Referral to memory clinic declined, what to do next?

[Jay586]

MiL is pretty bad. The GP gave up on questions after about 3 as she was getting so distressed. She doesn't know the time of day, where she lives or anything that's happened in the last 70 years. She's currently remembering things that happened before the age of 10 and is extremely repetitive. Doesn't know she needs to take medication, etc. Won't remember the GP visited if asked.

She's had referrals in the past and refused to go.

GP referred her again but said in the letter she has capacity, so memory clinic have declined the referral.

FiL is currently looking after her and she needs 24/7 care. His health is not so good either.

We are going to go back to the GP to discuss what to do next but is there anything else we can do?

I understand we might need to involve social services but we're hoping to get things managed, rather than wait for or cause a crisis and they also need to consent. We were trying to plan care if something happens to Fil but that requires a diagnosis.

We are also carers for my mum (90, stroke, lives a fair distance away), so it's getting quite daunting.

 

[SeaSwallow]

Hello @Jay586 You certainly have a lot going on at the minute, it must be so difficult for you. I am not sure why the memory clinic has declined the referral just because the doctor said that your MIL had capacity, unless it was because of her previous refusals to attend.
You say that you are reluctant to get social services involved at this stage but I would suggest that you start the ball rolling now, rather than waiting for a crisis to occur. It can take time to get these things organised.

 

[SAP]

Hello @Jay586 , you will find lots of advice and support on here so please ask as may questions as you need. This is indeed a daunting time and not really helped by the GP with the capacity situation. It’s tricky to get right as there are a lot of legal requirements but still it sounds like your MIL struggles with this. I wonder if the assessment would be different if your FIL was not available to care for her.
The question to look at now is how any care would be paid for. If your MIL has savings of over £23,500 then you done need to wait for social services to get involved and can arrange care yourselves ( does anyone have LPA?) or a cleaner/ home help.
You could still approach social services without a diagnosis as this situation does have the potential to become a safeguarding one. Have a discussion with your FIL about his wife’s issues and behaviour, he may be masking the true extent of how she is.

 

[Jay586]

Thanks. They are a very close couple, so getting involved has taken a while and a lot of diplomacy.

They would be self-funding but we're in Wales, so I think there's a cap.

Money isn't the issue, it's getting FiL to agree to anyone coming in. He worries about her reaction and she is vehement that she does not want or need help.

It's hard enough for us to get over the doorstep.

 

[Jaded'n'faded]

It seems very strange that the memory clinic have declined the GP referral - I would query this.

I'm pretty sure that a referral to the MC is not dependent on whether or not the person has capacity or not.

 

[nitram]

It seems very strange that the memory clinic have declined the GP referral - I would query this.

The reason may be related to

She's had referrals in the past and refused to go.

GP referred her again but said in the letter she has capacity, so memory clinic have declined the referral.

 

[Jay586]

Yes, we think it's do with previous refusals, tho they were all cancelled in good time, not missed and not all in the same health board.

The letter was literally we're declining the referral, one sentence. But my husband rang to chase the referral and they told him it was due to the previous refusals.

 

[Jay586]

We did a wee video of Mil and went back to the GP, seeing our own doctor and she's been re-referred as in the video, it's very clear she does not have capacity and GP agreed.

Thanks all.

 

[canary]

Well done @Jay586
Hope the referral goes through
xx

 

[Jay586]

The CMHT have deemed it's not appropriate for the memory clinic again but explained why.

They are asking for blood tests and then going to do an assessment, maybe at home.

They have also referred Mil to Social Services. And FiL seems ok about this, much to our surprise.

Anyone had an assessment at home?

 

[Bunpoots]

Hi @Jay586

My dad had assessments both in the memory clinic and then 3 years later at home.
There wasn’t a lot of difference between the two. The home assessment was carried out by a CPN and her approach was less formal and more intuitive than that the clinic which may suit your MIL better.

