MMSE and 'Translations'

Tom Thumb

Registered User
Mar 22, 2014
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0
I believe my Mum has dementia. She's 92, doesn't live with me. She has a number of conditions including DVT, Macular.

There were various symptoms of dementia, but I hadn't realised until last year. I eventually got her to the doctor for a MMSE last year - but regrettably I wasn't there (as I was ill myself). The GP supposedly didn't think she had dementia, 'because she can do translations'.

The carer would have family letters, then start to translate them from one language to another. Method: get the letters on the computer, sit together, carer reads, and they translate verbally. Mum is very good at this, I've witnessed it ... but as far as I'm concerned this doesn't mean she hasn't got dementia. I believe this skill is a familiar task which she can do, whether she has dementia or not, having lived abroad as a child and teenager in that original language country - and spoken the language often later.

My concern with all this, is the risk that Mum is enduring, and the lack of diagnosis, so she can't be properly supported.

What do you think about the 'translations' and dementia?
 

Moonflower

Registered User
Mar 28, 2012
773
0
Just one quick point - are you sure that the doctor really said that she didn't have dementia?

My mum had a MMSE with her GP many years ago, and told us she sailed through it. We were all surprised because her dementia was very evident, but put it down to the fact she had been a primary school teacher so some of the exercises were tasks she had repeated so often in the past. Based on her "passing" the MMSE we were all set to rely on this to demonstrate she had capacity to agree to a POA

Then we saw the letter - confirming that mum had refused further investigations despite significant memory problems.
 

Tom Thumb

Registered User
Mar 22, 2014
7
0
Just one quick point - are you sure that the doctor really said that she didn't have dementia?

My mum had a MMSE with her GP many years ago, and told us she sailed through it. We were all surprised because her dementia was very evident, but put it down to the fact she had been a primary school teacher so some of the exercises were tasks she had repeated so often in the past. Based on her "passing" the MMSE we were all set to rely on this to demonstrate she had capacity to agree to a POA

Then we saw the letter - confirming that mum had refused further investigations despite significant memory problems.

Thanks Moonflower. Evidently the GP did say that, and sent her away to swat up on relatives names (as she was beginning to forget them). There were other things that were wrong with the way the MMSE was conducted - but as I say I wasn't present, even though I had worked hard to get her there. Yes, I can see similarities with your Mum's familiar exercises.
 

Delphie

Registered User
Dec 14, 2011
1,268
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Thanks Moonflower. Evidently the GP did say that, and sent her away to swat up on relatives names (as she was beginning to forget them). There were other things that were wrong with the way the MMSE was conducted - but as I say I wasn't present, even though I had worked hard to get her there. Yes, I can see similarities with your Mum's familiar exercises.

I hope this won't offend, but I really wouldn't take your mum's word for what happened.

It's not impossible that your mum fooled her GP into believing everything in her world is fine apart from some age related memory loss - my mum could talk a good game too - but I don't think most doctors would be so unconcerned because of one particular skill. Having said that, one visiting consultant questioned my mum's Alzheimer's diagnosis because she was able to recite a poem.

The GP may well have said well done on the translating but let's run some more tests.

If you're still worried, take her along for a 'flu jab' (or something else you might get away with, like a well woman check up) for you both and see if you can get a better feel for the situation.
 

Tom Thumb

Registered User
Mar 22, 2014
7
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I hope this won't offend, but I really wouldn't take your mum's word for what happened.

It's not impossible that your mum fooled her GP into believing everything in her world is fine apart from some age related memory loss - my mum could talk a good game too - but I don't think most doctors would be so unconcerned because of one particular skill. Having said that, one visiting consultant questioned my mum's Alzheimer's diagnosis because she was able to recite a poem.

The GP may well have said well done on the translating but let's run some more tests.

If you're still worried, take her along for a 'flu jab' (or something else you might get away with, like a well woman check up) for you both and see if you can get a better feel for the situation.

Thanks Delphie. It's not my Mum's word that I'm taking - it's another family member who was present. It was so frustrating not being able to be there (I was in hospital) so I couldn't see what happened there.

