I could scream...

[BenidormBelle]

...I really could. Here is my story, if anyone has had this same experience (and I bet their is many) please can you point me and my husband in the right direction.

For the past couple of years now, we have noticed my sister-in-law (husbands sister in her 70's) change, mainly memory problems.
Anyway, earlier this year she seemed to be having a serious problem remembering to take her medication - right amounts or right time of day. So, we got her G.P in, who in turn got a Psychiatrist out, who in turn gave her some tests to do (and she failed everyone) after 5 month of waiting for brain scan results, the psychiatrist gave her results....There is nothing wrong with sister-in-law its just OLD AGE and how it can be for some

I know 3 women in their 80's who lead active lives and would, apart from wanting to smack the psychiatrist, feel insulted at this comparison.

So, here are the symtons of OLD AGE....
Still has problems administering medication
Can't understand simple tasks, such as the T.V being in 'Stand-by', not a month goes by without t.v man called out to switch telly on.
Nearly everyday goes to next door neighbour to ask for time, she has at least 3 clocks (use to collect them) in every room, all saying same correct time.
Telephones/knocks on friends door, across the road, anythime between the hours of 11pm - 5am to see if she is going shopping.
Has her lunch at 9.30 IN THE MORNING.
Sat eating her breakfast at 2am, and wonders why its dark.
Counts £10 notes out as if they are £1 notes, when asked if she thought they were £1's, she confirmed she thought they were.
Not a week goes by she doesn't fall in her home, she can't explain the bruises because she does not remember.
I can no longer agree to take her away on holiday, as I feel she is more at risk away from home...it reminds me of watching a child to learn to walk not to hurt themselves.
She has gradually withdrawn from activities away from the home, and withdrawn into the comfort zone of her home.
The list is endless. IS THIS THE SIGN OF OLD AGE?
I THINK NOT.
My husband is retired now, and I worry more for him because he has suffered two minor strokes and this is now really getting to him. He suffers more with headaches. His own G.P is concerned for him.
But what can we now do when this Psychiatrist ( I could spit feathers for her stupid diagnosis) says its OLD AGE SYMTONS.
The sister-in-laws G.P is calling in on her regually. Personally, I think she should be taken into respite care to be observed more.
She has lost vast amounts of weight. There are more cleaning products in her cupboards than food. My husband got caught once, putting food in her cupboard and she shouted at him ( she has fallen out with a number of people with her attitude).
Please, is there anybody out there who will listen and help!!!

 

[Kayla]

My Mum had very similar symptoms and completely lost track of time and would eat her dinner at 3am or ring up to go to Church at 11pm on a Friday night. When she had hallucinations, she was referred to a specialist doctor who prescribed Haliperidol, which helped a little. When she became very unsteady on her feet, she went into a Care Home and she enjoyed the company and the routine.
She continued to be unsteady and fell several times, eventually breaking her hip and needing to go into a Nursing Home. My Mum was only 82 when she died of a heart attack but her symptoms were typical of Vascular Dementia, definitely not old age.
Age Concern or a similar organisation may arrange time at a Day Centre, which could help, or the Social Services might provide a carer to check up on meals or medication times.
It can be very demanding to look after somebody who has lost their sense of time and also very risky if they can't take their medication properly, so the GP might help to provide some extra support.
Kayla

 

[Canadian Joanne]

What is the GP's opinion? If the GP was concerned enough to get the psychiatrist in, surely he/she thinks there is something wrong. Perhaps what is needed is a geriatric psychiatrist - a specialist specialist, as it were. Get another opinion, if you can. Relay all your concerns to the GP & say you think another opinion would be in order. Since the GP seems to have a handle on this, I would recommend you having a meeting as soon as you can. After all, doctors make mistakes at their jobs just like the rest of the world. I don't understand how someone can have very low scores & have it brushed off as "old age".

Also - does anyone have power of attorney? This is essential for you and your husband to have some peace of mind.

Let us know what happens.

 

[BenidormBelle]

Kayla
Thank you for your suggestions. Im not sure what Vascular Dementia is, I presume its to do with the heart? My sister-in-law is taking various medications, which are all associated with the heart.

Earlier this year we had social services in to chat with her, but she was adament that she did not need help. In the long run the only thing she was prepared to accept was Careline.

We thought it may be a good idea to get her help in the home couple of times a week, meals on wheels (because we feel she is not eating enough), anything just so she can maintain independance in her home for as long as possible.

