GP Reviews

[BuspassBill]

My OH recently had an annual review with the surgery carried out by a Paramedic. I take random BP readings at home and took these with me. So, the BP wasn’t taken instead mine was added to the screen, no medication review, no discussion to include me. So, as far as the surgery are concerned everything is fine and my OH said the only noticeable problem is that the mobile phone is a bit tricky! I nearly fell off the chair! Angry outbursts, extreme anxiety some days, repetitive questions, worsening memory, reduced mobility, falls, to mention a few. My input wasn’t required, the appointment was just for my OH. What about me? Whatever happened to the holistic approach? No offer of a Carers consultation, I feel I’m being completely overlooked and my input is of no interest, it was simply a tick box exercise to earn funds for the surgery. Anyone else feel the same?

 

[Blissy]

My husband was called for an annual dementia review but it was the GP. He did do BP and med review but a lot of other information was already on the records having been done when we saw a social prescriber so that was just transferred to the template. I did do most of the talking as my husband couldn't answer the questions. I had thought it was going to be a review of how my husband was day to day and how dementia was progressing and to see what help we might receive. No, all I got was another set of questions related to him to take away and complete about what he is capable of day to day and his likes and dislikes. The boxes in which you wrote the answers held about 25-30 words at most and considering the answers were supposed to help someone who might have to step in as an emergency if anything happened to me as carer, it indicated how little the professionals know of how complex our days can be and how quickly things can change. As you say another box ticked. I did work for a GP surgery so I do know that they get these things to do but to my mind some of them are just a waste of time and money. They get filed away and are of no use to anyone.

 

[BuspassBill]

I’m sad to hear the same is for you. We didn’t get any paperwork, just advised to get a stick to help with the falls.

 

[SherwoodSue]

What’s a dementia review?

Seriously this seems to be unique to folks with Alzheimer’s with a focus mostly about prescriptions and adjustments to dosage etc

No specific meds for Vascular Dementia so no reviews

Or is it just us ?

 

[jennifer1967]

my husband was called for annual review for chronic illnesses. he had one last year where my daughter went with him. he has copd, diabetes and vascular dementia. this year, ive had a survey to answer on my phone for me to ask him for his copd. that is it. should have blood test for diabetes. not had one yet. the dementia is not really mentioned and like by the way...... yes no meds for vasc. dementia so no reviews,
i cant go out so trying to explain one of the kids will go with him and for the meds review will be with me so just phone, they cant cope with not the normal.

 

[BuspassBill]

What’s a dementia review?

Seriously this seems to be unique to folks with Alzheimer’s with a focus mostly about prescriptions and adjustments to dosage etc

No specific meds for Vascular Dementia so no reviews

Or is it just us ?

My OH has vascular dementia but has medication for anxiety and blood pressure, the review was inadequate for us but ticked lots of their boxes!

 

[Sue741215]

My OH was recently called in for an Alzheimers review but this was the first time in 5 years. He has visited the GP practice for other medical issues and I have to say they have been very thorough in dealing with the issues I have raised. The review was carried out by someone brought in to carry out these reviews and while it was obviously a checklist that he had to go through I mentioned 2 minor medical issues and he arranged quick follow up - my oh was called for a hospital skin clinic appointment a couple of days later to check a suspect mole and a physio appt for a knee problem within a week so I can't complain. I was listened to - he didn't have much choice as my oh doesn't really understand the questions but I was also asked if I was getting support and I said I was getting family support - presumably he would have referred me if I'd said I needed it. I think the main problem is there isn't anything they (or anyone?)can do other than give us the available medication and deal with other illnesses. They should , of course listen to carers, but I guess it is difficult for them not to communicate with the patient when the patient appears to be clear about their situation they have to take it at face value. I do feel that GP organised reviews are important as they are the only opportunity to check on Dementia patients who may not otherwise interact with anyone particularly those who do not have family carers. I sometimes wonder what situation my oh would be in if he lived on his own without friends or family and it doesn't bear thinking about.

