To not take my mum to the GP? (Mild cognitive impairment)

[Didimum]

Sorry this is long. I'm fairly certain my mum has mild cognitive impairment. She is 68 and lives alone, after my dad passed away two years ago.

She has had a fairly stressful life for at least the last couple of decades. Firstly my dad had always been very controlling and, to be honest, mildly abusive. She was always very anxious of him. He controlled bills, finances, things around the house etc. She worked in the NHS and the workload was horrendous – she used to cry often and was very beaten down. Luckily she could retire early, so she did. Shorty after she left the NHS, Covid hit and my parents did not fair well – all loss of routine and socialisation, my dad grew worse in his behaviour towards her. She lost an enormous amount of confidence during all this.

My dad then passed suddenly in 2023 after a very short illness. She was shattered and shocked. Her brain fog was severe. She has improved since this, has got happier and does enjoy life on her own – she sees her friends, has a cat, joined a pilates class, keeps up with all medical appointments. I do not worry about her living day to day – she is able to follow her routine perfectly well. She struggles with bills, paperwork, insurance, pensions, computers, etc – but she never had these skills as my dad just took over all of it. Myself and my sister help her mange these things.

My sister and me noticed, probably 5 years ago, that her memory was beginning to be affected in stand out ways. Her short term recall is quite poor (with some things and not others, though she can remember when prompted). For an example, I'm sorted out some insurance stuff for her – I asked if they had called her the day before and she said no. They told me they had, so I prompted her and then she recalled it. Later that evening, my sister asked her the same question and again she said no ... this is fairly typical. However, it's more typical it happens with things like insurance as she just seems to blank it out. She was babysitting my kids recently and asked repeatedly what time to put them to bed. She also repeats questions and stories a fair bit – to the point where others have noticed. She has also been scammed by phone scammers a few times as she panics over the phone when strangers call about something seemingly 'complicated'. She doesn't struggle to find words or follow conversations or take care of herself, cat, medication, her appointments etc. That appears to be the extent of it right now, and it has remained fairly stable over last 5yrs, perhaps dipping a bit when my dad passed.

My sister and I sometimes discuss getting her assessed, but we both really fear that she will be extremely upset and anxious over it and that it will be a detriment and not benefit her. Another really important part of this story is that her sister was diagnosed with dementia in 2019 and just passed away a month ago (sister was 20yrs older than her however, and there is no other family history). My mum, again, was devastated by her sister's rapid decline and death. She is aware of her memory issues and I know she is very anxious that the same fate awaits her.

Long story short - while my mum is still independent and functioning well, AIBU to leave her be and not cause her distress unless it becomes necessary, since there is no treatment for MCI? She has regular check ups and blood tests and is physically very fit and well.

I do know MCI can be caused by stress/depression/anxiety, and my mum is still prone to bouts of upset and crying. She says she feels stupid and that everyone feels annoyed at her all time. This is not true, and I fear her confidence in herself has been battered by decades of how my father used to treat her. He always used to call her stupid and tell her she wasn't capable of anything. I think counselling might be a good option for her?

AIBU? Or is the GP and memory clinic always the best?

I’ve not read the whole thread, but in my experience, yes get her to the GP. Tbh it sounds like it might be beyond MCI already, and the sooner she can get on medication the greater the chance she will hold steady at the stage she’s at for longer. Also - look at lifestyle - exercise and brain games are all important.

My mum was similar, MCI diagnosed when she was grieving for my dad / adjusting to life alone, but actually she was further along, they just didn’t want to diagnose dementia so soon after my dad had died.

What stands out as being beyond MCI?

I think you will find that there is only medication for Alzheimer's. There doesn't seem to be medication for other types of dementia, such as vascular. I have known people who have been diagnosed as having both.

Hi @Didimum ,

My mother has dementia, mixed Alzheimer's & Vascular as per doctors.
Her symptoms started like your mams.

I think you should get her checked in the GP's/ memory clinic as sometimes thyroid problems can also seem like a cognitive impairment. This can be fixed!
I would attempt to organise a power of attorney as we didn't and it was much harder to do after her diagnosis.
Also keep on top of her paperwork, bills etc.
We didn't realise for a short time that bills weren't being paid despite mam saying she was. We don't know where that money went.
Hope you get sorted, take care,

Taz.

Meds are only appropriate for Alzheimer’s and there are several different types of dementia. But yes, l agree with you. Better to get this sorted now in the hope of slowing things down and getting coping mechanisms in place.

The process is to go through the GP first. They do a preliminary assessment and a referral to a psychiatrist will only be made if the GP thinks there are red flags. The earlier you get help, the more that can potentially be done to ease symptoms and slow progress, depending on the type of dementia. I also found that there were support services available l didn’t know about until mum was referred. I think there’s a difference between experiencing and acknowledging memory issues yourself and it becoming noticeable to others.

OP says her mum is repeating things often. This is a red flag for dementia -repeating things frequently, especially in a short time frame can be a coping mechanism - repeating questions, stories, or phrases, are often linked to more significant memory loss and difficulty remembering what was said or done previously.

This is a really good point. There are a few things that can mimic dementia. UTI’s are an issue too. In older people they can be more severe and can cause levels of distress and confusion consistent with dementia onset, so are often missed. For OP it might be a good starting point to actually get her mum to the GP and then take it from there.

