Letter to GP about mother?

Surely you could trawl through recent medical visits or medial issues and see if there's anything whatsoever that crops up. I know for my mother. She always looked after her health. She's now being very stubborn about some issues and I know from what she tells me she has high cholestrol. There's probably more bits and pieces being neglected too. Surely something could be picked apart and found and used as an excuse for referral onwards to elderly phsciatric or geritician or whatever.

I had some bad few days with my mother. She definitely has the mind of a child now but I don't have a diagnosis. In other parts of the day she is ok-ish. A lot of the time no matter how gentle I approach issues she's very defiant. A diagnosis would be hugely helpful for me so that I can get supports for her and for me too. I find have to babysit her more and more and I am falling behind on so much work. I'm utterly depressed and I feel much much worse than this too with feelings of the big S but I don't want to type it.

It's not awkward - that's not the problem.
It's just impossible, if the patient says 'thanks for asking but I'm fine', and they have capacity, to do anything further without permission to say that you have written.

It's not writing the letter that's the problem.
It's asking the GP to keep it a secret.

It is not awkward.
Gp s are there to serve their community
Elderly should not slip thru net and relatives can alert to declines

Hopefully many gp practices have designated elderly nurse as per my relative. This designated nurse did home visit and knew exactly what to assess and look out for . And called me after to say had visited.

I don't know, I'm out in the community and ask a lot of patients to do things to help us rule out any issues, including quite detailed cognitive screening. Or even just recording that they've declined it 'because you'll only get my daughter upset'.

At the very least, giving the patient a bit of info at the start of the appointment (their blood pressure or whatever) and seeing if they remember what it was at the end, and if they do, what strategies they are using to remember it. Not in a judgemental way, but just to have it on the record what's happening at this point in time. God knows we all use memory strategies.

You know all this. I just do believe that it shouldn't be that difficult just to record 'family concerns re memory' on the timeline, if nothing else.

My mum was quite happy to do the memory test as she was convinced it would prove that everyone else was wrong once and for all.

Likely to be refused if patient in denial and can't refer with no history

A dementia organisation would only advise you to write to the GP.
Yet there's a person here on this thread claiming to be a GP suggesting against a letter.

First of all that may not be their advice - we do not know that. And secondly it is not bad advice. We have one GP against this. There are lots more GPs! My experience is that GPs put the letter into the patient's file and next time they see the patient they will be alert to signs of dementia. That is all good.

What the Alzheimer's Society helpline would do is to provide the OP with someone to have a live supportive conversation with. To talk it through, to express their concerns, to listen to the experiences of others, to get some perspective, to not feel alone in trying to work their way through the problem, to get advice on the next steps. I think that would be very positive. Indeed I know it would be as I have seen this happen.

Well, our GP did help.

The Gp that came out was concerned mil still had capacity, so the memory clinic declined the referral, as she'd already refused to go several times.

GP, re-referred after discussion about capacity & the cmht sent a cpn out. She reported back to a consultant, who dx mixed dementia.

This was the very best solution to an intractable problem. Mil wasn't disturbed too much. Nothing much had changed but we are now known to the cmht & have access to the local dementia coordinator.

I didn't know what the tests were called, but yes, these are what I imagined a GP might do if they'd received concerns in writing from a relative.

Writing a letter means that if someone ends up having a fall or similar, it hasn't come out of the blue. It may give some kind of timeline - concerns first raised by family at point x, etc.

Would it be so hard to do the MMSE or the MOCA as part of a check up?

It's not that I don't understand why you'd do it.
It's just that it puts us in an impossible situation.

I say again - I get this letter, get your mum in on a pretext, ask her if everything is ok, any concerns about memory, she says 'kind of you to ask doctor, all is fine'.

what then?
if I can say - well your daughter was concerned enough to write to me - that might move things along

without that, I can do nothing

I'm in the exact same position as the op and I am also considering a letter to the GP.

My response and reply was in relation to another poster who's writing on this thread saying that she's a GP and a letter to the GP as a family member with someone suspecting dementia and asking to remain anonymous is useless. There's a GP arguing against letters to the GP.

A dementia organisation would only advise you to write to the GP.
Yet there's a person here on this thread claiming to be a GP suggesting against a letter.

