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

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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?

What meds are these? To my knowledge there aren't any.

Take her to the GP. Talk about memory not dementia. (Speak to GP privately before appointment explaining your concerns) If GP thinks there's an issue they will refer to memory clinic.
We are going through this with my mum and the feedback we've had is the earlier they get checked out the better.

My relative and a friend's mum are both on meds that they have been told will slow the progress of their disease. I don't know the name sorry, and maybe they misunderstood.

I'm 61 and my memory is terrible. I also am poor with organisational stuff, even though 15 years ago i was a valued secretary. I do have insomnia though. My MIL has mixed dementia and takes memantine which is a drug that may help symptoms of dementia and slow decline so there may be a value in a diagnosis if you continue to worry.

I suspect your mum isn't sleeping well and may be depressed. As friends and family retire she may feel she's missing out on that side of life, even if it wasn't something she would have done anyway, for example going on a cruise with her husband. Maybe give her some one to one time just having fun so doesn't feel guilty with you sorting things out?

She has anxiety, worked in a stressful field, and lost her (abusive) husband only two years ago. No wonder she has some cognitive difficulties. She sounds like she needs help with her anxiety and quite likely ongoing therapy and support fo the ongoing aftereffects of her marriage. Also a review of any medications or overthecounter drugs she may be on, and some vitamin B12 and iron pills.

Just not sleeping well or being dehydrated can make someone vulnerable to memory and cognition problems.

My MIL has rapidly deteriorated since she fell and broke her hip last October. She has been in and out of hospital with health issues since then as she is refusing to eat and drink most of the time. She has carers four times a day and is partially bed bound. We have noticed a real decline in her cognitive ability. She no longer remembers my name. We have asked her GP to have the memory clinic do an assessment after the hospital did the test and she scored 11 where 10 and below indicates medium to severe cognitive deficits. We are still waiting and it has been quite over a month since she has been home. We are stuck in limbo as she officially can still make decisions regarding her health care. She recently told social services that she doesn’t need care and gets herself out of bed every day and has a shower. She hasn’t been upstairs since last October.

It is devastating that we feel it is such a battle to get the GP to act in her best interests and get the test done. We do have POA for financial but now will struggle to get it medically because of the situation we are in.

They always give ‘meds’. Sadly a dr friend told me they are placebos.

Your dr friend is talking utter rubbish. If your dr friend even exists as a couple of posts ago you didn't even know drugs existed.

With respect you haven't got a great deal of knowledge of the issue. Cognitive change could be a sign of other health or neuro problems too.

I would present this to your mum as a 'baseline check' so she can take action if need be.

Might be an idea to have bloods (e.g. cholesterol), a hearing check too.

There are meds that aim to slow down the progression of dementia. Management plans don't revert the patient to their 40 year old self, that's not realistic but please encourage your mum to speak to the GP. Also it will help if she keeps herself as mentally and physically active as possible.

Donepezil, rivastigmine or galantamine if you want to google

@sipandcleanjust seen your further comments. You initially said there are no meds. I have worked as a dementia nurse for many years. For some people you can’t see how they’re helping (they may slow down progression but it’s hard to measure(m) but others they make a huge difference. Rivastigmine also really helps with symptoms of Parkinson’s dementia/ lewt body dementia.

Hi if there are genuine concerns then she needs to be assessed in order to get access to medication that might significantly slow her decline.
There is not much out there to treat later stages but there are drugs to help at early stage to slow progression. How will you or she feel if she loses the opportunity to be treated by these drugs by avoiding seeing a doctor until it is too late? Cholinesterase inhibitors are the primary drugs - but you need a diagnosis.
It may also be the case that she would benefit from antidepressants
Assessment need not be awful. My father was assessed in his own home by a doctor- who kept it a reasonably light conversation and did not push too hard if my did not want to count backwards in 3s etc.
If she still has capacity then you need to do power of attorneys now. You cannot do it after mental incapacity has been diagnosed.
You could minimize the stress of doing the POA by saying you were doing one for yourself.

This. My biggest fear is dementia because it’s very prevalent in my mum’s family. I’ll be off to the GP at the merest hint of a symptom so progress can be slowed.

And with respect, I do have knowledge of the other conditions and relevant health checks. She has been tested for all that you mention.

I have already said POA is in place.

You’re correct, she sleeps quite often poorly.

OP if you can get her to the GP ask about mirtazipine. It’s an anti anxiety medication and it works well for older people with cognitive issues. They start with a low dose and build up as needed, and the beauty of it is that it doesn’t need to be taken every day - just as needed. If taken at night it helps with sleep too. Was a game changer for my mum as she had anxiety and panic attacks alongside the dementia.

My mum.had very similar symptoms at that age, she has remained the same the last couple.of years but has now been diagnosed wih Alzheimers. She is having and ECG so she can access medication to support her condition. She was diagnosed with MCI first please seek early help. You might not like the news but it's better in the long run.

Why have you posted at all then OP??? Any post which have offered support and suggestions of what might be other issues/concerns that can be corrected and are not signs of dementia- you have apparently now already checked, yet not mentioned in your OP earlier! That is great that results are all normal. Why not mention this in your op to save so many of us making suggestions- when you have already done this and know the answer??? 😕

I have said twice, in original and subsequent posts, that my mum has got herself to various health checks – no, I don’t need to reel off the list she has had. I am allowed to clarify when someone mentions a specific test. No, I don’t know the answer – I didn’t say I did.

My post is concerning a very complex balance of mental health issues, mental wellbeing and physical wellbeing. I did not ask for other conditions or what else to check for.

This. It can be sensitively handled as a suggestion to attend for a routine health check or similar, or maybe a visit from a district nurse depending on the practice.

Sorry, looks like I’ve repeated a question already answered.

Could I jump on this thread and ask hue about you go getting your patent checked if they refuse to go to the doctors. I have absolutely no doubt in my mind that my mum has issues (I can’t bring myself to say the actual term I’m sorry 💔) but she refuses to go the GP about it as she’s scared. I don’t know what else to do. I’ve rung the helpline and they advised she does sound like she has it and to see the GP but she won’t go.

I'm with you OP in thinking it's best not to press your mum to pursue getting her memory checked. Her symptoms sound quite mild and ordinary for her time of life, and even if, God forbid, there is some disease starting, the memory clinic would be unlikely to pick it up at this stage. And there's no treatment, so no point in stressing her and probably making the cognitive problem worse.
Also it sounds as if she would refuse to go, and she has capacity and can make her own decision about that.
She's very lucky to have your love and concern.

Anecdotally, my ex FIL declined from MCI to dementia very quickly.

I would say within 6 months of getting his MCI diagnosis he’d declined rapidly and was really struggling in a lot more areas. Within the year he wasn’t using cutlery to eat, for example. He was fully diagnosed in 2018 and by summer 2019 he’d forgotten his grandkids.

I know that’s doom and gloom, but still.

My only concern would be that delaying now, while it’s not too bad, might put a delay on getting the help you need quickly if things change.