OP my mum in her early seventies is very similar. Its been going on subtly for a while but I really realized the other day seeing how much she struggled with a parking meter. Against my better judgement, I agreed for her to come along when I'm visiting a city she wants to see for work next month - I'll be at a conference one day and the next day I'll be free, so I guess I will see how well she does (or not) during that and whether its getting to the point I really need to do something. She does manage her day to day life absolutely fine, but anything new or different can be problematic and multitasking is definitely long gone. She's not the easiest person so overall I'm just trying to be patient, but I doubt she'd be receptive to any kind of testing anyway. Her mother had dementia.

My DB had Parkinson’s and dementia he did the Montreal Test with a psychiatrist and failed (though I prob wouldn’t get a high score now at 70) - copies are available online.

Get her a white board for the wall that she’d walk past regularly to remind her of things.
I have a big one in my kitchen which DH and I use. Perhaps buy her a diary so she can jot down what she’s done in the day.

Get the legal stuff sorted out as a priority. She should definitely be assessed. It might be something that can be treated or controlled with medication. Even if it isn't, a diagnosis will enable forward planning and decisions to be made to ensure the best possible outcome, rather than floundering around in 'what ifs'.

You have my sympathy op. I could have written your post op, except my dad is still alive. He’s a total fucking twat, always has been and she has gone from a focused, determined, independent woman to a shell of her former self since she retired. I too have noticed the confusion and the lapses in memory and they are definitely getting worse. I don’t know if it is a memory issue or just from years and years of being ground down. I have mentioned it to dad and he just won’t discuss it. He’s also like creeping fucking Jesus and makes sure I never get to speak to her alone, even on the phone he makes her put it on speaker. We’ve had occasional conversations over the years about her leaving him (before she became confused) but she could never find the strength to do it, even with support. I am now in the process of moving them closer to me, which is also complicated because to be honest, I never had a very good relationship with her and the rest of my siblings are very low contact with them. But, she’s vulnerable now and I have to try and protect her. It’s a nightmare and I am very concerned for the future.
In your case. I do think it would be worth getting her assessed so you can put whatever necessary legal measures in place to protect her if she does have a progressive illness.

I would. There's many treatable causes of memory loss (b12 folate thyroid abnormalities etc) and early treatment is better if does need dementia meds

One thing to consider is writing confidentially to her GP. Although the GP can’t talk to you about your mum’s health (without her permission or a POA), your concerns will get logged and the GP can be on the lookout if she’s there for other issues.

I don’t think this new disease modifying drug is available on NHS as not approved by NICE.

I’d suggest chatting with her and seeing if she’d be willing to have blood tests just in case she’s got thyroid problems or things that are easily treatable, but cause memory issues and perhaps make her feel not as good as she could.

Perhaps a gentle chat about anxiety and if there is anything that she would like to do or try.

POA health and finance is a must do.

From someone who had a parent with dementia, I would get her assessed. Or at least get the ball rolling. It can take SO long to get things into place.

I do appreciate everyone can have different experiences with medication, my DF had a dementia diagnosis and was put on medication to slow it down. The medication had to be taken before bed, my DF experienced flashing lights which he described as a ‘disco’ and it stopped him sleeping. He therefore came off the medication. My DM was on the medication for at least 12 years, once she had been given the diagnosis and put on the tablets there were no follow up appointments at all, she just had them on repeat. Her dementia did progress but was much slower than my Dads. Of course no one can say if that was down to the medication or not

The medications that are typically provided for Alzheimer’s don’t slow the disease. They make the remaining brain signalling work better. I don’t think starting sooner slows the disease. It puts the effects of the disease off for longer.

Sounds like a form of PTSD

My mum was diagnosed with early alzheimers. I worried it was more anxiety and trauma related to significant bereavement but the diagnosis was made and medication given. The memory clinic assessed tgat the anxiety was caused by the memory impairment, nit vice versa.

The medication for her resulted in a significant change. It reduced the anxiety wnd paranoid thoughts and she began to get more pleasure back in her life and be calmer which meant able to do more tasks.

I dont regret the diagnosis and it came at the right time. The medication if Alzheimers may not work for all but was transforming for her and she lived ten years and died of non-dementia illness whilst still having mental capacity.

I thought my parent had MCI and in fact it is dementia - just for some reason (possibly cognitive reserve) their cognitive skills are pretty good (it was the brain scan that was the giveaway). They are now taking medication which is helping plus has had some brilliant local support.

My mother has has significant anxiety all of her life, which is an issue.

Yes, I have chatted with her on numerous occasions. She wants help to address her anxiety (which she's had all her life, and isn't new or recent), so me and my sister are trying to put that in place. She gets herself to health MOTs annually, including thyroid.

POA isn't as issue for everyone mentioning it.

You have my sympathies too.

My mum was never focused, determined and independent. She went from overbearing parents, straight into an overbearing marriage at 22, and has always been anxious and under the thumb.

POA is in place, so that's not a factor at the moment. The detriment to her happiness with investigations are, however.

Yes, she has these things already which she put in place for herself.

She doesn't repeat things in a short time frame. She might tell me a story twice within a fortnight for example – I've never been worried about that part. She re-asks questions for reassurance and is aware she has asked them before. My sister and I find it very hard to asses the 'red flags' as many of them seem tied up in her anxiety.