Help from the GP

Oh Knickers

Registered User
Nov 19, 2016
500
0
Oilovlam,

I can hear the concern in your posts. It gets to a stage, as a carer, where we get tired and worn down. Not just with the care but the continuous juggling act of trying to think ahead.

One comment gave pause for thought - urosepsis. Now normally UTIs are down to stray bacteria, but sepsis. Might be worth having a check with the GP on what was meant by that.

Are you getting any support in? It sounds as though you could do with breaks? I know that is like adding another couple of balls to your juggling act. Please contact your local Alzheimer's Soc. If you use the link below they may be able to help guide you not just on support but with some of the health issues that have been raised. Scroll down the page and put in your mum's postcode and the local number will come up. Another good organisation is Admiral Nurses. I have found them really helpful.

Alzheimers Society
https://www.alzheimers.org.uk/

Admiral Nurses
https://www.dementiauk.org/get-supp...2rPq4q5i2VWCyic4ta2G_L_lZzuUWNfhoCJroQAvD_BwE

In terms of getting more fluids into mum, you could try jellies and fruit lollies.

It sounds as though you could do with a big {{{HUG}}}. We all get tired at times. It is sometimes just getting enough of a break to recharge.

Thinking of you.
 

Saffie

Registered User
Mar 26, 2011
22,513
0
Near Southampton
Kevinl, I don't think it is necessarily a matter of poor hygiene....some people are more prone to UTI's than others. Apparently constipation can make someone more at risk of UTI....so I'm feeding mum with laxatives....which causes massive sloppy poohs....which are a devil to clean hygienically with wet wipes.

I would have thought that the result of laxatives would make a UTI more likely and have not heard that constipation can be a risk although both are not helped by being dehydrated.
Equally not all UTIs are caused by infections as sometimes it can be interstitial cystitis which has another causes, so hygiene only plays a part in some cases.
 

Philbo

Registered User
Feb 28, 2017
853
0
Kent
Hi

Our surgery are reasonably good however, we have not found them to be very good at dealing with dementia issues.

It took quite a few visits before our GP (who we like) took my concerns about my wife's increasing memory issues seriously.

We got referred to the memory clinic who diagnosed FTD and she had 6 monthly follow-up visits. After 2 years though, they said there was nothing more they could do and discharged her back to our GP.

Naively, I assumed that the surgery would contact us to arrange a care plan and we settled in to trying to keep our lives as normal as possible.

The only thing that did happen was we got a letter around 18 months later, asking us to make an appointment for a mental health review. Great, I thought, there will be interested parties there to review our needs etc. But all it turned out to be was a 15 minute chat with the GP who seemed to be going through a tick-box exercise. The only useful thing to come out of it was I got him to take my wife off the water retention tablets, as she was getting through up to 6 pull-ups a day!

So much for the health campaign "get an early diagnosis, so you can get the help you need"?
 

Saffie

Registered User
Mar 26, 2011
22,513
0
Near Southampton
GP practices get paid extra for the checks they make regarding the various government camlaigns of the time, so yes, the mental health check are probably just tick boxes. When I go for my annual CHD and asthma checks I now get asked how my memory is and how I feel mentally - another box ticked! The other checks might well fall into the same catergory.
 

oilovlam

Registered User
Aug 2, 2015
386
0
South East
Hi

Our surgery are reasonably good however, we have not found them to be very good at dealing with dementia issues.

It took quite a few visits before our GP (who we like) took my concerns about my wife's increasing memory issues seriously.

We got referred to the memory clinic who diagnosed FTD and she had 6 monthly follow-up visits. After 2 years though, they said there was nothing more they could do and discharged her back to our GP.

Naively, I assumed that the surgery would contact us to arrange a care plan and we settled in to trying to keep our lives as normal as possible.

The only thing that did happen was we got a letter around 18 months later, asking us to make an appointment for a mental health review. Great, I thought, there will be interested parties there to review our needs etc. But all it turned out to be was a 15 minute chat with the GP who seemed to be going through a tick-box exercise. The only useful thing to come out of it was I got him to take my wife off the water retention tablets, as she was getting through up to 6 pull-ups a day!

So much for the health campaign "get an early diagnosis, so you can get the help you need"?

Philbo, I think we are going to have to face up to the fact that there are just too many people with dementia for the system to cope with. There are clever & persistent people who can get more attention but I suppose unless you are a little 'shouty' they (GP & people who have you on their 'list') will assume that we are coping and it is better not to ask us how things are going.

AT least I know how the system works...or doesn't and I can pull my socks up and try to find ways to keep mum safe.