Very interesting to hear about your Mum reciting a poem. I visited a woman of 93 via Age UK's Visiting Service. The brief was to read her poetry - just that. I was told in advance that she was a bit forgetful. Boy was she forgetful! There was the classic day thing - I visited on Tuesdays. She said 'is it Friday?' NO. Saturday? NO. Will you visit on Wednesday? NO etc. If I left the room, she thought I had gone altogether! She was a wonderful person, really lovely. I read all sorts of poems to her, and I played her the piano too (which luckily was in the room). We both had such a good time. And she had a remarkable talent for reciting poems she'd learnt 80/85 years before. You just had to say the first couple of words ... and she was off! Often long poems, word perfect. She had one huge long favourite poem. I read it to her often, or she recited it. On one occasion I had read it all, then about 10 minutes later, she said 'Is - (then the name of the poem) - there? !!!

No, in my Mum's case the doctor didn't suggest any further tests. He said it doesn't need to go further. Actually this was last year, right now I've got her in for another MMSE, and hopefully a brain scan this time.
 

Delphie

Registered User
Dec 14, 2011
1,268
0
It's amazing what the brain retains. Poems, music... My mum can still sing many songs she learned in childhood, yet can't recognize her beloved grandsons.

As far as your mum, good luck for the next appointment and obviously if you can make it too then that's great.

Just one more thing. I saw my mum's GP a few days before her appointment and had my say as far as all the things I could see were going wrong. It was very much a one way conversation due to confidently but it prepped the next step. The GP was very helpful later in casually suggesting to my mum that my details should go on her file so that they could chat to me if they needed to. This immediately enabled me to be included in everything which was massively helpful.

Anyway, good luck. Let us know how you get on.
 

Tom Thumb

Registered User
Mar 22, 2014
7
0
It's amazing what the brain retains. Poems, music... My mum can still sing many songs she learned in childhood, yet can't recognize her beloved grandsons.

As far as your mum, good luck for the next appointment and obviously if you can make it too then that's great.

Just one more thing. I saw my mum's GP a few days before her appointment and had my say as far as all the things I could see were going wrong. It was very much a one way conversation due to confidently but it prepped the next step. The GP was very helpful later in casually suggesting to my mum that my details should go on her file so that they could chat to me if they needed to. This immediately enabled me to be included in everything which was massively helpful.

Anyway, good luck. Let us know how you get on.

Thanks again Delphie - good advice. In my Mum's case I emailed the GP when it came to a head while she was on a week's holiday with me, just recently. And then - even worse, I heard that she may have had a mini-stroke (tia - trans ischaemic attack) a couple of weeks ago (I only heard about it a few days ago). That has to be notified to the doctor as it's so serious (and further tia's can happen, or a full stroke), so I wrote again about this possibility with a timeline since that date. The doctor has enough info now!
 

Tom Thumb

Registered User
Mar 22, 2014
7
0
MMSE was set for next Monday, and I was going the day before, to go with Mum and the carer. This morning Mum phoned to say she had cancelled the doctor's appointment as 'she doesn't feel she needs it'. Help! I've said to her that is a big mistake but it's just not possible to reason with her - particularly if it turns out she really does have dementia.

This is hell. It's like slipping down that slippery snake back to square one. Two years down the drain trying to get her to be diagnosed. Everything points to her having it, but of course I don't mind if she hasn't. All I want is her to be diagnosed.
 

canary

Registered User
Feb 25, 2014
25,018
0
South coast
Mum kept cancelling hers too. Can you phone them up yourself, explain and re-instate it? Then just turn up to your mums on the day and say, oh you have an appointment today, and take her.
 

Tom Thumb

Registered User
Mar 22, 2014
7
0
Mum kept cancelling hers too. Can you phone them up yourself, explain and re-instate it? Then just turn up to your mums on the day and say, oh you have an appointment today, and take her.

Nice try Canary, but it won't work. Mum is saying that the thought of going for the appointment is what's making her ill. It's completely illogical, but that's the way she sees it - forgetting all the troubles leading there. Her carer/family relative is obstructive. If it was left to me, she would have had decent tests by now.

I only hope the brain scan that was supposed to be in-hand is still going ahead, but that will probably be met with the same fate. Thanks again for your comment.
 

BR_ANA

Registered User
Jun 27, 2012
1,080
0
Brazil
About her career/family. Explain that there are some reversibles dementias. That there are no reason for postponing a diagnosis. That it may be healed (or not), but a full diagnosis is necessary.
 

Tom Thumb

Registered User
Mar 22, 2014
7
0
About her career/family. Explain that there are some reversibles dementias. That there are no reason for postponing a diagnosis. That it may be healed (or not), but a full diagnosis is necessary.

Thanks BR_ANA. I hadn't heard of reversible dementias before. I understand these form a small percentage. I'll keep on trying to get a diagnosis.
 

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