I will pass these suggestions on, and believe me we will use them.

I just feel sometimes no one is listening, who should be...Do you know what I mean.

 

[BenidormBelle]

I contacted the G.P last week. I understand he is not able to comment on his patient, although we do know about her medical problems. So, I informed him, that we were not happy with the Psychiatrist (who was a Geriatric Psychiatrist, would you believe) report.
Also, that my sister-in-law is falling at least once a week. She won't even listen to us when telling her not to climb buffets to hang curtains.
It was the same G.P who eventually admitted my mother-in-law into care, because she had dementia and eventually became violent towards my sister-in-law, so he knows theres an history there.
I ,or my husband, have contacted her G.P a number of times in the past few months in connection with her. I just feel though they might be thinking we are nuisances. Especially when we are telling him she falls, and when she is asked says ' No' because she can't remember.

Of course I will keep you inform, because who knows our experiences may then help others.

Thank you

With regard to Power of Attorney..No. How can we get it done, when there is nothing wrong with her!!!! I did manage to get her to have all household bills going out of her account on a monthly basis, which thankfully I can control. But when she is handling cash, on a weekly basis from her pension, there the problem lies. She just does not use safe security precautions. Personally, she is a victim waiting to happen, and thats what scares us.

 

[Skye]

Hi Benidormbelle

First of all, welcome to TP. I have to say that none of us is medically qualified to give a diagnosis, but we can offer you advice and support.

I can tell how worried you are about your sister in law, and there certainly seem to be symptoms that are not appropriate for normal aging.

In your place, I would go back to the GP and ask for a referral to a another psychiatrist. You are entitled to a second opinion.

I assume that the test was the mmse, which is the standard test for Alzheimer's. The fact that your SIL's score was so low is a good indicator that something is wrong.

It would be a good idea if you wrote down all the signs you have seen, just as you have here, and give them to the doctor. They are all things that people on this forum have experienced.

You could also contact social services and ask them for an assessment. It certainly sounds as if she needs some supervision in the home.

I'm afraid you're going to have to be very firm with everyone, it's all too easy to put things down to 'old age'.

Let us know how you get on.

Best wishes,

 

[sue38]

Hi BenidormBelle,

Welcome to TP.

It is very important to get a proper diagnosis and no one on TP could say whether your sister-in-law has dementia or not, however the symptoms you describe, the inability to perform every day tasks, the confusion as to the time of day and so on are very common in dementia sufferers.

Can I ask who told you that your SIL's behaviour was just due to old age? If it was your SIL herself, might it be that she is not telling the truth/ forgotten what was said?

If it was the G.P. or psychiatrist who told you would they be prepared to discuss the matter with you further?

You say that the psychiatrist carried out tests and your SIL failed every one. I presume that this was the MMSE or mini-memory test. This is described in the AS fact sheet http://www.alzheimers.org.uk/How_is_dementia_diagnosed/Diagnosis_process/info_mmse.htm

Do you know what she scored?

A brain scan might show Vascular dementia but Alzheimers itself (and maybe other types of dementia - I'm not sure) cannot be diagnosed from a scan.

It does sound as if your SIL needs help before she comes to any serious harm. Is it worth asking the GP if he/she believes that your SIL is safe in her own home, particularly given the wandering in the early hours.

I'm sure others will be along with suggestions and advice.

Let us know how you go.

 

[Skye]

Sorry, I was interrupted in my reply, so missed all the bits in between. You can find out about Vascular Dementia on this factsheet:

http://www.alzheimers.org.uk/Facts_about_dementia/What_is_dementia/info_vascular.htm

 

[BenidormBelle]

It was the Geriatric Psychiatrist who stated it was due to Old Age, and she felt that there was no need for a revisit.
My SIL did do some simple tests, in her home, earlier this year and failed everyone. Even the year, to which she thought was 1997.
She couldn't even draw the face of a clock, and she use to collect clocks.
We have installed, at her eye level, a clock that shows the Day- Date- month - Year - Time am or pm - and still she does not comprehend these.
We did keep notes on things we witnessed with her, advice from social worker, for the last 6 months.
She has also had hallucinations, of people sitting in her room who would not leave. And that someone must have got in during the night, because she got up one morning to her t.v and fire being on.
We have sent those notes to the Psychiatrist, for her to at lease record we are not happy with her results.
After reading everyones kind suggestions, and links, on this Thread. I can now tell you that I am printing off copies of the observation notes we made. With these notes I will be sending them to my SIL's G.P with a cover note, requesting that we have a consultation with him a.s.a.p.
If we can find ways of her maintaining independence, until time allows, we will do it. My SIL is one of these who will listen more to her G.P then the next of kin.
And, Yes we will be asking for another referal to another Psychiatrist.
I will of course keep you all informed, when things should and will start to happen.