It becomes expensive for the NHS when people like my mum start falling & breaking things (£25,000 I heard for a hip....although she only had partial hip replacement but also 4-5 weeks in hospital+2-3 weeks reablement), a bit of early intervention & preventative treatment may reduce the risk of falling....but I guess we need to keep the surgeons busy & the under-worked nurses need something to do.
 

oilovlam

Registered User
Aug 2, 2015
386
0
South East
I would have thought that the result of laxatives would make a UTI more likely and have not heard that constipation can be a risk although both are not helped by being dehydrated.
Equally not all UTIs are caused by infections as sometimes it can be interstitial cystitis which has another causes, so hygiene only plays a part in some cases.

Saffie, we went to the 'Older person rapid assessment unit' because I thought mum might have 'normal pressure hydocephalus' based on some suggestions on this forum (the doctor dismissed that out of hand btw)....but whilst there the doctor told me that constipation in older women can create pressure on the urine 'pipework', causing trouble urinating and increase the risk of UTI. So laxatives are a necessity for mum and it's just a case of finding the right dosage.....which I haven't found yet.

Tried 'flax' seeds (another forum suggestion) but they didn't seem to do anything.
 

oilovlam

Registered User
Aug 2, 2015
386
0
South East
Have you thought of giving her some cystopurin?it is an over the counter remedy for cystitis but I have found that if I think mum is cooking a UTI then I follow the instructions on the packet( it's a powder) and give it to her for a couple of days. Maybe worth a go if you have reluctant GP re antibiotics.

Doodle1, I will try anything that would get mum back on her feet.

Thanks for the suggestion.

Seems a little odd that we have to self-medicate. But I suppose it is prevention rather than cure.....it would also make me feel as if I was doing something to prevent the 'car crash'.

I suppose it's why the pro-biotic industry is worth so much money. It's as much about mental well-being rather than scientific effectiveness sometimes.
 

AlsoConfused

Registered User
Sep 17, 2010
1,952
0
I'm probably trying to do the impossible....prevent her from falling. I can see it's going to happen and I'd like to find a way to reduce the risk.

There are hip protectors for people at special risk of falling. Mum wears these now. They cost about £47 (a pair?) and I'd have thought they'd be prescribed for your Mum by the GP or by the OT.

Hip protectors obviously can't protect all the bones when someone falls; however the health consequences of a broken hip are probably much more damaging than broken legs, arms or wrists.
 

Saffie

Registered User
Mar 26, 2011
22,513
0
Near Southampton
Saffie, we went to the 'Older person rapid assessment unit' because I thought mum might have 'normal pressure hydocephalus' based on some suggestions on this forum (the doctor dismissed that out of hand btw)....but whilst there the doctor told me that constipation in older women can create pressure on the urine 'pipework', causing trouble urinating and increase the risk of UTI. So laxatives are a necessity for mum and it's just a case of finding the right dosage.....which I haven't found yet.

Tried 'flax' seeds (another forum suggestion) but they didn't seem to do anything.

I can see that this makes some sense.
My consultant has said that golden linseeds (flax seeds) make motions soft so might help in that way. Quite a lot might be needed though. It's a case of trial and error as with so many of this type of things.
 

LadyA

Registered User
Oct 19, 2009
13,730
0
Ireland
Kevinl, I don't think it is necessarily a matter of poor hygiene....some people are more prone to UTI's than others. Apparently constipation can make someone more at risk of UTI....so I'm feeding mum with laxatives....which causes massive sloppy poohs....which are a devil to clean hygienically with wet wipes.

Another thing that makes elderly women much more prone to UTIs is vaginal atrophy, caused by lack of estrogen after the menopause, which causes thinning of the vaginal walls. This can also be a reason for an older woman's seeming obsession with going to the loo, or thinking she needs to go, even when she doesn't. Eventually, untreated, it can lead to incontinence - so frequent UTIs or an unreasonable obsession with the loo, it's worth asking the GP about this.
 

oilovlam

Registered User
Aug 2, 2015
386
0
South East
There are hip protectors for people at special risk of falling. Mum wears these now. They cost about £47 (a pair?) and I'd have thought they'd be prescribed for your Mum by the GP or by the OT.

Hip protectors obviously can't protect all the bones when someone falls; however the health consequences of a broken hip are probably much more damaging than broken legs, arms or wrists.

Alsoconfused, nobody has mentioned hip protectors (as far as I can recall). I will definitely have a look. As with everything there are probably unintended consequences of such things....but if it could prevent the hips being broken again (I hate to think of how they would fix that) then it's a no brainer.

Shame she didn't have them on when she fell and broke her second hip.

I have suggested to people (as a joke) of wrapping her in bubble wrap.
 

oilovlam

Registered User
Aug 2, 2015
386
0
South East
Another thing that makes elderly women much more prone to UTIs is vaginal atrophy, caused by lack of estrogen after the menopause, which causes thinning of the vaginal walls. This can also be a reason for an older woman's seeming obsession with going to the loo, or thinking she needs to go, even when she doesn't. Eventually, untreated, it can lead to incontinence - so frequent UTIs or an unreasonable obsession with the loo, it's worth asking the GP about this.