 

[Jay586]

Hello, yes it will. That's definitely what's needed. Thanks.

 

[Sarasa]

Glad you got an assessment sorted @Jay586. My mum was a memory clinic refuser too. They sent an occupational therapist round who chatted generally to mum and said she'd discuss what to do next with the rest of the team. Nothing came of that, but a few weeks later mum had a meltdown in the doctor's surgery. The receptionist who phoned me about it sounded very scared. The family had seen such meltdowns, but mum had always put on a good front at the surgery before that. The upshot was a psychiatrist saw her at home. My brother and I didn't know when he was coming and as we didn't live near mum couldn't be there. However he put my brother on speaker phone and had a chat about what he thought with my mum disagreeing in the background. The diagnosis of vascular dementia was enough to finally persuade him that mum needed a care home and a few weeks later I moved her to one near me.

 

[Supermumpicnic]

Hello @Jay586 You certainly have a lot going on at the minute, it must be so difficult for you. I am not sure why the memory clinic has declined the referral just because the doctor said that your MIL had capacity, unless it was because of her previous refusals to attend.
You say that you are reluctant to get social services involved at this stage but I would suggest that you start the ball rolling now, rather than waiting for a crisis to occur. It can take time to get these things organised.

After 2 years of insisting that my MIL was having memory issues, she was referred to the community mental health team. A nurse came out and asked her questions. After a few weeks a doctor came out from this team and asked her questions. On the way out she told us that it was Dementia. I understand your reluctance to involve social services but its useful to have them on side for when you need them. We played it clever and requested a carers assessment. This triggered a worker to come and question my MIL and to complete a care needs assessment. This made it easier when 6 months later, she needed a couple of care visits a day.

 

[Jay586]

The cmht have referred Mil to social services too. We thought FiL would be very unhappy and he got told before we had a chance to tell him but actually he seems ok about it. I think it helped it was a 3rd party that did the referral.

Mil is actually ok, albeit declining physically as she pretty much refuses to do anything at all and she's definitely remembering less and less.

More worried about fil as he's now pretty old and has quite a few medical issues. It's good we're making progress finally, been quite a long time!

 

[Ladylucy]

MiL is pretty bad. The GP gave up on questions after about 3 as she was getting so distressed. She doesn't know the time of day, where she lives or anything that's happened in the last 70 years. She's currently remembering things that happened before the age of 10 and is extremely repetitive. Doesn't know she needs to take medication, etc. Won't remember the GP visited if asked.

She's had referrals in the past and refused to go.

GP referred her again but said in the letter she has capacity, so memory clinic have declined the referral.

FiL is currently looking after her and she needs 24/7 care. His health is not so good either.

We are going to go back to the GP to discuss what to do next but is there anything else we can do?

I understand we might need to involve social services but we're hoping to get things managed, rather than wait for or cause a crisis and they also need to consent. We were trying to plan care if something happens to Fil but that requires a diagnosis.

We are also carers for my mum (90, stroke, lives a fair distance away), so it's getting quite daunting.

 

[Ladylucy]

Interestingly the doctor that tested my mum said she performed ok on the tests and had capacity, but then went on to say that she clearly had dementia and he could refer her but she would likely be rejected on the basis of those tests.
Frustrating. We know, he knows but according to the tests some mild impairment only!!!

 

[SeaSwallow]

Interestingly the doctor that tested my mum said she performed ok on the tests and had capacity, but then went on to say that she clearly had dementia and he could refer her but she would likely be rejected on the basis of those tests.
Frustrating. We know, he knows but according to the tests some mild impairment only!!!

Hello @Ladylucy Welcome to the Dementia Support Forum. It is possible to have dementia but still have capacity. It might be an idea to speak to the doctor again and ask for a formal referral, at least that way you would know if the memory clinic is willing to see your mum. In the meantime if you have not already done so please discuss arranging LPA for Finances and Health and Welfare with your mum because these have to be done whilst a person still has capacity.