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Original poster

Gp's 'mental test' on my 90 year old dm

36 replies

Zakinthos · 04/08/2012 21:41

Questions were :-
What day/month/year is it?
Who is prime minister?
When was the 2nd world war?
Who is reigning monarch?
What is your address?
Subtract 7 from 100, then subtract 7 from your answer and so on.

She did ok (said year was 1912 but corrected herself when gp queried it, knew day and month as she had asked me in waiting room, 1 error with maths which gp let her off.)

Gp says that she 'passed the test' and does not have dementia which is great.
However her short term memory is dire now and gp did not test this really. For example, I gave her her new pack of antibiotics to take. She took one and then literally 30 seconds later, she picked them up and said 'what are these?'. I told her and she said 'have I taken one?'. I have to keep telephoning her to remind her to take the pills. Today, I went round to her house to remind her that 'appetito' were coming with a hot meal (she is trying out this service). We discussed this at length. When I left (20 mins later), I said 'don't forget appetito are coming so don't make anything to eat yourself'. She said 'oh yes, good job you reminded me, I was just going to get some lunch!'

I just worry that this is the start of dementia. Was the test the gp did appropriate? Or is this normal memory loss? Every time I see her she says the same things but is still good with dates things happened (has always been good with dates). She never remembers to tell me when she runs out of things either so I might go round there and find she has no loo roll and is using kitchen towels. I am just finding it very hard to run her life as well as my own (and my dc's). I have to do all her finances now, shopping, cleaning in between cleaner visits as she will only have a cleaner once a fortnight, reading her post (as eyesight very bad), take her to appts etc. and I work as well part-time. How do other people cope? She is still able to wash and dress herself so does not need a carer.

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achillea · 17/08/2012 11:17

So good to hear that I'm not the only person with a cantankerous mother, it was really getting me down as we have had 3 bereavements in the family within four years and I haven't wanted to upset her yet she has made me feel desperately inadequate by denying help from me and then badmouthing me to my remaining siblings and their partners.

I will definitely pursue the weekly arrangement - I have asked before but they ignored it.

gingeroots · 17/08/2012 11:09

Yes yes to huge difference .
My mother is so much better physically .
So worth persuing .

CMOTDibbler · 17/08/2012 10:32

With the blister pack, my parents pharmacy sorted it all out with the GP - I think they have to approve it as it does cost money for the pharmacy to do it.

If the pharmacy isn't helpful, then is it possible to change to another ? Boots do a home care packaging for medication as well as the blister pack which has more info in it. But its made a huge difference to my mum (and my dad who no longer frets about her oding/picking them out) in spite of some resistance.

gingeroots · 17/08/2012 09:27

Good going Zak .

achillea with the blister pack for meds ,it starts with the GP doing the prescriptions in a different way .
I think they have to print off and sign a whole pile of prescriptions - so instead of a prescription that says 28 bisoprolol ,28 x 80mg fruesmide etc it will be for a week and say 7 x bisoprolol ,7 x frusemide etc ..

Can you get the receptionist and or/pharmacy to pester the GP to set this up ?

I find that after many requests about things a letter of complaint sometimes works .

I do sympathise with you about your mum - mine trusts no one and always blames someone else for any misunderstanding or misshap .

She never misshears - the radio " got it wrong " ,she never mislays anything " someones moved it "
.
Sounds trivial but her relentless mistrust and inability to accept advice or acknowledge that sometimes she doesn't know best ,wear me down .

