1. shylan20

    shylan20 Registered User

    Sep 28, 2007
    2
    Hi my name is Sean. Myself and my family have become increasingly worried about my nan who seems to be demonstrating all the early signs of dementia (Alzheimers). We have had a recurring situation with her pension and her being un-able to remember her PIN no and the correct card to take. She has on numerous occasions gone along to the post office without the card and/or pin and been refused her pension due to PIN wrongly entered ect.. The problem we have is that she does not believe there is a problem, she has become agitated, angry, depressed but yet she still refuses to go and see a doctor. Is there anything we can do? Is it possible to force the GP to call on a house visit and perform the MMSM test? Any help/advice would be great.

    Thanks

    Sean
     
  2. Brucie

    Brucie Registered User

    Jan 31, 2004
    12,413
    near London
    Hi Sean

    welcome to TP

    how old is your Nan?

    are there any other things you have noticed that seem strange to you? What you have said so far is by no means wholly indicative of a dementia.

    If it is a new technology issue only, then you should also consider other options. Pure age, for instance. Some people are simply not able to get to grips with the technologies of today.

    Try not to pressure her - that may make her feel worse about something that may actually not be a problem.

    Why not start to keep some notes - a diary - of times when you think something is not quite right. Do it in a little detail.

    Ultimately, if necessary, showing that to the GP might help.
     
  3. Kate P

    Kate P Registered User

    Jul 6, 2007
    565
    Merseyside
    Hi Sean,

    As Brucie says are there any other behaviours that are causing concern?

    I work for the DWP and to be honest there are a lot of our older customers who struggle to use the cards and PIN numbers.

    It may be worth ringing (they'll need to speak to your grandmother first to complete security questions etc) and ask to have her put back on to cheques which will be delivered to her home on a weekly basis.

    If you go down this route I would also ask them to check that all her benefits are paid together on one cheque so she only has one payment to deal with each week.

    If you're in the UK the number for the Pension Service is 0845 6060265
     
  4. shylan20

    shylan20 Registered User

    Sep 28, 2007
    2
    Help..again.

    Firstly many thanks for your speedy response. I think before I may have weighed heavily on the post office issue. This really has brought to light the behaviour we have slowly been seeing over the last 6 months. My nan is 82 and as long as I have known her she has always been a very lucid person. Now unfortunately she asks the same questions over and over, struggles to follow the thread of a conversation and will respond with a number of different answers to the same question. I have noticed recently that her diet is also poor. She survives on fish, bread, biscuits, tea and cereal..Oh and crisps sometimes. When my mum tries to introduce fruit or veg to her weekly shopping she becomes angry/upset/frustrated. She sometimes freeze's also and you can see she is struggling to remember/comment in the conversation.

    I think we will change her pension back to a weekly cheque. This would really take some of the stress away from the chip/pin issue.

    What I really need to know is what to do with regards to the GP. She refuses to go as she is adamant that there is nothing wrong however ultimately if she gets worse we will feel responsible for not pushing the matter. The doctor refuses to discuss it with us, re Patient Confidentiallity, but surely there comes a time when they realise we are acting in her best interests?

    Many thanks for the advice/support, very much appreciated.

    Sean
     
  5. Nebiroth

    Nebiroth Registered User

    Aug 20, 2006
    3,511
    The things you describe sound suspiscious, but it is also true that some people suffer some loss of the abilities due to old age. This is the insidious nature of dementia - it's very hard to tell when you reach that point where the alarm bells should start ringing. Certainly we dismissed my father's forgetfulness as being nothing.

    Does your Nan display anything else? These might be: replacing words with "fillers" during conversations (for example, repetetive use of something like"wass-name" in place of real words); losing the sense of time (confusing morning with evening, not knowing what day it is, and so on); loss of short-term memory (eg forgetting having just had breakfast, or repeatedly asking the same question). More worrying symptoms might be strange beliefs/behaviors - such as people being in her house, saying "someone" is "stealing" things or "moving" them, putting things away in odd places (clothes in the fridge say) ,speaking as though someone long deceased is still alive, etc.

    It might be that Nan is simply losing some of her abilities through sheer old age - and maybe not. One thing - if she is struggling with conversations, is her hearing OK?

    As has been said, all you can do is note down everything that is worrying you, and present these to her doctor. Most doctors won't discuss a patient with anyone else, but I don;t think there's any reason why a relative/friend should not raise health concerns.

    If the symptoms are sufficient, the GP might be willing to "invite" your Nan for a "regular checkup" on some pretense or other. At that point the GP could ask some questions (such as - what day is it, who is the Prime Minister, what did you have for breakfast) and based on those decide whether further investigation is needed. There are conditions which give the same symptoms as dementia and they have to be eliminated.

    But you can't force Nan to see her GP. Sadly the idea that "there's nothing wrong with me" is very common; it is due to lack of insight (Nan really believes there is nothing wrong, and that she is perfectly normal) and denial. The idea of losing one's faculties is very frightening.

    it occurs to me that the annual flu jabs are due soon. This would be an ideal opportunity to get Nan to the GP's surgery, at which point the GP could "ask to see her". Most people regard the GP as an authority figure and are reluctant to say "no" to them!

    As to diet - well, it's not good, but if Nan is not actually starving then there is not much point in pressing her about it. With someone of that age the usual advice is, I believe, to worry about getting enough calories in rather than a balanced diet.

    Our CPN has said that lots of her patients have very poor diets. My dad at the moment is refusing to eat anything except jam sandwiches (no crusts), biscuits and sweets! He constantly worries about eating anything "in case I get a blockage" and keeps saying "I don't go to the toilet, I must be constipated" and demands laxatives!

