What is the point of memory assessment?

[FruHagen]

My Mother has loss of memory and recently had a trip to hospital with a heart related condition.

On release the doctor said she should attend a memory clinic. He must have noticed my Mother's difficulties while treating her.

So I am trying to make an appointment for her however she is adamant that she doesn't need it and it's stressing her out.

So my question is -
What is the point of the memory clinic?
We know she is losing her memory, so what help could we expect from it?

A diagnosis? A treatment? Or just a lot of stress and upset for my Mum?

Any input appreciated

Memory clinic and assessment was the first point of call for my nan who now has dementia. They probably want to access her to check nothing more serious like dementia is going on, instead of just general memory loss. I would recommend going for peace of mind

It's worth going. They can be very reassuring ironically. There's medications that can help slow the process and the type of memory loss can be diagnosed. This is actually very useful as it will enable your Mum to be better supported.
Engaging with professionals and taking advice really will help - my Mum had mixed dementia, but mostly vascular. Living well and independently for as long as possible was our ambition.
Regular checkups at the clinic do help track changes and they are the places with access to the best information and the newest treatments.

A diagnosis, because it was a way of getting my mum on the radar. If your mum needs care in the future, it’s a lot easier (for which read slightly less difficult) to organise if you can tell, say, Social Services that she has a diagnosis of cognitive decline or whatever.

They can offer medication which can slow the decline but it does not work in many cases.

It's a clinical diagnosis and there are meds which may slow some of the decline.
The initial test will be a baseline, future tests will track any changes.

You and your mother get time to plan for the future.

If your mother is still medically competent you should discuss what happens in the future.
Is she driving?
Has she assets or income which will have to be managed?
Has she made a will and is she willing to grant someone the right to act for her if she can't?
If she declines further can you or other family become more active in day to day items or will a carer or a care home be needed?

I work in this area. The assessment takes into account blood results and brain imaging as well as a cognitive assessment. It can rule out other causes for memory loss such as certain deficiencies that can contribute. As others have said sometimes medication can be prescribed but I think the most important outcome for many families is that we can link them in with services.
Another thing that comes up a lot is that the patient themselves may not recognise the degree of impairment they have and still be driving. Often it takes diagnosis for the person or their family to realise how unsafe it would be for them to continue to drive.

I went through our GP to get an assessment for my own mother. Among other things, they checked for syphilis and many deficiencies that can also cause memory loss. In these cases, a correction of the deficiency can cure the memory loss and it may never occur again. I'd see it as neglectful NOT to get a proper diagnosis and insight into what ever is causing your own mothers difficulties!

There are obviously memory problems which can be degenerative in nature, but again, having a proper diagnosis can help with meds which might slow the progression, provide support for her and the family and possibly financial assistance.

In my case, I had concerns from my mums relatives about her behaviors, repeating stories etc. After seeing a consultant, blood tests and various cognitive tests- they found absolutely no evidence of any degenerative memory loss above normal for her age! They gave her advice on concentrating when speaking to people so she is aware of the conversation and keeping track (not speaking on the phone, watching TV and also cooking all at the same time for example).

No one would want to admit to forgetting things and being aware of ones own mental decline must be torture. You might find some useful tips or advice from Age UK or the various dementia support websites. Could you go with her to the memory clinic/GP and highlight the positives of knowing what is going on? Is there anyone she trusts?

As Thunderface said, the process starts with blood tests to screen for things that can cause confusion or memory loss. She may not want to hear about dementia but this could be something that's turned around with vitamins (B12 springs to mind).

Mum spoke to the doctor and was referred to the memory clinic. She had a diagnosis of dementia, medication for it and it qualified her for attendance allowance. We had time to get the lasting power of attorney sorted out and she reviewed her will. MIL agreed to speak to the doctor then hung up on him, so has never been formally diagnosed, no attendance allowance, no medication.

Please get the lasting power of attorney sorted out if she hasn't already done so. The alternative is applying to the court of protection and it's a much more complicated and expensive procedure.

