Getting a GP to initiate a conversation about memory (problems)

[agur]

Hello,

I've been coming on this website and reading posts for some time now and have found it so helpful to read about and learn from other people's experiences. I have tried to follow some of the advice given to people in similar situations and have got stuck so am hoping that I might be able to get some (much appreciated) help myself.

Over the past two-three years my family and I have become increasingly concerned about my Grandad in relation to his deteriorating memory and the impact this is having on him and my Gran.

Following advice I have read to others on this forum we have tried a few things e.g. made a detailed and specific list of concerns and wrote to Grandad's GP, we have visited the GP without Grandad to share the family's concerns, we encouraged Gran to try to broach the subject with him gently (which she did but he became very angry and brought up unrelated historic problems in their relationship so this just led to distress all round).

Eventually and by coincidence my Grandad had some physical health symptoms that needed a GP visit. We had hoped that this would be an opportunity for the GP to discuss memory with Grandad. Unfortunately, the GP came back to us to say that he could not initiate a conversation about memory and that my Grandad would need to instigate this himself or be accompanied into the clinic room by a relative who could raise their concerns. He has never been accompanied into the GP or other appointments so has refused this when my Gran has suggested (in relation to his other health problems).

We are now feeling quite stuck and would appreciate any advice/ideas for us to reflect on.

With thanks in anticipation,
Ali

 

[Mibs]

Hi, welcome to TP - My husband had known for years that he was starting to suffer from dementia - he denied it because he knew too much about it and the inevitable consequences, and so resisted any efforts to get help, and I wonder whether your Grandad is similarly well informed.

I'm still grateful for the day that he acquired an toe infection which, in time, made a visit to the doctor inevitable. I spun him a line about new medication etc and would he like me to come with him, or would he be able to write down all the details himself.

It took some time, but eventually he allowed me to go with him, and after the toe had been sorted, amd my husband's behaviour had become obvious, the doctor said to me 'is there anything else you would like to discuss' and I handed him a list of concerns, the last item being dementia. He was then able to discuss memory problems with my husband (not me) and this led to a short memory test and a referral to the memory clinic. It's worth noting that several things can contribute to memory problems, and the doctor will probably want to do blood tests.

Subterfuge is the name of the game with dementia, I would ask the doctor to call your Grandad in perhaps for a medication review, and then one of you attend the appointment as well - not with him, but just behind him or even just as he has entered the room.

If it is dementia - sometimes you just have to shoulder the responsibility of getting them the support they need, in the right place at the right time by whatever means possible, and then you can take comfort from knowing that you have done the very best you could for them. That's all we can do.

I wish you the very best of luck.
M x

 

[SoyHJ]

I had a similar experience to Mibs. My husband was persuaded to go for a full general checkup - I had to do it too so we I could say we were both having it done. The GP asked at the end if there were any other health worries. OH thought and said no, he didn't think so. GP hesitated and then I took a deep breath and plunged in with, 'well, there is just one thing, you do keep saying you're worried about your memory and keep forgetting things...did you ask the doctor about that?' The GP seized on this opening and eventually managed to persuade OH to have some tests done, 'just to be on the safe side..'.

 

[agur]

I'm very grateful to the two people who kindly shared their experiences and ideas with me about my Grandad.

We have some success to report. My Grandad's GP has confirmed that if someone were to follow Grandad into the consultation he would use this as an opportunity to ask about general health etc, providing a way in. It had not occurred to us to suggest that Gran, who always sits in the waiting room when Grandad sees the GP, follow him in...on one occasion we had encouraged her to ask if he would like her to go with him, which he declined in no uncertain terms as we think she asked him shortly after mentioning his forgetfulness. So we will try our hand at subterfuge but also accept we may need to be patient and just be there to support them both where we can.

With thanks,
Ali

 

[jen54]

we are having same trouble, mum hates drs- and although worried about memory loss, when I suggest dr may be able to help, she flatly refuses- every opportunity I try to get her to agree to see dr- she did have pills for BP so am keeping saying perhaps need to get some more, but she refuses..and nothing that crops up is that bad that she has said she needs to see dr, ie her leg has played up and she ddi want to go, but it hasn't flared up now again..sounds awful, I keep asking about anything she mentions seeing if i can use it to get her there-no way she would go against her will
at same time not sure if I brought up her being a little concerned about her memory in a health issue appointment-it wouldn't be shot down by her, covered up by her and stress her, as she keeps on about the fact she would hate to be old and dolally (her words) and would jump off a cliff - this on watching recent news about rising dementia figures

 

