Need to talk to dad and encourage him to see a GP

[SunburstsOrMarbleHalls]

My dad has developed numerous health issues over the years mainly due to a really unhealthy lifestyle. He had a heart attack about 7 years ago and it was then discovered he had popliteal aneurysms in both legs so required bypass surgery. He also has a stomach hernia due to being overweight and diabetes.

Over the past 5 years he seems to have cognitively declined.

He is not forgetting specific words but occasionally forgets recent conversations or what he has gone the shop for etc. He frequently forgets to take his medication if not reminded and would struggle to tell you the specific name of his medication.
His gait changed to a shuffle years ago but originally I thought that was due to the vascular surgery on his legs. This has led to reduced mobility and an increase in his weight.
He seems unable to learn new skills such as operating the TV remote or a phone.
Over the last 18 months he has developed urinary incontinence which he is in complete denial about. He refuses to wear any kind of pads. Every day he has dribbling but more frequently he is having bigger accidents. He is unable to use the toilet standing up but refuses to sit either. I don't want him to develop sores and smell (which he does) but he will not discuss this with me or lies and says he will get it sorted.

He is becoming more agitated and has heightened emotions.
He does not seem able to organise any life admin and leaves this to me or my 87 year old mum. Mum always ran about after him so he never cooks or cleans but I suspect he would struggle if he tried.

His speech is becoming more difficult to understand and it sounds as if he mumbles a lot. I often have to ask a few times for him to repeat what he is saying.
He seems to be buy random things on impulse that he has no need for or that are totally unsuitable for his needs (last week it was a £20 fan with a usb charging port and no plug, he opened it but then was going to throw it away)
If he has a conversation with medical professionals (pre covid) he will nod along and agree to things but he has no idea what they are talking about. As a result his current health conditions remain challenging because he wont cant/wont check his blood sugar, change his diet or lose weight. Mum and dad eat a lot of processed meals now as my mum struggles to cook due to her age.

He is able to do things he has done for years such as placing a bet at the bookmakers, go the pub or going fishing with friends. He seems to have absolutely no awareness of his decline at all and is understandable very defensive if the subject is raised.

I think the pandemic has made me more aware of his decline but I really think he needs to be assessed by a GP. Any tips on how I can encourage him? I would like to go with him but if I bring all these things up with the GP while he is present I think he will either lie or become agitated.

I know there may be a multitude of reasons for his condition such as a his diabetes, a UTI, vitamin deficiency etc but I am increasingly worried it could be vascular dementia or similar.

Would he go in for a “general check up” if invited by the GP? If he might, then you could write to his GP, setting out your concerns.

I spoke to him today and very casually said that maybe he needs to get his prostate checked as lots of older men have issues in this area and it can play havoc with the bladder. He seemed more receptive to this idea.

If I could get an appointment booked I was wondering if it would be appropriate for me to write down a few bullet point concerns about my fathers health. I could maybe hand it to the doctor to read and it might make my dad less defensive than if I start speaking about my worries in front of him.

Sounds like a plan to me.

The GP isn't allowed to discuss your Dad's medical matters with you without his permission, BUT there's no rule at all against you telling the GP stuff you've observed in your DF! You can contact the GP ahead of the appointment if you think it will help.

You can drop a note into the Dr before the appointment.

If I could get an appointment booked I was wondering if it would be appropriate for me to write down a few bullet point concerns about my fathers health. I could maybe hand it to the doctor to read - or better still, post it in advance, headed "dad's name, dob> re appt ". Take a copy with you just in case, but if the doctor has already read it in advance, they'll be geared up straight away, and you don't have to face your dad's questions about what was in the note you handed to the doctor.

Also does the GP know your father or is it a different one each time? If it’s the latter then hang on to the notes and hand them over in person, otherwise they get lost in the system.

I would suggest that you contact your Dad's GP prior to the appointment with a list of concerns given that it sounds as if your dad either isn't bothered by them - the incontinence - or can't remember them - the memory.

In non-Covid times of course you could have gone along with your dad to point out everything he had forgot or was missing.

The likelihood your dad will give an accurate account of himself without you seems very low, or that he will remember what he has been told at the end of the appointment so it is going to need some set up in advance.

The likelihood your dad will give an accurate account of himself without you seems very low, or that he will remember what he has been told at the end of the appointment so it is going to need some set up in advance.

This is so true. I'd give the GP a letter setting out your concerns as suggested above but could you also ask to be there with him?

I'd also talk to your DF & DM about getting POAS and see if you can apply for Attendance Allowance for your DF.

Have either of them had a Care Needs Assessmentt*? It sounds as if your DF really needs one.

How is your DM in all of this? She can't be happy looking after him in that state. Is she still ok to do all of the cooking? What does she say about his incontinence?

If it’s the latter then hang on to the notes and hand them over in person, otherwise they get lost in the system. At our surgery they are scanned on to the computer. So I'd go with the belt and braces approach of sending them ahead in the hope they'll be read, and having a paper copy at the appointment in case they've been lost.