Do the Memory Clinics stop doing the MMSE after a certain point?

skaface

Registered User
Jul 18, 2011
109
0
Ramsgate
I took mum to the Memory Clinic last week to see the Nurse Clinician (she last saw the Consultant last year) and she did the usual thing of taking her blood pressure and weighing her, but didn't do the MMSE, other than asking her what the day, date and year is (she didn't have a clue).

Up until six months ago, mum was scoring 20 odd on her MMSE, back in March this went down to 13 - I just wondered whether at a certain point of deterioration there's no point in measuring it. Since that last visit she's got carers going in and I got her donepezil prescription renewed and she's started taking this drug with the help of the carers. It was the same clinician nurse as last time, and she reported that she thought that mum appeared to be much brighter.

In my mind, my mum has deteriorated still further, but as it's known dementia sufferers can only deteriorate, is there any real point in continuing to measure the rate of it? I suppose there might be in terms of long-term data on the disease, but I'm not sure how much help the MMSE might be in that case.
 

Beate

Registered User
May 21, 2014
12,179
0
London
Our doctor at the Memory Clinic hasn't completed an MMSE test in ages. She always tries but gives up as he can't answer a single question anymore. She still prescribes Donepezil for which I am thankful as I always thought that's discontinued once the score is under 10. But I guess every doctor does these things slightly differently. To me, those visits don't make sense anymore and they are in fact distressing. An MMSE test is no indication on how someone is getting on otherwise. But if we want to keep the medication we have to keep on going.
 

LYN T

Registered User
Aug 30, 2012
6,958
0
Brixham Devon
Once Pete got to 7/30 I said 'no more' -he DID have another test when he was sectioned and managed 3/30-no point at all really as he couldn't take Aricept as it made his asthma worse (he was really struggling with his breathing). As Beate says if meds are prescribed you have to do the test (I think).

Take care

Lyn T XX
 

LizzyA

Registered User
Feb 21, 2013
72
0
Near Reading
Yes, mum got discharged from the memory clinic when she was taken off donepezil....so they don't monitor her any more. Luckily her social worker has stepped up so we have support x
 

JayGun

Registered User
Jun 24, 2013
291
0
We don't go to many Memory Clinic appointments because my mother in law finds them so distressing. She gets very angry, denies any problems with memory, or anything at all ever, is largely uncooperative, bares her teeth, rises out of her chair as if she's going to wallop somebody, and just keeps shouting about how she's not mental, "and you'd better not be writing down that I'm aggressive"

I have a phone appointment with the consultant or the mental health nurse fairly regularly, but we only do the MMSE every 18 months or so. We take her for coffee and cake beforehand with no walking about so she isn't tired, and talk about things that relax her and make her happy. Then we tell her that it's time for the "stupid questions" again, remind her that the nurse has to do what the doctor tells her, and basically beg her indulgence. :D

So far we have always got through the test although she rages and bares her teeth and refuses all the maths questions out of hand for being "too stupid". She said she would be better if we weren't there watching her, so we left the room last time, but if anything she raged more and we had to come back in and tell her off a bit for being so horrible to "the poor young girl who's only doing what the doctor told her" because we could hear from the hallway that MIL's rage was building up and up and I was quite frightened that she was going to lash out. When we went back in she was up out of her seat with her teeth bared.
 

Tin

Registered User
May 18, 2014
4,820
0
UK
My mum has an appointment at memory clinic this month and I am seriously considering saying no more. Her score was low last time and I could see that she was beginning to get upset with the questions, also its an afternoon clinic when mum is not at her best, deafness and the accent of the person asking the questions all seem to irritate and worry her. The consultant told me that he is now just monitoring her progress, in his words "we still don't know if its Azheimers" Its hard though because I know the professionals need this data and research, but the thing that really gets to me is that we are always on time for these appointments yet the clinic always seems to be running at least half hour late and that half hour in the waiting room just seems to increase mums anxiety.
 

skaface

Registered User
Jul 18, 2011
109
0
Ramsgate
Thanks for your replies - I'm really not sure what use the clinic is to my mother now - she refuses to think about going to the day centre (which I think will help her), however she doesn't seem to find these visits distressing, though she does pull a face and roll her eyes when I remind her that she's due to go to one. The only thing that is an issue for her is her mobility - thankfully all the taxi drivers we have had driving us there and back have been very patient with her, waiting for her to come out of either her house or the hospital.

When we have the appointment, I don't mention the "memory clinic" but "your hospital appointment" and when she asks what it's for I tell her "it's your usual six-monthly check up, nothing to worry about, Ellen (her older sister) has them too" which is a complete and utter lie (Ellen is nearly 89 and completely sane) but it would upset her if I told the truth. I hate lying but I am becoming quite proficient at it!

Also the Nurse Clinician was quite open about testing her memory with her and while talking to me about it, but mum sat there quite passively - usually she gets aggressively angry if she thinks people are talking about her or over her head. Though we didn't speak about residential care though it was implied very heavily, it was all "next steps" and "should she not be where she is now".

The clinic can't really suggest anything else as Social Services is involved now, as are Age UK, ICT and various other bodies with Crossroads Care and an Admiral Nurse to support me. Everything is really in place that she needs apart from me having an LPA which she steadfastly refuses to grant me.
 

Leswi

Registered User
Jul 13, 2014
120
0
Bedfordshire
Probably depends where you live, as with all the other Service responses. When we got to the point where mum was becoming distressed by the Memory clinic appointments I asked if I could attend without mum and they agreed. Medication changed to Memantine from Donepezil somewhere down the line to make mum more manageable and we just get repeat prescriptions. As mum has deteriorated drastically recently I requested a review which will be at home but I am doing telephone consultation beforehand as mum can answer no questions of any kind now. I just want to know if she can have anything to help with the night time hallucinations and getting up couple of times each night and this time they need to physically see mum.