    We know that he isn't open to reason, is unlikely to actually starve - so we decided not to worry about it! It is a battle that cannot be won, so there is no poit in starting it.
     
  6. Margarita

    Margarita Registered User

    Feb 17, 2006
    10,824
    london
    #6 Margarita, Sep 28, 2007
    Last edited: Sep 28, 2007

    that a real issue with many carer on this forum .

    What I had to do to get mum to the doctor was to say that it was to do with her diabetic medication , then seeing mum could not also follow the thread of a conversation , I told her what was happing to mum in-between conversation about diabetic medication , with mum losing her temper a lot . that the doctor notice that my mother could not follow a conversation , she some how got my point thank - god that she made a referral to the elderly consultant .

    I got mum to go to elderly consultant also by saying its to do with her diabetic medication , when with consultant I openly talk in front of mum told him all the symptoms , while mum saying I was betraying her that she OK , but she did let him do the memory test on her . then done referral for brain scan

    Could you not get your grandmother to the doctor saying she has to have the flu jab , and you or a member of you family go along with her also have read that people on TP write a note then pass it to doctor
     
  7. elaineo2

    elaineo2 Registered User

    Jul 6, 2007
    945
    leigh lancashire
    Dear Sean,you have had wonderful responses to your post.I and my family were concerned about dad.He saw the G.P (thinking it was a routine appointment),and the result was "prenicious aenemia",which can produce dementia like symptoms.We thought "great,its nothing to worry about really".Then the symptoms became worse and worse.I wrote to dads G.P and expressed our concerns over his memory and behaviour.To cut a long story short,dad was diagnosed with Alzheimers last weekend.His score on the mmse made hima candidate for medication.All in All,if you are as concrened as your post portrays then contacting the G.P can only be a good thing.love elainex
     
  8. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    69,850
    Kent
    Dear Sean,

    I would take Bruce`s advice and start a diary. I did this with my husband. I wrote down in detail, all his confusions, `mistakes`, and behaviour changes,--- times, dates and places.

    Then I went to the GP by myself. He took the diary seriously and sent for my husband for a diabetic check.

    Does your nan have a flu jab? If so, it would be a good idea to try to see the GP before then. Otherwise, perhaps he could call her in for a Senior check up.

    Good luck.
     
  9. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    3,725
    North Derbyshire
    Whilst I appreciate the necessity for patient confidentiality, my mum's GP (who is also mine) has always appreciated the need for me to have certain information about my mum. I'm sure he would never disclose anything truly personal, but to tell me what her score was, or her history of blood pressure, it wouldn't be a problem. When my dad was dying, he gave me the whole history and it helped me accept the situation. Perhaps I should report him?

    I am 100% confident that he wouldn't give out any information about me to my mother, but the other way round is totally different.

    He's the best GP in the world to me.

    Sorry everyone doesn't have the same experience.

    Margaret
     
  10. nortonowner

    nortonowner Registered User

    Apr 9, 2007
    4
    If it's not too late already, your gran really needs to put Power of Attorney in place with a solicitor. Then, if the financial side of things continues to be an issue ( I'm afraid switching to cheques did not help in my father in law's case ), POA can be invoked and whoever has been nominated can arrange for her benefits to be paid into an account which they control on her behalf. If she does not have POA in place and is subsequently labelled with dementia, the Court of Protection become involved. This is very, very expensive indeed. My mother in law put POA in place, my father in law did not. The difference in cost is considerable.
     
  11. Nebiroth

    Nebiroth Registered User

    Aug 20, 2006
    3,511
    Yes, although you will now have to do a Lasting Power of Attorney, because Enduring Powers cannot be created after October the 1st.

    LPA's are rather different to EPA's, they are more complicated for one thing, in that they can grant certain powers over health and care decisions as well as financial matters.

    In the meantime, I believe it is possible for the DWP (Department of Work and Pensions) to nominate someone as either an agent or an appointee.

    Agents are authorised to collect benefits on someone's behalf, and nothing else. They are usually nominated by the person who receives the benefits. Agents can cash giro cheques etc on behalf of the claimant, but can also operate the Post Office account - they will have their own card and PIN number.

    An appointee is someone who manages all the benefits of the claimant. They can fill in and sign claim forms, are obliged to report changes in circumstances and so on. An appointee must be age 18 or older. They must apply in writing to the office dealing with the benefit; most commonly, the DWP. Once the DWP appoints someone, they are usually accepted by the local authority and Revenue without having to apply separately and can thus deal with things like Council and Housing benefits etc.

    The DWP will usually visit both the claimant (to make sure that they lack mental capacity and require an appointee) and the appointee to make sure they will be acting in the best interest of the claimant.

    I believe that if you have Power of Attorney, this is not necessary, because the power enables you to act in the name of the donor in such things anyway.

    But it might be a useful interim step.

    Also, consider Attendance Allowance.
     
  12. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,438
    As Nebiroth rightly points out, from October 1st this will have to be an LPA. Of course, you could, if you get your skates on, download the EPA form from the guardianship website, and get it signed AND witnessed no later than midnight tomorrow (September 30th)

    http://www.guardianship.gov.uk/formsdocuments/forms.htm

    You can use the same link to download the LPA forms should you choose to go that route.
     
  13. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    3,725
    North Derbyshire
    Having just gone through a claim for Attendance Allowance, the department will accept a certified POA OR do the interviews to make you an appointee. If you can't manage the POA by tomorrow, you'll have to wait for the interviews.

    Good luck

    Margaret
     

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