I do feel that the surgery is doing its best for those with dementia and hope that this is part of improving recognition of dementia including the situation of carers. I am sorry that others are having bad experiences with their GP reviews particularly those carers who are unable to make themselves heard - it must be extremely frustrating. When my oh was more vocal and insisted nothing was wrong I wrote the GP a note and asked the receptionist to pass it to the doctor which worked well - I always feel it is hareder for people to ignore things that are written down!

 

[jennifer1967]

i wish they had a difference system as im housebound so cant go with him, one of the kids usually go with him. as the sole carer i dont actually take any part in this but its me that does all his care, tablets so im best place to be an expert for him and any changes they might need to do.

 

[BuspassBill]

My OH was recently called in for an Alzheimers review but this was the first time in 5 years. He has visited the GP practice for other medical issues and I have to say they have been very thorough in dealing with the issues I have raised. The review was carried out by someone brought in to carry out these reviews and while it was obviously a checklist that he had to go through I mentioned 2 minor medical issues and he arranged quick follow up - my oh was called for a hospital skin clinic appointment a couple of days later to check a suspect mole and a physio appt for a knee problem within a week so I can't complain. I was listened to - he didn't have much choice as my oh doesn't really understand the questions but I was also asked if I was getting support and I said I was getting family support - presumably he would have referred me if I'd said I needed it. I think the main problem is there isn't anything they (or anyone?)can do other than give us the available medication and deal with other illnesses. They should , of course listen to carers, but I guess it is difficult for them not to communicate with the patient when the patient appears to be clear about their situation they have to take it at face value. I do feel that GP organised reviews are important as they are the only opportunity to check on Dementia patients who may not otherwise interact with anyone particularly those who do not have family carers. I sometimes wonder what situation my oh would be in if he lived on his own without friends or family and it doesn't bear thinking about.

I do feel that the surgery is doing its best for those with dementia and hope that this is part of improving recognition of dementia including the situation of carers. I am sorry that others are having bad experiences with their GP reviews particularly those carers who are unable to make themselves heard - it must be extremely frustrating. When my oh was more vocal and insisted nothing was wrong I wrote the GP a note and asked the receptionist to pass it to the doctor which worked well - I always feel it is hareder for people to ignore things that are written down!

I’m so pleased to hear that you’re surgery are supporting you both. I take your point about writing to the GP, really good advice, thank you

 

[Rishile]

I have certainly had my share of tick-box exercises. A woman from the Mental Health team visited us for about 2-3 months following my husband's discharge from the dementia unit. She would spend 30 minutes with us mostly talking about her dogs, the weather, walks along the beach etc. On one occasion she asked my husband if he was sleeping alright. He said he was having great night's sleep. I sat there shaking my head and mouthing 'no'. She said 'oh, that's great - I'll see you in three weeks time then'.

 

[Lawson58]

My husband was called for an annual dementia review but it was the GP. He did do BP and med review but a lot of other information was already on the records having been done when we saw a social prescriber so that was just transferred to the template. I did do most of the talking as my husband couldn't answer the questions. I had thought it was going to be a review of how my husband was day to day and how dementia was progressing and to see what help we might receive. No, all I got was another set of questions related to him to take away and complete about what he is capable of day to day and his likes and dislikes. The boxes in which you wrote the answers held about 25-30 words at most and considering the answers were supposed to help someone who might have to step in as an emergency if anything happened to me as carer, it indicated how little the professionals know of how complex our days can be and how quickly things can change. As you say another box ticked. I did work for a GP surgery so I do know that they get these things to do but to my mind some of them are just a waste of time and money. They get filed away and are of no use to anyone.