Gosh - that's bit harshly expressed. Not necessary really.

I have worked for the NHS in the field of dementia care and can understand the OP's quandary - she wants to do the right thing by her parent, but does not want to overstep the mark. The Alzheimer's Society are very well respected and will give her the chance to talk it all through with someone who has experience of the problem - which many other AC face. I think that will be very helpful.

So ask them. As a GP, I get the letter. I call your Mum in on a pretext of a health check, check her blood pressure, cholesterol, pulse etc. Ask her if she has any concerns, any issues with her memory. She says no.

What do they expect me to do then?

I've been there. I've confronted a parent with no insight. It's shit. I get it. But if you can't bring yourself to deal with it, you're expecting a lot from a 'don't tell anyone I wrote' letter.

The first time I said anything at the GP office to the GP, I was at my own appointment and the GP asked about my mom. I said it in conversation that there's some things that are not quite right. My GP said that they will never go to the GP and say this and talk to them about this kind of stuff and someone has to do it for them. She was invited for a wellness check and she did attend. But since then I am coming up to a brick wall.

I mentioned your response in a dementia group that I am in letsgoskiing. I never gave your name but I said that there's a GP in an online discussion saying that they hate letters from patients families because it creates an impossible situation for them and in relation to dementia concerns they would much prefer someone to attend to a GP appointment and sit in on the appointment and tell the GP in front of the person.

There are people utterly utterly utterly shocked at this. In that dementia is hard enough and it's so hard to even get them to the doctor and now you expect people to sit in front of their parent and explain everything and all your concerns and worries and observations when passing a letter to the receptionist to give to the doctor is often more than enough for some doctors. It's an American based group but still.

I find the idea of sitting in front of a doctor with my mother and listing out all my observations and worries and concerns in front of my mother sickening. One of my observations is that she is taking my plus size underwear and she is half the size of me and it's appearing in her laundry as if they are her own. Other observations is that she has plus size period swimwear from Primark in her wardrobe. She is a size 10 and she doesn't swim and her periods are over. Imagine saying all this in front of her?

The very idea of it is enough to fill me with dread and sick and fear and her response will be one of rage where I might as well just go and buy a rope. This isn't a joke or an over exaggerating. I am trying to do the best I can but I feel like my hands are tied. I just don't know what to do. The majority of my observations are behavioural and mood based. Not memory loss. I think if there was memory loss it would be easier.

Per year

Is the 200-300 people to stop one event per year or a lifetime risk?

This is exactly what I am going through. My mother was very dominant when I was younger. She did mellow. But now it's like she is on steroids. I would love to sit her down and talk to her and tell her that I am genuinely concerned and ask her to attend to the GP but she will never tolerate that.

I am on a dementia support group. I know I don't have that diagnosis but I strongly suspect it. Even people who have diagnosis find it hard and it's suggested to give notes to the doctor because many people are unable to say anything information front of their person.

Yes I get that.

good luck.

Having the permission to just watch the car crash is helpful, actually. @letsgoskiing

Yes.

If you have capacity, you have the right to make your own decisions.

Even if everyone else thinks that they are bad decisions.

It's very frustrating to watch - I've seen patients with eminently treatable cancers refuse all treatment, then seen the fall-out when they change their mind and it's too late, the cancer is everywhere.

I've waited for the car crash with relatives, and cleared up the mess afterwards.

But what's the alternative? Legal powers to remove decision making ability from competent adults? That's a very slippery slope.

If you don't have POA for your mum, you need to organise it now - many medics won't discuss her medical matters with you otherwise.

Yes. And so on a population basis, giving them to millions, we stop a lot of events. But as an individual, the chances of you benefiting are small

I'm viewing this as discussion @letsgoskiing, not trying to have a go, particularly as as you've already explained how your hands are tied.
But this is the problem as I see it - somebody presumably retains capacity all the time they insist that there is nothing wrong, even though there very clearly a lot wrong.
It's a conundrum all right ( I've come to terms with my mother and the slow car crash effect, partly because of the therapy and partly because I have siblings and we support each other, but it makes trying to keep her safe extremely frustrating.