For my mum, the testing was really important in unpicking what her issues actually were- her memory wasn't great, but her ability to word find, process visual information and reproduce things was absolutely shot and that really helped us to manage her world better. For instance, people often recommend looking at old photos with someone with dementia - for my mum this was really distressing as she couldn't actually 'see' it but got the message that she should know what was going on.
The clinic mum went to was really supportive and didn't distress her at all. Lay all blame at her heart doctors door 'Well, Dr X said you had to go and be checked out, so we need to do what he says'

Thanks all. So helpful to hear your opinions.

I have booked in. Next hurdle is getting her to go.

We have applied for LPA also

Also finding this useful to hear, we have moca test at memory clinic this week.

My mother was so distressed at the idea of memory clinic that I didn't force her to go. Hope you manage to. I think in her specific case it didn't make much difference but it might have got some things on the record that would have been helpful.

I never took my mum to the memory clinic either. To be honest her mobility and age meant that by the time she was really showing signs of dementia she was in her nineties and just a very old lady who sat on the sofa all day.

All the reasons above explain why memory clinic is important.

If she does have a treatable "to slow down progression" type of dementia that could help and add on years of a better quality of life ; a diagnosis could help with an attendance allowance claim (£65-89 a week) and also make her eligible for council tax exemption with her local borough council- you have to apply though. Amongst other things.

It also helps with later using the LPA as to act on her behalf in finances ( as opposed to 'under her direction) you need a capacity assessment & the very first criteria in mental capacity act 2004 is do they have an impairment that disturbs the functioning of the mind (ie a diagnosis)

GPs are increasingly reluctant to give diagnoses in MH / dementia these days as it is psychiatrist (in local community older persons mental health team) ie the memory clinic , that does so

Sorry in second paragraph I meant for some dementias, medication can help slow down progression

The diagnosis and any suitable medication are very important to keep her as well as she can be and access support that anyone involved in her care can be helped by. Also for planning purposes such as the LPA.

I was very worried about getting my mum diagnosed as it would upset her but we framed it as 'getting her memory checked to see if it was normal ageing or if she would benefit from some medication to help keep her brain healthy.' At the memory clinic she was very nervous before the test and asked if she was going to be sent to the funny farm. Dad and I just laughed and said the funny farm didn't exist and she was stuck with us.

The (one) good thing about Alzheimer's is that she quickly forgot she had even been for the memory test. Recently I took her to the doctors and while talking to the receptionist I mentioned mum had a bit of Alzheimer's. When we sat down in the waiting room she said to me 'what were you talking about? I don't have Alzheimer's'. I tell a lot of white lies these days!

Just following up here in case helpful for others.

We had the assessment last week and they promptly followed up with detailed report, referral to mental health team and psychiatrist to do follow up diagnosis and care plan.

The memory test results weren’t good, they used ACE III assessment - does anyone know anything more about this?

Ace III - not masses - it's quite a detailed cognitive assessment, much more so than a screening tool like the MOCA or the MMSE. Makes sense that they would use something like that. It's quite heavy on language skills.

ACE III is out of 100 and less than 80 is suggestive of dementia although pre morbid ability and other factors like any disabilities that could impair performance need to be taken into account

@ShipwreckSunset
That's amazing! Where do you live?

My mum got tablets 'although it's probably too late', and nothing since from the medical profession. My dad is her live-in carer by default, and we muddle through with no further support.

At her last annual review at the GPs (pre-Covid, none since) the nurse conducting it handed my mum a list of her medications and asked her to say what they were all for. My dad intervened and quietly said 'She doesn't always remember everything. I can tell you what they are for', and the nurse responded 'I know she's got dementia. It says on her notes. And I don't want to know what you know. I want to hear from her what she understands about what she is taking'.

So shocking and distressing for my mum who still asks if the 'lady who's nasty' will be there when she has to go for her B12 injectìon. She, who forgets almost everything, has not forgotten that. So little care from a health professional.

From the sound of it, your journey should be more supported. I wish your family well.

@Scarby9 I am so sorry your parents had that treatment, it must have been so distressing if she can still hold onto that thought.

I have been really impressed with the care they have had from their local health team, other than the gp who has been v poor.

The Ace test gave a score of 59 which looks really bad. Language score was high and fluency v low within that. I’m going to try to speak to team to understand what it might mean going forward.

Spoke to the lady who did the assessment and she was very kind and patient in explaining. Not confirmed by doctor but looks like dementia, not sure which sort. Not sure if that really matters to some extent. Had a big cry this afternoon.