 

[BenidormBelle]

Just one more thought, as anyone actually been able to have a follow up meeting with one of these Psychiatrists. Since the 'diagnosis' I have tried unsuccessfully a number of times to speak to her, but she is either on the phone or on her rounds, there is no suggestion of her RETURNING my call. I find this very poor quality service coming from a professional person.

 

[Kayla]

When the doctor came to see Mum at home, she performed well on the tests he gave her, scoring 29 out of 30, which was good for her age and he commented on how tidy her home was and the way Mum had colour co-ordinated her clothes etc.
Right up to the end, Mum could hold a sensible conversation and even make little jokes, like she had always done. For no reason, she'd suddenly say something strange or talk about animals in her room or people who weren't there.
Mum also had rheumatoid arthritis which complicated things and probably stopped her walking again after breaking her hip. The doctors and social workers were not at all helpful, but the staff in the Nursing Home explained about the Vascular Dementia and I discovered Talking Point.
Try and insist on help as soon as possible as there is too much to deal with on your own.
I know how you must feel and I hope you can get answers to your questions from the professionals soon.
Kayla

 

[BeckyJan]

Just chipping in here - you have already had excellent advice and you have a hell of a problem.
I wonder if you might get local advice from the Alz. Society - our local group is excellent and they do understand the local problems (? ablity of local psychiatrist). You have nothing to lose in contacting them.

Thinking about you alot - there is obviously a dementia problem which needs dealing with and you are already doing all the right things.

I do not think we would get a 'follow up' easily here in North Derbyshire. The mental health team are massively understaffed and only when one reaches crisis point do we get attention. I think you have to show serious 'signs of strain' for anything to happen.

I truly hope you receive some answers soon. Best wishes Beckyjan

 

[sue38]

Just one more thought, as anyone actually been able to have a follow up meeting with one of these Psychiatrists. Since the 'diagnosis' I have tried unsuccessfully a number of times to speak to her, but she is either on the phone or on her rounds, there is no suggestion of her RETURNING my call. I find this very poor quality service coming from a professional person.

You could try asking for an appointment... but this may take some time. In the meantime keep up the pressure on the GP. I have posted this in another thread which may help...

On the question of next of kin and disclosure of information, it appears that one of the exceptions to the general rule that a doctor cannot disclose information without the patient's consent, is 'to a close relative or another third party in the best interests of the patient.' No mention of next of kin.

 

[Skye]

Just one more thought, as anyone actually been able to have a follow up meeting with one of these Psychiatrists. Since the 'diagnosis' I have tried unsuccessfully a number of times to speak to her, but she is either on the phone or on her rounds, there is no suggestion of her RETURNING my call. I find this very poor quality service coming from a professional person.

I've had regular appointments with John since he was diagnosed. Once a month to stsrt with, then every three months. We now go once a year, but I could call at any time for an emergency appointment.

But I assume that is because he has a diagnosis of dementia. It's an easy opt-out to say the problems are normal aging.

I think you have to press for a second opinion, if you are to get any help. I presume there is more than one psych/ger in your area?

 

[Nebiroth]

What an awful situation you find yourselves in. With everything you say - from experience we've had - my Dad and Gran both had dementia - this sounds like more than just "old age". I can't understand how the Psychiatrist can say this, particularly with the low test scores. All the things you describe sound so typical of dementia. Particularly the loss of time-sense, the inability to do simple tasks and the lapses of memory. I don;t think that someone with "just old age" should be confusing the time to that extent. People with dementia often have a very poor sense of time (carers become very familiar with "what time is it?" "It;s the evening isn;t it?" "What day is it again?"!)

The GP is usually the first point of contact for all these things. Was the Psychiatrist from the local Memory Unit? Were you or your SIL's husband present and able to speak with the Psychiatrist?

Also, you should make it very clear that you feel your SIL is at risk - if she is falling regularly then that is the physical risk, but her confusions etc leave her vulnerable as well. At the very least she should be assessed by Social Services because of the risk to herself, and to her husband because his health and safety sounds as though it;s at risk also.

It sounds as though the GP should be pushing hard for a second opinion.