Note to GP?

[Wombat27A]

I've posted before under a different name and found the replies very helpful.

My Mil has been asked to go see the GP for the first time since moving back to our local town. Fil had finally written to them but we don't know what he actually said. He's definitely struggling now but wanted to sort out the house first...they'd moved back near us, after moving away...

Anyway, my question is should we drop a line to the GP before the appointment with our observations? Or is that interfering? DH has POA but with no assessment of capacity, is it overstepping? The GPs are actually our GPs too.

Background is that Mil has refused any care for the last 3 years but is now physically poorly and very confused. Been forgetful for at least 7 years.

[PermanentTemporary]

You could, and I often suggest it, but it depends what you are trying to achieve. I think perhaps I would leave the first visit for them to get to know each other a little. Or write but tell your MIL that you are doing it and that you're worried.

[ZekeZeke]

Your DH should contact the GP (not you) and advise he has POA, that his dad has gone downhill and he would like a cognitive test done.

The GP can do a simple test or arrange for a more detailed one at a memory clinic.
This would be a starting point to get help for your PIL.

[Wombat27A]

@ZekeZeke

Your DH should contact the GP (not you) and advise he has POA, that his dad has gone downhill and he would like a cognitive test done.

The GP can do a simple test or arrange for a more detailed one at a memory clinic.
This would be a starting point to get help for your PIL.

Yep, I know it's DH's responsibility but I'm the one on MN, so thought I'd ask and was probably sloppy when posting.

The reason to ask is that there's been a fair bit of denial going on and it's "recollections may vary" type situation. We think she's more ill than he realises.

[Wombat27A]

Mil refused to go to or talk to the GP.

The appointment has been rearranged.

Anyone got any tips?

[PritiPatelsMaker]

This must be such a struggle @Wombat27A

It is such a difficult situation for you all to be be in.

I think the first stage would be for your DH to make sure he's down on her records as POA.

What is it that you are trying to achieve through an appointment with the GP? Is it a diagnosis or some care?

[Wombat27A]

The LPAs have just come through, so DH and BiL (who lives 5 hours away) are named, so that's good.

The main issue isn't actually MiL, as despite being pretty poorly now, she's well-looked after, solely by FiL. The problem is FiL is 85 & physically breaking down. He needs joint replacements, has cancer & had small strokes...

We are trying to get a framework in place for when she does need care or carers or indeed, just some medical care. It was ok whilst she was still going out but she hurt herself and has refused to leave the house since she was injured.

I'm more than capable of organising things but we can't interfere really until there is a proper crisis. I'd rather manage things better (in whatever way suits PiL) but it does need some co-operation. We have other elderly people that also require help, so it's a question of managing my MH and actually my physical health as much as anything, as I'm at that age I'm coming apart a bit too.

How do you get someone who is physically resisting to the GP?

I might give the dementia co-ordinator another ring on Monday!

Thanks for letting me sort my thoughts.

[PritiPatelsMaker]

Ok so how does FIL feel about having carers for MIL?

Would he be willing to have a Carer's Assessment with your DH/You there so that he can tell them he's not coping and needs help?

As for getting her to see a GP. I'm not sure that's the best route at the moment but once you've got DH down on record as POA, they might be willing to do a home check if you frame it as a friendly chat with the GP?

Have you spoken to the Admiral Nurses yet @Wombat27A? They might have a few suggestions.

If she has a medical need this weekend, like delirium, you could always call 111.

[SheWoreYellow]

If they aren’t managing to look after themselves then adult social services would be well placed to help.

[WhatNoRaisins]

Maybe they need a referral to SS if they are no longer coping

[Wombat27A]

That's the thing, they are coping still but it's getting ever more precarious.

We've talked to the dementia co-ordinator before and we've agreed that now isn't the time for Social Services.

Me and DH are just discussing whether he'll agree to a Carer's Assessment. We've mentioned it before in passing but we need to raise it again. It's a bit like kicking a puppy tho. He's doing a sterling job of looking after her but we think he doesn't really realise she's forgetting processes as well as facts.