[SoyHJ]

we are having same trouble, mum hates drs- and although worried about memory loss, when I suggest dr may be able to help, she flatly refuses- every opportunity I try to get her to agree to see dr- she did have pills for BP so am keeping saying perhaps need to get some more, but she refuses..and nothing that crops up is that bad that she has said she needs to see dr, ie her leg has played up and she ddi want to go, but it hasn't flared up now again..sounds awful, I keep asking about anything she mentions seeing if i can use it to get her there-no way she would go against her will
at same time not sure if I brought up her being a little concerned about her memory in a health issue appointment-it wouldn't be shot down by her, covered up by her and stress her, as she keeps on about the fact she would hate to be old and dolally (her words) and would jump off a cliff - this on watching recent news about rising dementia figures

My husband at first brushed off the idea of being a little concerned about his memory when I mentioned it at the doctors. 'Oh, it's nothing - I just can't remember the word sometimes' etc etc. He then went on to cite how, for example, he can't remember the name of a particular tree in the garden (which I wouldn't expect him to remember anyway!) It didn't matter, it still gave the (already primed) GP the opening he needed.

Since that original GP visit we have moved from a diagnosis of MCI to early stage AD. He is now on medication however he still says that forgetting the occasional word is his main problem.

Good luck.

 

[SoyHJ]

I'm very grateful to the two people who kindly shared their experiences and ideas with me about my Grandad.

We have some success to report. My Grandad's GP has confirmed that if someone were to follow Grandad into the consultation he would use this as an opportunity to ask about general health etc, providing a way in. It had not occurred to us to suggest that Gran, who always sits in the waiting room when Grandad sees the GP, follow him in...on one occasion we had encouraged her to ask if he would like her to go with him, which he declined in no uncertain terms as we think she asked him shortly after mentioning his forgetfulness. So we will try our hand at subterfuge but also accept we may need to be patient and just be there to support them both where we can.

With thanks,
Ali

Hi Ali, when my husband and I both went to the GP for our 'checkups' at the end, the GP simply said that now he'd spoken to us each privately he wanted to speak to us both together to round off the appointment. There was no question of asking my OH if I could come in, he was simply told that that was what the GP now wished to do! No arguments!

 

[jen54]

I bite the bullet, and rang the alzheimers helpline earlier- she was very nice, and said they recommended ringing mums gp and having a talk
I ddi so, and explained to the receptionist, who didn't seem to know what happens in this situation, but she left a message for the two drs who saw mum last, and one of them rang me back quite quickly
I explained,symptoms, BP worries,trying to get her to go to see dr etc, her fear of drs, and the fact I was scared of starting a ball rolling I couldn't stop- ie if dementia was mentioned to her,
he said about patient confidentiality, and that they couldn't force themselves on her as she seemed mentally competent- which she is generally, he asked if she was on her own, or a danger to herself,if perhaps a friend or neighbour could persuade her..
he is going to send letter through mentioning BP and saying about needing to see her to update pills etc which she was on- it was up to me he said to try my best to get her to want to see him- then he will do a simple memory test, knowing to be discreet. and would send her for blood test..mm, I did say the last app she had..she tore up the blood test form- so stressed about going to get one
at least I have forwarned dr if nothing else, he noted my concerns- but seems until thigns get worse..they wont act

 

[Lawson58]

I will be eternally grateful to our GP who is extremely skilled at getting conversations with his patients to where he wants them to go and maneouvred my husband into agreeing to all sorts of tests to do with memory without him ever bringing it up in the first place.

My husband was in total denial and completely resistant to the idea that he had any problems but in the previous couple of months I had spoken to GP about my concerns and we worked out a strategy to deal with this. It took 2 consultations and it never ceases to amaze me how such a nice man could have been so devious but he succeeded in spite of my husband's attitude.

When does patient confidentiality become more important than the welfare of the patient?

 

[jen54]

Difficult with patient confidentiality. Dr has sent letter as he said. Again I stressed that we should make app.i could do it and take. Her etc.mentioned bp and the fact she had zigzag in eyes and I was worried as she had been on bp pills. I got short shrift and told her bp was
probably Up due to getting the Drs letter and she hated Drs and hospitals.

 

[Brandysal]

It has taken us about 18months to get my mum to go to her GP about memory problems. The first appointment he sent her for blood tests, understandable to rule out anything else, she had to go to the nurse who told her all was well blood test showed she was fit and healthy. We then had another nagging few weeks for her to go back to the Drs, which she has done but has told the Dr it's just old age. My dad attended with her to give examples of the problems, but he just said if she notices it getting worse to go back to see him! She has not had any memory tests done but we have noticed a dramatic change in mood, memory etc
We don't know what to do next as she gets very irate if we mention going back and asking for a referral
Help