Mum is incontinent - or I think she is. She cannot communicate but recently we have noticed that she gets very agitated & stands up, so we take her to the toilet & she usually has a pee (it does mean a lot of trips to the toilet which becomes tiring). So she is halfway incontinent I suppose....she knows she wants to go but cannot really communicate to us to take her. That's when the pads save the day.

I can see the doctors roll their eyes when I say "someone told me on a forum" about such-and-such condition. But I suppose it starts a discussion....although I know they are thinking..."I have the medical degree". But GP's don't know everything.

Thanks for the suggestion.
 

Lawson58

Registered User
Aug 1, 2014
4,333
0
Victoria, Australia
Just like to throw in a comment about falls and broken hips.

I know of a lady who had two broken hips several months apart. Like most people, her daughter initially assumed that she had the fractures as a result of falls but it turned out to be the opposite, that she in fact had both falls because the hips broke, the bones being very thin and brittle. The first occurred when she was with her daughter walking down the footpath when she collapsed on the ground. And I understand that the second occurred in the care home walking down the hall with her granddaughter.

She eventually had to use a wheelchair as she had lots of complications with the hips and the state of her bones.
 

AlsoConfused

Registered User
Sep 17, 2010
1,952
0
Osteoporosis can be picked up in a simple scan and treated, no matter how porous the bones have got. Usually well worth doing.
 

Coulddobetter

Registered User
Oct 19, 2016
54
0
I'm a little worried that I'm not getting much support from the GP surgery for my mother.

She has broken both hips in the last 8 months after falling with UTI (& Urosepsis...is that UTI?). I can sometimes see that mum is acting strange....angry, unsteady on her feet etc...but the GP's don't seem too interested. So that makes me ignore the symptoms and so she falls. It's like a slow motion car crash.

I learned recently that the GP surgery has 'proactice care team' and mum is on their list....but I have no contact with them. I was told today that being on the list means that mum is discussed 'regularly', and I guess they assume that I'm on top of things, so I presume they say 'No action required'.

What sort of support do people get from their GP. Do they have a 'proactive' team and what do they actually do ('proactive' is the wrong name for them IMO....I suspect that it is a requirement of NHS to have a 'proactive' list of vulnerable patients....but resources being finite I guess it's just a tick-box exercise).

Mum is advanced stage dementia. She eats & drinks OK (with support) but swallowing may be an issue in the future. Risk of falling is an inevitable part of dementia but I cannot see the GP is trying to reduce that risk....I feel I'm on my own sometimes.

When I started on this journey as a carer I went on a course where they described all the healthcare professionals who will support you (District nurses, GP, OT, etc etc). If I knew then what I know now I would have laughed out loud and told them they were talking rubbish. Austerity probably hasn't helped.

Ask GP to prescribe a maintenance dose of anti-biotics. Has worked for my Mum who had a spate of the wretched things, one led to a serious fall and hip fracture, costing the NHS thousands. Mum has been UTI free for over two years now. She takes in in liquid form, as she was so resistant to taking any kind of pill. Do think that the health service should run some kind of campaign about UTIs, so catastrophic is the impact on the frail elderly, and those with dementia.
 

oilovlam

Registered User
Aug 2, 2015
386
0
South East
Ask GP to prescribe a maintenance dose of anti-biotics. Has worked for my Mum who had a spate of the wretched things, one led to a serious fall and hip fracture, costing the NHS thousands. Mum has been UTI free for over two years now. She takes in in liquid form, as she was so resistant to taking any kind of pill. Do think that the health service should run some kind of campaign about UTIs, so catastrophic is the impact on the frail elderly, and those with dementia.

What's a maintenance dose?

If you're talking about a constant supply of antibiotics then I didn't know they did that....anti-biotics are supposed to be used for a short period of time. They are worried about bugs becoming resistant to anti-biotics aren't they?

Definition I found: "the amount of drug required to keep a desired mean steady-state concentration in the tissues."
 

Juliematch

Registered User
Jun 24, 2017
167
0
My dad has COPD as well as dementia.A chest infection can lead to pneumonia very quickly.His GP has given me antibiotics and steroids which I give him at the first sign of infection.I have always got them and just ask for more when needed.Hes had them 4 times in the last 6 months ( still had to have time in hospital once for intensive nebulising)Perhaps it would be worth asking for some .Sometimes it can take so long to get an appointment or even to talk to a GP.Ive saved dad many a hospital trip in the last 4 years and I'm getting to be an expert on different coughs.We all get to know our loved ones so well when dementia comes along,Probally better than ourselves. I know not all GPS would do this but it might be worth asking.
 

WORRIER123

Registered User
Oct 1, 2015
1,174
0
For those who know me sounds you have my late dads chocolate GP
The struggles I went through and got no help only talked to like he wasn't well but not as bad as I said. Well the end of life support the hospital said he needed soon ended her attitude. Too little too late