Original poster
Zakinthos · 16/08/2012 19:17

We are on holiday at present for a week (back tomorrow) but I'm phoning dm daily. She seems to be coping ok and has remembered when appetito (hot delivered meal service) are coming too thanks to large note on fridge written in huge writing with a thick black marker!! (thanks for that tip Ginger!). She confessed that she is not using her oven to heat up her ready meals on other days though (just having cold meals' such as quiche and salad). I need to find out whether she just can't light the oven now (new model of oven) or whether she just doesn't have the energy to cope with this anymore.
I feel rejuvenated after our break however, and feel ready to cope with things now. I'm going to book an appointment with a solicitor next week about the power of attorney and order some useful things from the rnib shop which should help her.
Thanks everyone Smile

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achillea · 16/08/2012 09:21

That's great news Zak, your gp appointment was a success. Mine keep getting things started and then nothing happens, eg dosset boxes. I have been asking for the pharmacy to put everything in them for ages and it's just not

I like your idea to ask her the question back, eg 'what time do you think I said last time'. I got into a huge bustup with my Mum because some eejit doctor wrote a lit of meds down for her but didn't date it or sign it which she had sitting there for months, but which she told me she picked up the other day. She is now telling me she doesn't trust my memory. Great.

Add to that we have 5 people going in and talking to her about her meds (she asks), despite me putting everything in a book, everyone else seems to know better than me, or the record book.

gingeroots · 10/08/2012 09:21

Its odd isn't it Zak ?

My mum is like that not wanting things done ,she barely allows me to .

My mums place is very small and a lot of it I think is she can't bear the noise and movement around her - a bit like if you're ill in bed and want peace and quiet and to be left alone .

But who knows what it must feel like being them ,old ,tired ,relenquishing power and control .

Original poster
Zakinthos · 10/08/2012 09:03

I hadn't thought that she might be resisting the cleaner as she doesnt want things moved - that could be the case although I suggested the cleaner doing things like changing the bed linen (as she doesn't change it often enough!) but she doesn't want her to do that either!

She does have a gardener though as I was firm about that - I never have time to do my own garden let alone hers!

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twentyten · 09/08/2012 21:45

Sympathies from me too. Could you sell it as helping you out? Don't give up. I'm now real listing I need to get my dm to accept others not just me.... Not easy but persisting is vital. What about time for you? You must put your needs up the list too.

CMOTDibbler · 09/08/2012 20:19

How about a soft start on the cleaner by thinking of specific things that you want the cleaner to do - like have a go at the kitchen cupboards (or something else) and selling your mum on that ?

I am trying to persuade mine to have a gardener as their gardens are running riot and are far too much for them. But dad is digging his heels in - though mum was more receptive. A cleaner is the next step as the house is rank

gingeroots · 09/08/2012 19:45

Sympathies about the cleaner .

Like yours my mum can't see the mess so not aware .
Plus she finds it an intrusion so we had to give up on the idea .

But I realise now that what really worried her was having someone in who moved stuff or didn't leave it in exactly the same spot .
And of course that's because she can't see ...so something to bear in my mind .

Original poster
Zakinthos · 09/08/2012 19:41

Thanks everyone. I went back to gp with my mum today. Urine sample now clear, finally. I mentioned to gp about not testing short term memory last time and she said she had wanted to do it when the sample was clear, so she did another test and my mum only remembered one item out of the three she had to remember, despite repeating them to herself a few times initially. Gp now referring to memory clinic. Dm still has a lack of insight into her memory difficulties though but I have started asking her question back to her if she has already asked me the same thing 10 times. Eg. What time are you coming to collect me? I then say ' what time do you think I said mum?' and she is actually often correct! Sometimes I think she just needs reassurance as things not clear in her memory.
The pharmacist showed me the blister pack today. It looks ideal. I now have to get gp to 'authorise' the blister pack and then he will sort it all out.
She's digging her heels in though about increasing the frequency of the cleaner - will have to keep working on this one.

Many thanks again - such great support and very much appreciated.

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gingeroots · 09/08/2012 10:15

And with the blister pack you don't have to remember to get repeat prescriptions - the chemist does it all .

CMOTDibbler · 09/08/2012 09:51

Another vote for the blister pack - Boots make my mums up like this now, and she is actually taking all her tablets and v easy to see if she's missed any. And (maybe not a concern for you) theres no tablets lying around, so no chance of taking too many.
An unexpected side effect of getting onto this system is that the pharmacist (who has always been great tbf) now has my mum flagged up as needing extra care, and has been phoning the GP to try and sort out some other things which has been a boon.

