How do I involve a GP?

Discussion in 'ARCHIVE FORUM: Support discussions' started by PatA, Jan 17, 2005.

  1. PatA

    PatA Registered User

    Jan 17, 2005
    13
    Gloucester
    I have spent the morning reading other people's experiences and I am more convinced than ever that my mother is suffering with AD. She will be 90 this year and my father, who will be 83 this year, is struggling to cope with it all.
    The first point of call would seem to be her GP - but she flatly refuses to see him as she feels that there is nothing wrong with her and he won't make a home visit to someone who doesn't want to see him.
    Can someone please tell me what I have to say or do to make the GP listen?
     
  2. Mjaqmac

    Mjaqmac Registered User

    Mar 13, 2004
    939
    Could you request your GP to ask a CPN (Community Pshychiatric Nurse) to call at her home and assess her? This seems to be what happened in my mother's case. I went to the GP on her behalf and a CPN called at the house and gave her a memory test and then went back to the consultant in geriatric phsychiatry. This got the ball rolling for care package and help etc. She would really need to be assessed.

    Hope this helps, there are lots of others here much more knowledgable than I but this is how I managed it.

    Best of luck to you.
     
  3. PatA

    PatA Registered User

    Jan 17, 2005
    13
    Gloucester
    Thank you
     
  4. Chesca

    Chesca Guest

    Dear Pat

    Can't add much to what Magic says, seems to be a good way around it. You can see Mum's GP to explain your worries, highlighting the stress on Dad and you. If Mum has dementia you won't be able to reason with her anyway, am sure you know that already.

    When I spoke to our GP at the beginning of Mum's AD, she said much the same as yours. She couldn't make any of it happen without a visit from Mum - but pointed out that Dad, as Mum was unable to really, could make the decision for a hospital consultation so that is the road we went down. But I'd stick with Magic's suggestion - sounds a much gentler solution.

    How a GP can expect somebody who doesn't know whether it's New York or new year to collate sufficient thought to ask for help is yet another of life's little mysteries.

    Best wishes and the best of luck
    Chesca
     
  5. Norman

    Norman Registered User

    Oct 9, 2003
    4,348
    Birmingham Hades
    Pat
    magic's advice is the way to go.
    We had a call from the CPN, two CPNs in fact,
    Following this the consultant made a home visit,and all went from there
    Norman
     
  6. Sheila

    Sheila Registered User

    Oct 23, 2003
    2,259
    West Sussex
    Hi all, Mums GP said to bring Mum along to the surgery for an "over 70s health check", that got the ball rolling for us. Love She. XX
     
  7. PatA

    PatA Registered User

    Jan 17, 2005
    13
    Gloucester
    Morning everyone,
    Thanks for the advice you gave me. I had a long talk with my sister about it and we decided that I would ring the surgery and try to talk to someone and she would ring the woman who runs the Day Centre that mum goes to. (We thought that she might be helpful as she rang dad last week and tactfully mentioned that mum sometimes has "an odour" ).

    However, events have overtaken us. I'd only just got to work yesterday when my sister rang to say that dad had called and was in a state. He had gone to wake mum up (she has had to sleep downstairs for some years ) and found her sitting on the bed, soaking wet and insisiting that someone had thrown a bucket of water over her. I rang the surgery and asked for a home visit and briefly explained that I had been on the verge of ringing anyway. They took my number and said that they would get "Helen", who does the assessments to ring me. Fortunately I have a good boss and I just left everything and drove over and waited for the doctor.
    When he turned up he was excellent. Talked with mum rather than asked questions and said he would arrange for a nurse to come and see her and collect blood and urine samples. He said "you'll like her, her name is Helen" and he just smiled at me.

    When he was leaving he suggested that dad makes an appointment for a check up as well, which I was very pleased about because the strain really is starting to show on him.

    I walked to the car with the doctor and he said "Phew, there's more there than incontinence and loss of memory, leave it with me and I'll get the ball rolling"

    So, I'm waiting for a call from"Helen" and I have woken up this morning feeling more positive/less stressed. I know that this is still the beginning of what will probably be a long drawn out process, but at least the process has started.

    Thanks again for your advice.
     
  8. Jude

    Jude Registered User

    Dear Pat,

    A rather belated welcome to TP from me.

    I was very heartened to read your post and to know that you have received such prompt help from the professionals in your area.

    It's wonderful to read such a positive post. AD is a long sad haul for families and carers alike. I'm so pleased to hear that your sister is so supportive too. So often one person ends up doing all the hard yakka.

    I wish you all good luck. Do keep posting and ask any questions that you need to during the coming weeks - we'll all be here to help in any way we can.