When confronted with these sort of forms, I don’t stick to the boxes or fit my responses into a minimalist square but scrawl all over them, adding in whatever I think is relevant. They can huff and puff all they like but what is the point in asking you questions if you can’t provide an answer that helps the patient? The questionnaire isn’t there to justify their jobs so give them answers!

 

[special 1]

Hi there. Yes I have had the same outcome as you are explaining. I had the mental health doctor come out a couple of times to see my Husband, and the same sort of questions were asked. How are you, what day is it, are you happy hear and are they hitting you etc. O.K. have a good day!!! WOW what was that then, I think they all read a texted book. At times I think they need help. 🤷‍♀️🤷‍♀️🤷‍♀️

 

[The Saint]

My husband was invited for an annual review for his 'long term condition'. In the 7 or 8 years since his dementia diagnosis he had never had a review but he had routine blood tests for high blood pressure until he refused to go anymore and refused to take his medication. So at the annual review which was done by a nurse at the surgery, I asked which long term condition this review was for. The nurse responded she didn't know. i came out the surgery thinking I hope it ticked their boxes for funding because it didn't tick any of mine.

 

[maisiecat]

My OH recently had an annual review with the surgery carried out by a Paramedic. I take random BP readings at home and took these with me. So, the BP wasn’t taken instead mine was added to the screen, no medication review, no discussion to include me. So, as far as the surgery are concerned everything is fine and my OH said the only noticeable problem is that the mobile phone is a bit tricky! I nearly fell off the chair! Angry outbursts, extreme anxiety some days, repetitive questions, worsening memory, reduced mobility, falls, to mention a few. My input wasn’t required, the appointment was just for my OH. What about me? Whatever happened to the holistic approach? No offer of a Carers consultation, I feel I’m being completely overlooked and my input is of no interest, it was simply a tick box exercise to earn funds for the surgery. Anyone else feel the same?

I think its worse than being overlooked I think when they don't listen and take notice of the carer's input they lose the ability to improve PWD lives.
From my experience reduced mobility and increased falls are a good marker for medical services to review.
To be honest I don't really think this is suitable for a paramedic appt. I know they will see lots of mental health patients but I don't think its where there training is focused.

 

[Fugs]

Personally I think that the NHS is broken and needs a complete overhaul. When we were trying to get my wife diagnosed we eventually managed to get a telephone consultation, which I sat in on and was able to highlight a number of issues that my wife glossed over. (We have all been there ). The GP wanted my wife to have a Vit D test to rule out other problems. OK, sounds sensible. After the test my wife got a telephone message left on her phone saying that the test was negative, and so nothing to worry about. No follow-up appointment, nothing. At that point I arranged a private face-to-face appointment. The GPs attitude still makes me cross almost 2 years later.

 

[maisiecat]

Personally I think that the NHS is broken and needs a complete overhaul. When we were trying to get my wife diagnosed we eventually managed to get a telephone consultation, which I sat in on and was able to highlight a number of issues that my wife glossed over. (We have all been there ). The GP wanted my wife to have a Vit D test to rule out other problems. OK, sounds sensible. After the test my wife got a telephone message left on her phone saying that the test was negative, and so nothing to worry about. No follow-up appointment, nothing. At that point I arranged a private face-to-face appointment. The GPs attitude still makes me cross almost 2 years later.

Hi @Fugs ,I couldn't agree more. The mental health nurse who visited my husband ignored his obvious psychosis and wished us a happy coronation weekend.

 

[Violet Jane]

I think that there needs to be a comprehensive review of NHS services for patients with, or suspecting of having, dementia. Dementia is a growing problem and the NHS can't ignore it or pay lip service to it any more. Underpinning the poor services are several major problems (there are probably more):
(1) the attitude that nothing can be done as it's a progressive disease and so why bother with these patients;
(2) the failure to use medication appropriately to relieve distressing symptoms;
(3) the practice of treating dementia as a matter for social care once a diagnosis has been made;
(4) unacceptable delays in diagnosis and poor diagnostic practices;
(5) the practice of treating the patient as if s/he is cognitively well and can give an accurate account of what's going on;
(6) the conflict that arises between the needs and wishes of the patient and the needs and wishes of the carer who, in many if not most cases, is effectively trapped;
(7) outdated ideas about family structures and lives; and
(8) appalling care for patients when they are in hospital.

