why didn't the doctor notice

[nemesisis]

my mum has suffered from high blood pressure since she was 60. untill she was 69 I thought she was ok just a bit forgetfull and then I got worried about her and it took a lot of persuassion but I finally got her to vist the doctors (because her knees were painfull) the doctor said oh where have you been for three years!! (I had no idea she had not had her medication as she had boxes of tablets in her cupboard) when he examined mum he was so concerned (she had also lost so much weight) that he refered her to the hospital straight the way for tests and three weeks later a MRI diagnosed Alzheimers. But what concerns me is why the doctor after treating mum for high blood pressure for 6 years didn't seem concerned that suddenly she had not been back for her repeat prescriptions or had her yearly check on her blood pressure
Although he has always been very nice and concerned since I have been taking mum with various problems (she had a fall in dec and broke her arm) I car'nt help feeling that the surgery should have noticed a problem and that is what concerns me - the elderly and vulnerable are at risk unless we all look out for them xx

 

[Brucie]

Most likely - and I have no personal knowledge - surgeries expect people to be well enough to understand when they are not well, if you see what I mean?

They seem to rely more on patients self diagnosing these days, so in the 7 minutes they allot you at the surgery, they can confirm [or otherwise] the diagnosis the patient has made, and then move on.

Not so much the National Health Service, more the Daily Mail health pages Health Service.

They all have computers everywhere, but they are primarily to save keeping records on paper, and not to alert them to the needs of patients.

Garages can send out reminders to customers of the need to take the car in; credit card companies can spot changes in credit patterns and contact customers in case of fraud, but doctors can't be alerted when some critical medication has not been repeat prescribed.... so it seems.

Patients of today have been well trained. The surgeries are full of Mums with young children who have a cold - but who might just have something worse, of course.

Older people may not want to bother the doctor so they try to manage, or they may not be well enough to go to the surgery. They may not be able to drive, and public transport may be poor.

Finally, they may never get past the receptionist - I'm not that old but I've been told so many times "the next free appointment is in 12 days time", which is another reason to self diagnose and self medicate where that is possible.

Last thing, which follows the lines of a thread elsewhere on TP.

When my Jan was at home, she would always ask me to call the surgery to make an appointment. If she, as a woman, called - the woman at the other end would manage to fob her off, saying there was nothing available. If I called just after, they would give me an appointment immediately, and within the day.

He or she who shouts loudest gets heard. If you shout louder you must be more unwell. Problem is that the older folk tend to think it rude to shout.

 

[Lila13]

When my Jan was at home, she would always ask me to call the surgery to make an appointment. If she, as a woman, called - the woman at the other end would manage to fob her off, saying there was nothing available. If I called just after, they would give me an appointment immediately, and within the day.

I remember women at work often used to ask male colleagues to make such phone calls for them when they'd been fobbed off, it usually seemed to work.

I wonder if that was why my mother was only prescribed Aricept (the first sign that any professional person admitted that she might have dementia) when my BROTHER went with her to the psychiatrist?

(Not that having the Aricept was necessarily a good thing.)

 

[Lila13]

Repeat prescriptions

I couldn't make out why doctors had been giving my mother repeat prescriptions without examining her for I don't know how long, not checking to see if she was competent to self-medicate.

Or why a nurse gave her a flu jab without noticing there was hardly enough left of her to put a jab into.

 

[Lila13]

And yes, I did complain, on the phone and in writing, and doubtless they just thought "oh there's that mad woman going on about her mother again".

 

[Grannie G]

. But what concerns me is why the doctor after treating mum for high blood pressure for 6 years didn't seem concerned that suddenly she had not been back for her repeat prescriptions or had her yearly check on her blood pressure

When I first went to live nearer my mother and consulted her GP about my concerns for her, I found he had been prescribing Thyroid medication, but she had not asked for a repeat prescription for over 3 years. My mother was very much into Nature Cure, didn`t like taking tablets, so I suppose it was `six of one, and half a dozen of the other`.

We moved back to an area we had lived in 6 years previously, but this same GP, had no idea we were not still his patients until I asked to re-register with him.

I`m afraid this happens. I don`t know whether it`s negligence or `computer error`.

 

[Taffy]

Hello nemesisis, You made a very valid point about the elderly and vulnerable. I can't help thinking, that if there were a patient shortage, then we would see a reminder system in place.

 

[Margarita]

because her knees were painfull) the doctor said oh where have you been for three years!!

I say negligence , because 3 years ago all doctor did not have all patents files on computer my surgery only put all files on computer late last year .

5 years ago , when I notices changes in my mother , only after my father died , I found out that my mother doctor came around and knock on they house , as he wanted to know why my father was not picking up his perception , as he also had hight blood pursuer , that lead to a stroke .

I never new the complication or implication just like my parents in not taking medication for blood purser that could lead heart attack dementia , till my father had a heart attract & died.

So nemesisis be proud of yourself now in helping your mother with her medication .

I know from getting my medication under control with her blood purser , diabetic tablets , cholesterol tablets , she is on a better level even with AZ .



PS
And if it make you feel better and would help someone else in the future make a complaint to your local PCT

 

[Lila13]

Or if they made proper routine check-ups for all elderly patients a target, as everything seems to be target-driven nowadays.

But that wouldn't help with younger patients with dementia, unless they offered us all routine check-ups, can't see that happening.

But of course the main problem remains that they have to believe what patients themselves say, until the patient has been proved not to be competent, and many dementia patients are obviously very good at putting on a convincing performance.

I can't help thinking, that if there were a patient shortage, then we would see a reminder system in place.

 

[Natashalou]

Perfectly possible

Its all perfectly possible if the practice is properly run. When my mum still lived in Chichester, she received reminders about everything , repeat medication, tests, flu jab etc.
If she didnt action them, she would then receive a telephone call from the admin staff.
Im in london and the same applies here...reminders for everythin. I recently forgot all about going for a mammogram and had a reminder through within less than a week to make another appointment. It has never gone as far as being telephoned, but that might be because I have always dealt with stuff.
However, I suppose if a couple of reminders go out and there is still no response, the surgeries cant really be expected to keep chasing people for ever, and this is where the more vulnerable sadly fall through the net.
I had an uncle who unexpectedly died at home, and we couldnt get anyone to come and certify his death because it transpired he hadnt been to the doctor for fifty years!..he had simply never been ill.

 

[Nebiroth]

Yes, our surgery sends reminders who things like checkups - I get an annual check at the asthma clinic, and Dad goes once every six months for heart/blood pressure/cholesterol etc. If you don't go you get a notice reminding you, with an option to send a signed note back if you decide you don't want to go.

However, I think it's harder to pick things up if patients who stop say collecting or asking for a repeat prescription. It's more likely to be flagged if someone asks for too many, than not enough. Perhaps connected with a patients right to stop treatment if they wish.

I think it would be hard for a GP who doesn't see a patient quite often to pick up early signs of dementia. We ourselves spent several years dismissing the very early signs. Not likely that subtle hints are going to be picked up in the few minutes a busy GP has...they really need to be specifically looking for the signs.

 

[Lila13]

And even when they are supposed to be looking for signs, when family and neighbours contact them about unusual or dangerous behaviour, they'd rather believe the patient than everyone else, as if they family and neighbours were colluding in some mysterious conspiracy for no apparent reason.