    Kind regards,

    Jude
     
  9. Sheila

    Sheila Registered User

    Oct 23, 2003
    2,259
    West Sussex
    Dear Pat, sorry you had a bit of a traumatic run there for a bit, but it looks as though your GP has come up trumps, good luck with the meeting with Helen, let us know how you get on, love She. XX
     
  10. PatA

    PatA Registered User

    Jan 17, 2005
    13
    Gloucester
    Dear all

    I can't believe the speed that things are moving at! A comment that the doctor made yesterday left me feeling that my parents had "slipped through the net" and the way they are running around now makes me think that a lot of people are trying to cover their own backsides.However , if it means things get done faster then we are not going to complain!!

    The surgery rang me this morning to say that Helen had been called to an emergency and she had asked them to ring me and apologise and to say that she would ring this afternoon. She rang about 3pm and I have arranged to be at mum's at 9.30 Monday when Helen will be round to do her assessment. She will also give dad the "once over" while she's there to save him having to go to the surgery.

    It's all too positive.......when do we hit the brick wall???

    I had a second phone call today which infuriated me at the time but I've calmed down - and laughed about it.

    Social Services rang to discuss my request to have my dad assessed! I've never spoken to SS but I told her that it was my mum who needed the assessment; I believe she may have AD, but right this minute the biggest problem we have is the incontinence which mum refuses to acknowledge. Well, you'll all be pleased to know that SS can solve this one. She said that she could send someone round with some pads and then the problem would be solved. GREAT!! Can they also send someone who can explain to mum that the pads are no use unless she wears knickers occassionally??!!

    I didn't dare say the words that were going through my mind as I thought I might have to ring this woman in the future and ask for her help, so I just said thankyou and put the phone down. As I said, I was furious at the time but pacing round the house calling her calling her everything I could think of -in extremely basic english - has helped and when I rang my sister to let her know what's happening we both laughed about it.

    Hope you all have a good weekend

    Will let you know what happens on Monday

    Pat.
     
  11. Sheila

    Sheila Registered User

    Oct 23, 2003
    2,259
    West Sussex
    Dear Pat, well it wouldn't be the first time it's happened would it, net I mean. Glad that at least now they are in a hurry to get their act together. Never look for a brick wall, you will know soon enough when you hit one! As for the pads, you can get ones like baby ones, they have tabs each side, so your Mum can go knickerless still Bless her! It's important to release the tension, thats what you did and in a safe way. By then laughing at it with your sister and now here, you have put it behind you and will be stronger to face the next hurdle. Love She. XX
     
  12. Norman

    Norman Registered User

    Oct 9, 2003
    4,348
    Birmingham Hades
    Pat
    this a real day to day,go with it accept the help that is there,now.
    I am sure you will hit a brick wall,Iv'e hit several but they all fell down in the end.
    You are off to a cracking start and I wish you all the luck in the world
    Norman
     
  13. Jude

    Jude Registered User

    Dear Pat,

    Great to hear everything is wizzing along so well. Just go with the flow..........

    Jude
     
  14. PatA

    PatA Registered User

    Jan 17, 2005
    13
    Gloucester
    Hi everyone,
    Well Monday came and went,as did the nurse. I went along prepared for a long session of questions and form filling but not even remotely prepared for what happened.She asked mum 4 questions:- What time do you think it is?; What year are we in?; Can you tell me the months of the year starting with Dec. and going backwards? and Can you count backwards from 20 to 1 for me? Well, she knew it was about 10.30 because it was coffee time but the other three she couldn't do. But each time she made a mistake the nurse stopped her and prompted until she gave the right answer. She then said to me that mum is an old lady who is a bit forgetful but that there are no signs of dementia at all. She will arrange for the "incontinence nurse" to come and assess her and see if she qualifies for free pads and then she left. The whole episode, including blood and urine samples took about half an hour and I felt like the wicked daughter who is trying to have her mother locked away.
    I went back in the evening and was greeted with "were there many people on the bus?" - I live 15 miles away and have been driving for 30 years. And then we had the usual "how are the children doing at school?" - my sons are 20 and 24 and once again I explained that they don't go to school anymore.
    There are times when mum doesn't know what day it;doesn't know who I am;doesn't know where she is. I'm certain I don't need to explain to you, you've all got the t-shirt. But mum's records now say that she has been assessed and that there is no sign of dementia. What now? Can we ask for a second opinion?
     
