no wiggle room to think that he’s deciding not to, can’t be bothered or is just being stubborn. The dementia means he can’t get to the surgery, so they have to take that on board and decide how to handle it.
Bear in mind that dementia is a physical disease, and whilst the symptoms sometimes exhibit as a range of mental health problems, the root is very firmly the dementia. I wouldn’t muddy the waters by mentioning ‘mental health’.
Also, they must have an established protocol for dementia patients. Your father will by no means be the first they’ve dealt with. Maybe augment Phill’s final sentence to something like ‘Please advise on your surgery’s protocol for this situation in housebound dementia patients, and let me know how you intend to proceed’. That stops them thinking they can act like this is an unusual situation.
I know GPs and nursing staff are very busy and working under near impossible conditions, but they can’t just abandon patients who can’t get to them for perfectly legitimate reasons.
All the best to you,
Must admit I’d be more blunt in my wording. Rather than ‘reluctant’ I’d say ‘unable to leave the care home due to his dementia’. Give the surgery no wiggle room to think that he’s deciding not to, can’t be bothered or is just being stubborn. The dementia means he can’t get to the surgery, so they have to take that on board and decide how to handle it.
Bear in mind that dementia is a physical disease, and whilst the symptoms sometimes exhibit as a range of mental health problems, the root is very firmly the dementia. I wouldn’t muddy the waters by mentioning ‘mental health’.
Also, they must have an established protocol for dementia patients. Your father will by no means be the first they’ve dealt with. Maybe augment Phill’s final sentence to something like ‘Please advise on your surgery’s protocol for this situation in housebound dementia patients, and let me know how you intend to proceed’. That stops them thinking they can act like this is an unusual situation.
I know GPs and nursing staff are very busy and working under near impossible conditions, but they can’t just abandon patients who can’t get to them for perfectly legitimate reasons.
All the best to you,
This advice is spot on! I was asked to take mum for blood tests and I emotionally did not have the energy at the time. So I just said ‘she is unable to leave the house without assistance and we are unable to do this, please refer her to community service for blood testing’.
Our GP was good but housebound does mean without assistance so you have every right to request this. I’m assuming your father does not have capacity to take himself alone - now that would make bad press for GP a surgery ‘ failing surgery asks dementia patient to take themself from care home to surgery’!
Our GP was good but housebound does mean without assistance so you have every right to request this. I’m assuming your father does not have capacity to take himself alone - now that would make bad press for GP a surgery ‘ failing surgery asks dementia patient to take themself from care home to surgery’!
That you all so much for your replies, I’m going to speak to the surgery on Tuesday and see where I can go from there.
My dad certainly can’t make it to his Drs alone and I hadn’t thought of going down that route.
The times he has made it to the surgery for blood tests is when I have been able to go with him, and I can’t always make the appointments.
You’ve been really helpful.
My dad certainly can’t make it to his Drs alone and I hadn’t thought of going down that route.
The times he has made it to the surgery for blood tests is when I have been able to go with him, and I can’t always make the appointments.
You’ve been really helpful.
