Social Worker Not Concerned About Possibility Nanna Could Have Dementia. What Would You Do?

[thatsallfolks89]

Hello,

My Nanna had a fall just before Christmas which saw her slip on ice and banged her head. She didn't want to make a fuss and go to A+E as she didn't think it necessary, though she was advised to. Since then there's been a gradual decrease in her mobility and what she can do to look after herself. Her personality has changed, she's extremely anxious and paranoid that a fire will start while she's at home. There's been several times in the past few months she has rang concerned about her radiators staying on too long and that they won't go off. She gets easily confused with time of day, days of the week, naming names etc. She uses a walker to get about but she says she feels like she's going to fall backwards. She can't get about by herself, and has to rely on friends or my mum coming round to take her out but she is immobile herself now.

We have tried encouraging her to move closer to us (mum and me don't get on due to past issues) as we can't move closer to her but says she's too old to be moving. Carers go in everyday at the minute but we are looking into a cleaner going in twice a week instead.

My DH rang her GP surgery on Monday which prompted a phone call from her social worker who said she'd visit her and see if she had any concerns but said this morning she had none and declined to get her assessed.

She was up at the weekend last week and she seemed so different. Her face was all drawn in and she appeared so childlike that it caught me off guard. Her brother has Vascular Dementia, so I'm aware there's a family connection there. She's also really hard of hearing too.

Anyone else experienced this? What did you do?

Hi, I work with people with dementia. It is quite possible she may have it- but it is worth just ruling out a UTI or other infection first, as they can show very similar symptoms.
If she would like to (and not everybody wants to know) you could see if she would like an assessment with GP. There are some meds which "may" slow down the progression. But really, routine and predictability are the answer anyway.
Is there any reason you want to stop the daily carers and get cleaners instead? I don't understand that part, as it sounds more like she may need carers more often?

Don’t swap out the carers for a cleaner and don’t make her move home. She needs the carers. Cleaner on top would be good. Once she can no longer cope at home with carers, next stage will be care home.

You need to speak to her GP and ask for a referral to the memory clinic, they can test for dementia. A social worker can’t assess for a medical condition

What is it that you want the social worker to do? If it's a dementia diagnosis the GP needs to refer to the memory assessment clinic.

Go back to the GP. Social workers aren't doctors. Ask for tests.

Sorry, I should've mentioned that the suggestion of getting a cleaner in twice a week instead of carers came from the social worker, not us. This came about as the carers she has now come in on the morning for 20 minutes - sometimes it's less and they say they can't do domestic duties, so the social worker thought it might be a better idea to get a cleaner and drop carers two days a week instead.

We're still waiting for a callback from her GP to discuss it. Surgery said they didn't know when it would be though.

That's a pretty odd suggestion from the SW. I wonder if your DGM had said that she can't afford a Cleaner and Carers. Is her home messy? What do the Carers do? Is she in receipt of Attendance Allowance?

Agree with asking her GP to assess your DGM for cognition and memory loss.

It might be better to email her practice with your concerns. Make it clear that you don't want to know anything as you know it's confidential but that you think she needs checking for a UTi and possibly a referral to the Memory Clinic.

Hi OP, social worker for adults here.
I’d suggest keeping the carers, one reason as its eyes on your Nanna every day. Also because it’s likely she will need them in the future and it could be weeks until they could be reinstated due to availability.

Also it may confuse your Nanna more to make a change.

Medication will only help if the diagnosis is Alzheimer’s, it won’t be prescribed for vascular dementia so she needs a diagnosis.
As PP’s have advised, a GP appointment is needed with a view to referral to memory clinic, again if your Nanna consents to this.

You could ask the social worker about Just Checking.

https://justchecking.co.uk/?accept-cookies

This is a system that involves putting sensors on door frames that monitor movement in the house. It would give you information on sleep
patterns so you can see how settle she is at night. Again it would need consent, so the social worker will need to complete a capacity assessment for this. Just a thought with you mentioning that Nanna is getting worried about radiators being on etc.

Re her mobility, ask about some telecare equipment such as a falls detector.

Great advice @Shallysally. I'd not heard of Just Checking before. Sounds like something that would work alongside the Herbert Protocol.

The Just Checking is only for use in the home. There are different pieces of telecare equipment with a GPS tracker on them that can be used if getting lost/going out alone is a concern.
It’s good practice to complete a capacity assessment when considering a tracker device due to the ethics around it.

The tracker can definitely be used alongside a Herbert Protocol.

OP, information here:
https://www.ageuk.org.uk/calderdaleandkirklees/about-us/latest-news/articles/2018/the-herbert-protocol/

Oh sorry @PolaroidPrincess, did you mean the Just Roaming?
That would depend on local authority funding and which telecare equipment provider they commission with.