If there is a local group for the VI, they may have a lending library of devices to try. My friends dad is blind, and he runs a group who do this

gingeroots · 09/08/2012 09:22

With my mum the optician didn't suggest or refer her or anything - although she has no sight in one eye and practically none in the other .
I asked the GP who referred her to the hospital and it was the hospital that did it .
But I see the RNIB has it all explained here
www.rnib.org.uk/livingwithsightloss/registeringsightloss/Pages/register_sight_loss.aspx

With the clock if you press it once you get the time ,if you keep your hand on it it tells you the date .

It's a struggle to get my mum to have anything new ,partly because she always assumes it will make her life harder rather than help .
I have to introduce things gradually and she does get used to them.

The medication thing has made a big difference ,my mum is so much less breathless I don't believe she was taking half her tablets before on her old "system" .
Tho I thought I was checking and was on top of it .
Here's the link to blister packs
www.medicineblisterpacks.co.uk/free_sample.php
Tho I do have to cut them up into individual days .

Original poster
Zakinthos · 08/08/2012 23:44

Gingeroots - thank you SO much!! That is very helpful. People often suggest things but then I have to say but she can't SEE to read labels etc. Those orange bumpy things and that talking calendar clock are just what I need for her!! She is forever checking asking me the day when I go round so this will be great. She seems ok with making tea at the moment. She sometimes forgets to take the tea bag out but otherwise can see the level I think or feels it with her finger.
How do I get her put on the register for the blind/partially sighted? Do I have to go back to the opticians or ophthalmologist?
Thanks a million
Smile

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gingeroots · 08/08/2012 21:00

OP - sorry my post seems to manage to be a bit bossy and know it all .

I mentioned about visiting my mum a lot ,not to sound smug ,but because I recognise that even something simple sounding like a microwave dinner can easily fail an elderly ,confused ,poor sighted person .

I visit my mum a lot partly because I can ,but there's nothing altrustic about it .Rather the opposite - lots of emotional stuff ( still hoping for her approval ) that I should have left behind many years ago .
It's not something I'd recommend or am proud of - my own family have suffered and emotionally it's very unhealthy for me .

But I've picked up lots of knowledge Smile

gingeroots · 08/08/2012 20:06

zakinthos - my mum has very little sight and mainly uses a microwave and a small table top electric cooker .

There are a lot of ready meals that can be microwaved - tho having said that I visit every day and get the meal out and peel off the film etc ( when she lets me ) .

Other things that have helped are these

www.rnib.org.uk/shop/Pages/ProductDetails.aspx?category=talking_clocks&productID=CC5301 one by the bed and one where she sits

www.rnib.org.uk/shop/Pages/ProductDetails.aspx?category=corded_telephones&productID=DH216X01 took her a while to get used to the 3 memory buttons ,she was pressing the label ,not the pad beneath the label

www.rnib.org.uk/shop/Pages/ProductDetails.aspx?category=utensils&productID=DK12701

www.rnib.org.uk/shop/Pages/ProductDetails.aspx?category=tactile_labelling&productID=DL1501 on the cooker

www.amazon.co.uk/Breville-VKJ142-Hot-Cup/dp/B001L5SSGQ lots of different ones around ,get one where you can adjust amount dispensed and with a lid that it is fairly easy to open .My mum fills hers with a plastic jug .

thick black felt tip pens

an anglepoise lamp with this light bulb www.energybulbs.co.uk/products/Day+Light+Bulbs/Daylight+Spiral+Bulbs/DAYLIGHT+Spiral+Bulbs/BioBulb+SAD+Daylight+Bulb+25W%3D100W+ES+/936376506

bowls and milk jugs with a dark interior glaze so that she can see her porridge and milk

And what really has made a difference is the new style dosset box from chemist ( Boots ,Lloyds ,Day Lewis ) which is a blister pack .
It's for a week and has 4 large cells/blisters for each day - morning ,lunch ,tea and bed .

I have to cut the blister pack up into 7 strips ( one for each day ) and she has one strip each day . Otherwise she was randomly opening blisters from different days .
She opens the first cell with a knife over a dark brown sort of pasta dish and feels the tablets with her fingers .

