Sorry, more advice please re MIL and GP

[Pleasemrstweedie]

Thanks for previous advice.

We drafted a letter for MIL to sign to say that the GP could talk to DH about her health. MIL was fine with this and thought it was a good idea. We hand delivered this to the surgery three weeks ago, but although we asked for it to be acknowledged, MIL has so far received nothing.

MIL now needs to see the GP. She has made an appointment for next week and is anxious for DH to take her. However, this will be the first time she has been out of the house since Christmas Day when it took three people half an hour to manoeuvre her down a flight of steps and into a car. DH will be singlehanded and is not in good health himself (and probably weighs less than MIL).

I don't think DH should even attempt this. I think if the GP wants to see MIL, which us the situation here, the surgery rang her and made the appointment, he should come out to her.

What happens with other people who are housebound?

[RB68]

Personally I would phone the surgery and explain the situation and ask for a housecall.

[lucymootoo]

Phone the surgery and explain. Im sure they will arrange something.

[Helenluvsrob]

I'm a Gp. We do visit truly housebound people still despite rumours to the contrary ( but no, just not having the bus fare doesn't count ). Well actually in my practice if you are lucky -and she's not on holiday , we have an amazing advanced nurse practitioner who managers out elderly housebound people far better than gps do ( she's properly holistic and knows about services not just medicine !)

Just explain what you told us. It's not safe to get her ou of the house

[Pleasemrstweedie]

I appreciate test advice - thank you.

[Pleasemrstweedie]

'that'

[Tarrarra]

Dm gets visited at home by her gp if she requests it.

[Pleasemrstweedie]

We hand delivered the letter to the GP surgery, but it has never been acknowledged and DH has been trying to speak to the doctor since last Thursday, without success. The office staff have repeatedly promised a call back, but it has just never happened.

DH has just rung me to say that the practice manager has rung him and said they will not be able to do a home visit.

Where do we go from here?

[putputput]

Can he book a telephone consultation with the GP? With the phone on speaker so him and his mother can speak/listen? The gp can then assess whether she needs seeing and who best to see her.
All surgeries will be linked with a district nursing team and many will have community matrons who are far more experienced in managing complex, housebound patients. They will do home visits and should act as a link between doctor and patient. You could request a referral, may be worth discussing with the practice manager.
GPs are doing a fewer and fewer home visits; in my experience these are reserved for end of life patients who are at home. In the time it takes to do one home visit ithey will be able to see roughly 6 patients at the surgery therefore targets just do not allow it.

[Pleasemrstweedie]

DH has been trying since Friday to have a telephone conversation with the doctor. He's repeatedly told that the doctor will call him back, but he never does.

I'm not sure it would be a good idea to put MIL on the phone. She is increasingly confused and doesn't want to be any trouble.

I understand that there are other staff who could possibly go and see MIL, but we aren't at that point yet.

DH is going to try again tomorrow and I'm putting an e mail together.

[QuerkyJo]

I had a similar situation with my step-dad. In total frustration I phoned the vulnerable older persons unit at his L A.

I explained the problems I had getting to see the GP. I said that I was trying to do my best for a vulnerable person but I am being completely stonewalled and did not no where else to turn.

I got a call from the surgery an hour later telling me they would arrange a home visit. You have to escalate these things to get anywhere. You just have To be really firm.

I have resorted, in the past to saying, I need you to refer this to a Senior Complaint Manager, because this person is now in danger. Harsh, but gets results.

[Pleasemrstweedie]

So DH has called the surgery again and the position is the same – they don’t do home visits. DH has now e mailed his request and has had a bare acknowledgement. He’s giving them until Monday morning, by which time it will be more than ten days and then he says he will complain.

The good news is MIL has about five weeks’ worth of drugs in the house, so we have a bit of time.

DH is at his mother’s now and she is fretting that she has had different drugs in the last delivery and doesn’t know what they’re for, but it’s not clear at the moment whether this is correct or whether she is just confused.

DH is making a list of what she has in the hope that at some point he can clarify this with someone from the surgery.

[Pleasemrstweedie]

No response from the GP. I am trying to find out what we can do now and who will support us/MIL. I have spoken to PALS, who say they cannot help. They passed me on to NHS England, whose call centre was unable to give advice without name rank and number of everyone involved. Even if I had been prepared to give that information, which I wasn’t at this preliminary stage (I didn’t want anyone contacting the GP if he was about to call us and sort something out), it actually sounded as if it was going to be quite a long process to get any advice. A colleague who used to work for the CCG advised me to call them. I’ve just spent 45 minutes on the phone talking to various people there and I’m being told they cannot help unless MIL is classed as receiving continuing health care, which she is not. I called back and have been given a direct number for someone who is not currently in the office, so it looks as if it will be Monday before I can do anything else.

This is so frustrating. How people fight like this for years, I just don’t know.

In the meantime DH visited MIL yesterday. He thinks she is developing continence issues now. He also found out how she is getting round the house. She is leaning on the broom and has rejected his suggestion that she has some form of walking aid because “it wouldn’t be safe.”

[Pleasemrstweedie]

I think we're near to resolving this. DH rang the surgery this morning an said he was going to speak to NHS England. That did the trick. He has now had a conversation with the GP.

MIL does not need a medication review. This was done in January. What she needed now was a blood test as result of that review, which was done perfectly properly by the Domiciliary Phlebotomy Service this morning.

So, there was never actually an issue. GP will now arrange to visit over the next week or so to run some preliminary memory tests.

I sense we are at the beginning of a very long journey. Thanks for all the advice. I'm sure I'll be back.

[QuerkyJo]

I assume the blood test was the one they do as the first stage in the Memory Assessment.

I have been through this recently with my step dad. After the test a lady from the clinic did a long assessment for him at his home. The next stages were to be a brain scan and a visit to the memory clinic. It took me a while to arrange the scan as he needs transport and a hoist.

When I explained it to him, he said he did not want all that fuss. I rang the scan dept and the clinic and they said it was fine. Lots of older people don't want the brain scan and the rest of the process can proceed without. Thought that might be useful for you to know

[Pleasemrstweedie]

Thanks. She had a blood test at the beginning of Feb for her meds review and another today because her alk phos had come back high on the first test.

I think today's events have confirmed that she's not coping, so we'll see how the GP's visit goes and take it from there.