Hi Cuppalover
Welcome to TP. I too was really relieved to find this forum. There are so many kind people here who offer all sorts of advice and comforting words, even when their own situations are far worse.
You've got over the first hurdle of getting your S-I-L to go to her GP. I went through this process last Sept. with my mum. Her immediate reaction to my announcement that I'd made an appointment for her was 'You've done WHAT!!', followed immediately by 'Well actually I was planning on making an appointment myself', although she said it was because she wanted to ask if she needed to continue taking the statins she'd been on for a while. She was aware however that she was 'mislaying' things and forgetting names etc. and I said it was a good idea to get checked out while she was there.
Her GP was brilliant. First he reviewed her meds and decided she didn't need to be on anything any more. Then he checked her blood pressure and said he'd arrange for some blood tests to be done. Then he said something like 'I understand your memory has been letting you down a bit recently'. To which mum responded that it wasn't really a problem as it was just mislaying things at home, not outside, and that she always found them eventually. He then suggested that it might be a good idea to a MMSE (mini mental state exam). He had a pad full of forms (I think each asks slightly different questions so they don't get the same form each time the test is done). If you Google MMSE you should get more details of exactly what it involves but basically it covers basic info like 'What day of the week is it?', 'Do you know where you are at the moment?' 'What floor are you on?'. One of the questions involved counting backwards from a given number in 7's (I had problems with that! Maths never was my strong point
). She was asked to memorise 3 items and then had to recall them later in the test. She had to follow some instructions e.g. 'I'm going to put this pen on the floor and I want you to pick it up with your left hand', and there was also a drawing that she had to copy. The maximum score is 30. Anything between 0 and 23 shows 'disturbance of cognition'.
Mum scored (I think it was) 28, but the GP still referred her to a psychiatrist. I think it was because of the way she answered some of the questions. e.g. in answer to 'What floor..' instead of saying 'We're on the first floor' she said something like 'We'll I know we're not on the ground floor. We had to come up some stairs' - she couldn't find the right words. The other thing she failed miserably on was the drawing - even after 2 attempts it was totally obvious she was never going to get anything like it and it was just 2 overlapping shapes not something by Rembrandt! When we'd arrived at the surgery she couldn't remember the date she was born to enter it into their computerised checking-in system.
The Dr asked me if there were any other problems I'd noticed. I had already written him a letter explaining my (and her friends) concerns but I remembered a couple of other things and I think mum was a bit shocked as she obviously wasn't aware of what she'd been doing. My problem is that I'm an only child and live nearly 200 miles from mum and there are no near relatives either, so I'm totally dependent on what she tells me on the phone (of course there are no problems!!!) and what I can find out from her friends. It's really awful having to go behind her back but I know she won't tell me much and she gets a bit agitated if I try to press her for information.
The power of attorney thing that citybythesea mentioned is also worth thinking about sooner rather than later. Over here it's called Lasting Power of Attorney (used to be called Enduring POA) and there are 2 versions. One deals with Property and Affairs (covers things like paying bills, managing bank accounts and invesments etc) and the other is Personal Welfare which deals with things like arranging care or going into a home if necessary. These do not have to be registered straight away (it costs a fair bit to do that) and you don't have to have both. There is plenty of scope within the document for the person to put limitations on the attorney. I suggest you google it for more info as it's quite involved. The person has to have a certificate signed to say they are competent to sign the doc i.e. that they understand what it is, what it's for and that there is no pressure on them to draw up the LPA. The attorney (or attorneys if more than 1) must not be present at the interview. I'm actually sitting here waiting for mum's gp to phone me back to discuss making an appointment to see him to sort this certificate bit out. It doesn't have to be the gp, it could be a solicitor or some other person (there's info given on who can and can't sign the cert). In another part of the doc the person can name up to 3 people who MUST be notified when the POA is registered to enable them to object if they think the person is still able to deal adequately with their own affairs etc. If a POA isn't in place and the person gets to the stage when they can not longer manage things like money it can apparently be a bit of a nightmare to sort it all out.
I agree with Nancy that it is perhaps better not to overload you SIL with too many things to think about at once. Whenever I go to mum's she claims she's fine when she's on her own but when I go she gets in a bit of a dither. My problem is that because I'm self employed and have a family I can't go very often (about every 6 wks at present), and it's usually from Thurs to Sun so I tend to be a bit like a whirlwind trying to get the place cleaned up (she used to be spotless but now there are cobwebs), her clothes sorted (be prepared for dirty stuff put back in the wardrobe and clothes not changed often) - not to mention getting rid of all the stuff that's now 2 sizes too big cos she's lost weight! ('Of course I have a meal every day' - oh yeah!!!) etc. etc.
I'll keep my fingers crossed that your SIL doesn't have this horrendous disease and that it's something as simple as a vitimin deficiency or something else curable. If it proves to be bad news then please keep visiting this forum. It really helps to know what to expect and to know there are lots of shoulders out there to cry on.
In the time it's taken me to type this lot I expect a dozen others will have told you the same info in a much less verbose form. Sorry, I do tend to have verbal diarhea (can't spell either).
GOOD LUCK and HUGS
Chris