My DM's not quite right, forgetting what she's doing come on very recently, advice needed!

[TabbyStar]

She's 88, has a couple of TIAs last year. She's previously been very sharp but over the last week or two she's been getting confused and forgetting what she's been saying half way through, not entirely surprising for her age but unlike her. Her blood pressure is on the high-ish side and she is speaking to the GP.

Not sure whether I should do something or what should I do? I don't want to alarm her, which will probably make things worse as she's v anxious. I thought maybe a call to her GP in the morning but feel a bit uncertain. Any advice?

With my gran, sudden confusion and forgetfulness was always, always a urine infection. So GP yes.

It might be an infection, but I noticed it last week and she doesn't seem to have any other symptoms (beyond things we already know about!)

Could be a UTI. However in my experience dementia starts like this too. It can go in quite sharp declines, rather than a gradual slope

She needs a gp review either way, if she has had tia's vascular dementia is closely related and tends to present with sudden declines then often stabilises for a while before a further step down.

However agree with others that an infective cause needs to be ruled out alongside blood tests for other less obvious causes of confusion in the elderly.

Get her checked for a UTI. If that's negative she needs a memory assessment via the GP, however theres a long wait for referrals to the memory clinic if she scores poorly and even then a diagnosis doesn't change much practically going forward.
Make sure you have POA if you haven't already, and that her will is up to date.
Now might be a good time to plant the seed about a daily carer (which can be stepped up as needed), plus gardeners, cleaners, local handymen etc. This is what we save for. The default answer however will usually be no, so think hard too about your own family and mental health and how relied upon you are willing to be if and when things deteriorate.

Thanks everyone, I'm going to call the GP this morning. I do a reasonable amount for her, she had a couple of crises in the last couple of years, and my dad died, and I did persuade her to get a carer for a while, but she stopped it during Covid as she could manage herself. Same for the cleaner. We have legal stuff all in place, but I do dread the prospect of having to do more as I know how exhausting it is. I was most concerned about another TIA, but it's interesting to know the vascular dementia link.

Is she on any long term painkillers? I started worrying about my mum’s memory/dementia and it turned out to be a side effect of her medication. She switched to a different pill and her memory was fine afterwards.

Good luck with the GP today. Let's hope it's medication or an infection

The GP will not be able to discuss any details of your mum's health unless she has given her consent, although you can give them as much detail as you can and raise any concerns.

Ask the surgery if they have a consent form or get your mum to write a short note giving her consent. It will make things much easier going forward if the GP can discuss all health matters with you fully.

You can absolutely speak in confidence to your GP about any concerns you have. They won't tell you anything about your mother's details, but they will act.
We spoke to my mum's GP under similar circumstances and they called her for a "routine review". She went along quite happily, saying "it'll be something they do to everyone my age".
From there referral to the memory clinic and scans etc. This was pre-Covid and she had the dementia diagnosis within a couple of weeks.
Having the diagnosis is important as it kick-starts other help. Regular memory clinic checks, meetings with designated nurse, and obviously medication. You won't get any help if you aren't in the system. Even practical stuff like getting a key lock thingy on the door in case people needed to get in all came from that. She went once a week to a club organized by the local authorities as well.

It may be a UTI in which case the above is redundant but if not, there is lots of help out there, but you need to be in the system to get it.

Oops forgot- my friend was recently in a similar situation with her Dad. She spoke to the GP and set the same wheels in motion. Took about three weeks from her chat to official diagnosis and he now has meds and a carer going in.

We've got a telephone appointment with her GP this afternoon, so that's good, and have her consent for the GP to speak with me, we have a key box outside and she has an alarm she wears. We went through this all with my DF and with her when she had previous physical health issues, so that side's set up, it's just sometimes difficult to call how urgent a medical issue might be. They were very quick responding at the surgery this morning, and I only waited about 5 mins for them to answer, which was a nice surprise!

When she had her TIAs last time the hospital sent her home saying she had high blood pressure and speak to her GP about medication without doing anything themselves. She reacts badly to some of the more modern drugs so she was on an old one, but the GP has changed it again but I don't know why. She's on a whole cocktail of various things! I think high blood pressure itself can cause confusion. We shall see....

Thanks to everyone who took time to respond, it's good not to feel alone!

Good luck!

Aaargh, the doctor called already so I wasn't there. DM mentioned the blood pressure to him but not the confusion or the vertigo. She's been prescribed an extra blood pressure medication to replace the one that's unavailable. I'm not sure they would have done anything different at this stage if I had mentioned it, so think I'll just monitor things for a couple of days to see what happens. It's so frustrating that they don't work effectively with carers when I'd said I'd go over there for 2pm to be there and that she was confused.

Oh no. What a pain.
Can you ring them again?

Ask if you can drop a urine sample off to be tested for an infection, if you haven't seen the mental confusion that a UTI can cause in someone for yourself it is hard to see that it could be a possibility but it really is. I'd ring the surgery and ask. Hope you get it sorted OP.

ChicChaos Would she not have some other symptoms in a week and a half with a UTI? I can mention it when I chase it up again as a possibility. My DF got v confused when he had pneumonia, so I know what you mean.

Geamhradh I thought I'd wait to see if it settles down with her blood pressure, as I don't think they'd do anything else anyway if it is dementia-related until they've seen whether her blood pressure changing makes a difference (this is sort of where we were with the TIAs too). If she takes the second medication and her BP is lowered and she's still confused, I think that indicates a bigger problem that might need a referral. Her normal medication is out of stock (as opposed to no longer prescribed by the GP), but there seems no system to flag that this might actually be a problem for people, or if there is a system it's not worked!

Hi OP, when my dad got utis he never had any other symptoms than confusion. The doctors would always do a urine test to rule it out and it would always come back positive. A course of antibiotics and he was as right as rain, so don't rule it out due to lack of other symptoms.

Yes, uti’s can often “hide” in older people so there may not be other symptoms. So frustrating for you that they called early but definitely worth following up.