  15. thompsonsom

    thompsonsom Registered User

    Jul 4, 2004
    97
    halifax
    Hi Pat

    I would certainly ask for another opinion preferably someone above the person that came who may have more guption when it comes to assessing for dementia and just forgetfulness, besides which there is no such thing as just forgetfulness in old age as i read on one of the many information sheets available, and if everyone was aware of this and took advise earlier we may be able to get a diagnosis earlier and get treatment before it is too late. The simple test used on my mother in law to determine dementia was a simple thing like drawing a clock and putting the times in, she knew 1-12 but put them all down the one side of the circle, other questions were such as who is the present prime minister and the what year are we in. This test was done by the psychiatrist himself and from that information he confirmed Alzheimers but on the outside m/i/l looks as normal as everyone else. Do not give up with this answer i think you are being fobbed off and the only way to get anywhere is to kick up a fuss. Don't feel like you are betraying mum, you are not, you are just getting the help she needs.
    Jan
     
  16. Brucie

    Brucie Registered User

    Jan 31, 2004
    12,413
    near London
    yes, you need to have someone competent do the tests. Sending along a nurse is not sufficient.
     
  17. Norman

    Norman Registered User

    Oct 9, 2003
    4,348
    Birmingham Hades
    Pat
    a nurse is not the ideal person to carry out such an assessmentI would definitely ask for some ,the consultant preferably, to carry out a teast.
    Have a look at fact sheet No 436, on thi board you will see the full test used there
    Hope this helps
    Norman
     
  18. Jude

    Jude Registered User

    Dear Pat,

    Speak to your mother's doctor again and ask for a referral to the Consultant Psych. Hopefully the CP will be prepared to make a home visit to assess your mother correctly.

    Jude
     
  19. Sheila

    Sheila Registered User

    Oct 23, 2003
    2,259
    West Sussex
    Hi Pat, your GP has already said there is more to it, get straight back to him and explain what happened then ask him to sort it that a specialist is asked to do the assessment. The nurse obviously had not read up on what the GP had put about there being more to it. Love She. XX
     
  20. PatA

    PatA Registered User

    Jan 17, 2005
    13
    Gloucester
    Hi everyone,
    Haven't posted lately as we've been "watching and waiting". Mum was prescribed antibiotics for a urine infection and we were told this would solve all of her problems. One good thing that came from the nurses visit was that she got mum to agree to have a weekly bath at the day centre.She did seem to be perfectly happy with this and was ok with me packing a bag for her with toiletries and a change of clothes. But about an hour after I left she was in tears because her bags were packed and she didn't want to go anywhere, she wants to live in her own home.By the next day she was fine and she enjoyed her bath and having her hair washed.I know it doesn't sound a lot but at least she is having a wash and a change of clothes on a regular basis and without any confrontation.
    My sister called in at the day centre to have a chat and was suprised to hear a description of a totally different person - although she was assured that most of their ladies behave in a manner that would suit the vicar's garden party! She asked if they had problems getting mum to use a knife and fork at lunchtime - absolutely none; but at home it's not unusual for her to eat with her fingers.We no longer try to stop her because it isn't worth everyone getting upset. They told my sister to get mum straight back to the doctor as she is very sore in places. She was told to lie if it was the only way to get an appointment!! She managed to get her in the following morning and insisted on staying during the examination after which he announced that mum is constipated and prescribed senna. She did manage to get the doctor on his own and told him that I was not impressed with the nurse who came out and he said her job was just to report back to someone else who would be in touch. We're not too sure what will happen there as she said there is no dementia.
    That brings us to last Saturday. I went over as usual and thought mum looked better than she had for a long time. She thinks the baths are wonderful. However she said she wanted to go to bed because she didn't feel good. Having changed the bed and got her settled I was putting her clean washing away when she started to tell me that her daughter Pat (me) always comes to visit on a Saturday afternoon and brings her great -granddaughter with her. I didn't go into explanations I just said "that's nice" and she settled down to sleep.
    Not too sure what we do now. I have to ring the surgery as no-one has turned up to sort out anything re the incontinence and I have to ring social services as they want to see both mum and dad.
    We would be grateful for advice/opinions on how we deal with the different personalities that mum is becoming. Although she doesn't always know who I am she is always fine with me. Sometimes I feel that I am treating her like a child but there is no confrontation. However, she is totally different with my sister. She is agressive, shouts at her, does the "how dare you speak to me like that" speeches. And then the person they see at the day centre - helping the "old" people and always volunteering to do things.( Mind you, she keeps telling me that she's not going any more because they make her work all the time she's there!)

    I seem to have rambled, sorry, but I think that stems from frustration - not understanding enough about what is happening and not knowing enough about how to deal with it.
     

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