( previously she had same system as your mum ,diuertics by kettle ,lunch time meds by microwave ,but it wasn't working .... )

And get her put on register for blind/partial sight because it's easier then to get a Taxi card ( in London ) and if Soc Services /your local council has a low vision service she might get some stuff free . My mum got the vibrating water level thing ,a talking clock ,etc .

And leave a plastic ,sports top bottle of water next to her and encourage her to drink more .

pippop1 · 08/08/2012 18:01

My MIL is in a similar state (v short memory) from the sound of it. We do all her shopping and just check what she's going to run out of. Why not buy e.g. 20 toilet rolls so you won't have to buy them all the time.

You can get medication delivered to her door in a dosset box. A plastic sectioned box with the days and times marked on so she can see if she's taken it or not. Combine with a radio controlled clock which shows the day of the week and date and that will help her.

We now have carers going in twice a day to give medication and make/heat up a meal. They use a key safe (little box with code to open its door) outside her house which contains her front door keys. Otherwise she can refuse to let them in.

Original poster
Zakinthos · 07/08/2012 22:43

Duchesse - I think you're right, I need to get more organised. She used to be the kind of person that would never let anything run out and would always have 'one spare' of things. The good news is, is that she likes the 'appetito' hot meals she has tried out and she has agreed to have two of these meals delivered a week.
Achillea - The gp didn't ask her to remember anything - short term memory was not tested at all but we are still waiting for a clear urine test after Two courses of anti biotics, and gp said this could affect her memory. However she has had a problem developing over the last 6-12 months so I think it is not just due to a urine infection. Will see if gp will refer to memory clinic when we go back on thurs.

Thanks again

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achillea · 07/08/2012 11:26

Hi Zak, my Mum had a GP memory test done recently which was similarly basic. But he also did a short term memory test where he got her to remember a number and then told her he would ask her again, had a chat to her and then asked her to recall the number. She didn't remember but the GP said that it wasn't a fair test etc and made excuses for her.

Did the GP do that test? They really should test short term memory too.

duchesse · 07/08/2012 00:00

I have not much advice or comments, except to say that if you could, maybe you could work out what she is going to need on a fairly regular basis (say monthly, and stuff like loo paper and washing up liquid and frozen stuff maybe) and have it delivered to her directly. It sounds as though she's beyond being able to work out what she needs and going to fetch it from the shops, so maybe having it delivered to direct would work? That way you wouldn't need to shop for her individually each time after having had to work out what she needs.

Original poster
Zakinthos · 06/08/2012 23:54

Thanks twenty. Had social worker assessment today who gaves lots of good advice too and is referring mum to age uk as dm may be eligible for a mobility allowance. I have looked at Wiltshire farm foods and may give them a try if she can reliably work her new oven. Social worker is also going to ask gp to refer to memory clinic. She has a cleaner once a fortnight and I suggested increasing to weekly visits but she doesn't think she needs it (as she can't see the mess!). I'm working on her with this though! She told the social worker that she was not having any problems at all with her memory and I felt really bad having to say that she does, in front of her. She is just not aware of it.
I am also going to investigate a power of attorney - I didn't realise that it is best to get it in place BEFORE dementia sets in. Social worker said it will only become valid once dm not mentally able to deal with finances etc.
Thanks so much everyone for all the advice - very much appreciated.

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twentyten · 06/08/2012 21:51

Feel for you Zak- it's hard. Have you looked at Wiltshire farm foods? Good to keep in the freezer. M&s meals are good too. What about you having a cleaner? Could your mum pay? You must look after yourself and your dc's age uk do great stuff- day centres etc. you deserve your life too. Loads of support here ,

Original poster
Zakinthos · 05/08/2012 21:46

She has had memory problems for the past year now and I can't blame it all on the urine infections, although she has had a few. I tend to find that she is more 'vacant' when she has an infection though. Thanks for the link,I will have a look. Taking her to see her younger 84 year old sister on wed as she wants a few jobs doing too!

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