Annual GP Dementia Reviews

[Lawson58]

I was looking at the report from the memory clinic when My OH was diagnosed with Alzheimers and found that it includes a care plan with a review in 6 months. Not sure who was supposed to review but it didn't happen.​

I've been told that PWDs should have an annual review but OH has never been called for one though when I asked at the surgery they agreed to arrange one and as @SAP 's experience I have had a really good response from GPs/locums when I have arranged appointments for checks etc. I tried to google if it was a right but only found some NHS England that was marked guidance saying that an annual review should be undertaken. I also found the extract below which isn't clear about who should instigate the review the GP or the patient. My OH has Lymphoma and heart problems but is never ill - touch wood so I am debating whether to request a review - however reading the extract below I can't think what good it would be especially after reading the first sentence - my OH has never acknowledged his diagnosis and will not listen if told it. I have obviously tried in the past to discuss it but he does not want to know and who am I to say refusing to think about it isn't the best strategy available to him. I think if you feel a review would be beneficial you should ask your GP - in a way I feel we all should ask for them to encourage the NHS to take notice of us - if we were more of a nuisance we might get more action - while we battle on behind closed doors we are perhaps not helping ourselves.

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GP annual review with a person with dementia

Annual reviews are a key part of a person with dementia's care. In an annual review the GP will ask questions, do a medication review, check for new symptoms or changes in behaviour, and discuss planning ahead and support for carers.

www.alzheimers.org.uk

Understanding the diagnosis​

The GP will check that the person with dementia understands their diagnosis. They may confirm which type of dementia they have, for example Alzheimer’s disease, vascular dementia or another type, and what this means.

Welfare questions​

To make sure everyone is safe and well, the GP may check whether the person with dementia or their carer is at risk of harm, or of not looking after themselves properly.

They may ask whether there is anything causing them to feel stressed or uncomfortable. The GP might also ask about the person’s hobbies, interests or how they are managing daily activities.

They may ask what living well means to the person with dementia, and what support they need to continue to live well.

Contact details​

The GP should check that the contact details of the person’s carer, family or friends are up-to-date. If you are a patient at the same GP practice, you should be offered a carer’s assessment and review of your own.

Sorry but I found this a little amusing.

How many PWD understand their diagnosis?

How many PWD can realistically answer what is making them feel stressed or uncomfortable?

What PWD would understand what living well with dementia means to them and what support they need to live well?

 

[Chizz]

Yes @Lawson58 I agree, but I think they mean at the diagnosis or at a review 6 months after diagnosis. I think the 6 month review is primarily to see if the meds are OK, but I don't recall my OH having any review after that.
Provided there hasn't been a huge delay in getting a diagnosis, which has become more prevalent as NHS deterioration has itself progressed, then a PWD at that early stage, may still have mental capacity.

A person with mental capacity would be able to deal with making or changing a Will or granting a Power of Attorney, and/or know that there is something wrong.

At that early stage, my OH knew there were things going wrong. She may not have been able to specify or clearly articulate it, but she knew, and that made her v frustrated. She would keep saying: sorry to me; what have I let you in for; I'm here to care you and you are going to be my nursemaid; I don't want to be like that; if I get worse promise you'll put me down, etc, etc It was all v distressing for both of us. The pleas to me to end it for her were daily for at least 2 or 3 weeks.

Now, several years on, the position is far worse, and the guide notes are out of date. Now, it is often 2 years or so, from first signs of dementing becoming apparent, when someone suggests getting to the Memory Clinic. People here are having to wait many months, a year, or more, to get an appointment for a diagnosis, but which time they may have had dementia 3 or 4 years, and are far beyond understanding the diagnosis, the medication, the care needed or to become needed. That's why the notes are out of date, overtaken by the failing health service and its depleted resources.

 

[Lawson58]

Yes @Lawson58 I agree, but I think they mean at the diagnosis or at a review 6 months after diagnosis. I think the 6 month review is primarily to see if the meds are OK, but I don't recall my OH having any review after that.
Provided there hasn't been a huge delay in getting a diagnosis, which has become more prevalent as NHS deterioration has itself progressed, then a PWD at that early stage, may still have mental capacity.

A person with mental capacity would be able to deal with making or changing a Will or granting a Power of Attorney, and/or know that there is something wrong.

At that early stage, my OH knew there were things going wrong. She may not have been able to specify or clearly articulate it, but she knew, and that made her v frustrated. She would keep saying: sorry to me; what have I let you in for; I'm here to care you and you are going to be my nursemaid; I don't want to be like that; if I get worse promise you'll put me down, etc, etc It was all v distressing for both of us. The pleas to me to end it for her were daily for at least 2 or 3 weeks.

Now, several years on, the position is far worse, and the guide notes are out of date. Now, it is often 2 years or so, from first signs of dementing becoming apparent, when someone suggests getting to the Memory Clinic. People here are having to wait many months, a year, or more, to get an appointment for a diagnosis, but which time they may have had dementia 3 or 4 years, and are far beyond understanding the diagnosis, the medication, the care needed or to become needed. That's why the notes are out of date, overtaken by the failing health service and its depleted resources.

My husband has been in total denial from day 1 and would never acknowledge that he had problems. It was always me that was ‘crazy’ (his word). He only agreed to go to the memory clinic to prove to our GP that there was absolutely nothing wrong with him and that I was just being stupid and critical of him.

This was not to say that he didn’t have capacity then to make a will or important decisions, just that there was this whole side of his life in his mind that didn’t exist in the way we would have understood it.

He was always the one who would say he was fine when asked by the doctor and he had lost so much empathy that he couldn’t respond to the notion of stress in either himself, others or me. His perceptions of support was that as long as I was around, that was all he had to think about. In other words, in his eyes it was not a problem.

Now his physical health is failing, he understands that he is unwell but doesn’t want to really know just how bad he is. Things are easier to deal with if you simply pretend that even though you might be feeling a bit off, everything is really OK.

I know that there are some people with dementia who have insight into their illness but my husband was never one of them. So I felt that those questions I listed had no relevance to my husband.