 

[LouiseW]

Hi
I'm so sorry that you are having to learn this but the truth is most medics know nothing about dementia and have no idea what is takes to care for somone who has dementia. Carers are totally ignored and the dementia symptoms get to run the show to the detriment of everyone.

I was chatting with Dads Care Home manager on Monday and he was telling me that the home have constant problems with medics coming in - listening to the person with dementia and belieiving every word they say - and this is residents who live on the secure dementia floor of a dementia specalist care home.

So it appears that even with the massive cues of being resident in a specalist dementia care home, with a DOLS order in place medics are still unable to grasp what dementia symtoms and behavoiurs are and ignore the professional carers in the same way they ignore the family carers.

It's grim - you need to take notes and make sure that everyone you come across in a medical or social care capacity gets a copy and acknowledges that they have read them.

good luck and I so wish it was not like this

 

[Rishile]

I think that there needs to be a comprehensive review of NHS services for patients with, or suspecting of having, dementia. Dementia is a growing problem and the NHS can't ignore it or pay lip service to it any more. Underpinning the poor services are several major problems (there are probably more):
(1) the attitude that nothing can be done as it's a progressive disease and so why bother with these patients;
(2) the failure to use medication appropriately to relieve distressing symptoms;
(3) the practice of treating dementia as a matter for social care once a diagnosis has been made;
(4) unacceptable delays in diagnosis and poor diagnostic practices;
(5) the practice of treating the patient as if s/he is cognitively well and can give an accurate account of what's going on;
(6) the conflict that arises between the needs and wishes of the patient and the needs and wishes of the carer who, in many if not most cases, is effectively trapped;
(7) outdated ideas about family structures and lives; and
(8) appalling care for patients when they are in hospital.

Oh @Violet Jane I agree with every single word you have said. I have said things like this many, many times. Another issue is that when the carer is at crisis point, there is NO help. In fact, when I reached crisis point, things just got worse and worse. I had a massive list of phone numbers given to me by all of the 'experts' and most were unobtainable, others I held on for over an hour only to be told 'there is nobody available to take your call - please try later'. How much use is this when it is 6.00am on Christmas Eve, you have a PWD yelling and screaming, threatening violence, wanting you out of the house (because he thought I was an intruder) when all you really need is someone to say 'try saying this' or 'let me speak to them and I'll try to calm them down'.

The only thing that kept changing for me was the phone number list got longer and longer. Long-term, things have now improved because all the 'experts' have gone away and left me alone.

Dementia is a HUGE problem waiting to explode. The government and NHS seems totally unaware of the problem. Most people I speak to have a spouse, parent or parent-in-law that has dementia and most are full-time carers for that person. I have even been in a queue at the coffee shop and got into conversations with people that are full-time carers.

Another point - at my husband's dementia review with the GP, the doctor asked me what I was doing that was so successful as his mother has dementia and he wanted to know if I could suggest anything to help her.

 

[Violet Jane]

@Rishile, to be fair, things only really improved after your husband was sectioned and got the correct medication and so the experts in the hospital did help you and your husband. Your case demonstrates that there are some medical solutions and that these should be offered as soon as they are needed. Many carers aren't even aware that there is helpful medication and only find out about it when things have reached a crisis point. Whether this is to do with lack of interest, wilful blindness, a belief that people with dementia shouldn't be medicated or a low priority being given to carers I don't know.

Too many people, including medical professionals, think that dementia is all about memory loss. They aren't aware that loss of functionality, personality changes, aggression, paranoia and delusions are common with all types of dementia and not just the less common ones.