I've seen her with delirum, well scary. It was after a long journey. Thankfully, they don't need to travel now.

[PritiPatelsMaker]

I'm not a HCP and I don't have an awful lot of experience with Dementia, just my DMIL but I'm not sure what seeing the GP would achieve though if DFIL is unwilling to accept Carers/Meal Service/Cleaner.

Ultimately he's got to be the one that is willing to accept they need help. How you go about having that conversation though is difficult and I'm sure that Posters on here can help you with framing that conversation with him.

[Anothernameforallthis]

I agree with the pp, it fits with what we experienced. Although MIL was the one with the medical issues, it was actually FIL and SIL who were blocking things getting sorted. They muddled on trying to care for her at home for far too long, with the best of intentions, but it caused a lot of problems. By the time they were willing to step back she was delirious, dehydrated, had been off her medications for weeks 🙄, she went into hospital and only left to move to a nursing home.

Unf muddling along in a precarious situation until a crisis arises seems to be the norm.

[Wombat27A]

She really needs to see a GP, as much for physical issues as much as anything. She's also refusing to go to the dentist, have haircuts, get clothes, etc. The repetition is also getting a bit much and she's muddling up their meds, too.

Where we are, we can't get the dementia co-ordinator to visit or attend things without a formal diagnosis. She'll need a care home too if FiL keels over and I don't think it's fair to the local services not to have prior notice of her situation in an emergency.

We have an amical relationship but we've never been "close", so it's quite hard.

[newbiename]

Could your husband explain all this a d and ask GP to do a home visit ?

[Wombat27A]

Yep, I think a home visit might be a good option. We'll wait to see what happens next week.

[PritiPatelsMaker]

Sadly this was our experience too. DFIL wanted to care for her at home but seemed to think that accepting any help was a sign of failure.

She could have probably stayed home longer and they could have both enjoyed it more if he had accepted help.

It all came to a bit of a head when she developed delirium one weekend and we called 111 who asked us to take her to A&E who were brilliant. The Hospital did everything they could to find out the cause for the Delirium.

They had a multi disciplinary meeting and decided she needed 24 hour care.

DFIL was actually relieved although obviously sad but as it wasn't his decision to put her in a care home the guilt was eased.

I think what I'm trying to say is that sadly lots of couples do carry on like this until there's a crisis. It's awful and it's commendable of you trying to avert that.

[Wombat27A]

Thank you, appreciate your kind words.

We really just want to support them.

[Wombat27A]

A wee update.

Mil did not go to the next appointment.

A home visit & other tests have been arranged. GP is good, so happy about this.

I really feel for mil. Must be so scary.

[Wombat27A]

This should probably be a separate thread but MiL is refusing to go for the tests.

Once someone is refusing to leave the house, what can you do?

[Mosaic123]

Can you try some kind of bribery/distraction?

Promise to take her, for example, out for tea. Don't mention the tests.

Once you get her in the car and are driving, arrive at where the tests will take place you get them done and then take her out for tea/lunch.

Well it might work.

[KangarooKenny]

@Wombat27A

This should probably be a separate thread but MiL is refusing to go for the tests.

Once someone is refusing to leave the house, what can you do?

It is time to get SS involved if she’s refusing care.
If she’s been referred to the memory clinic and is refusing to go, that is an indicator of dementia, as she knows there’s a problem and she’s masking.

[aramox1]

One way round this might be to talk explicitly about 'memory issues' not dementia and suggest there are meds that can help with 'minor cognitive issues'. So sorry, it's very hard. Ideally the Gp making a referral will convince her she has to go.

[Wombat27A]

It's been left to go too long. Fil is a very strong character & I think he assumed he'd always be able to cope/get her to do stuff.

GP is coming out in a week or so. Just contemplating contacting her briefly in advance, might, might not, we'll see.

I've said to DH & Bil that if the memory dx continues to be a problem, then organising a needs assessment will be the other thing to suggest to Fil. We can't make them let people in tho, we barely get over the doorstep. Bil comes up in a few weeks, as he's a visitor, they spend more time with her.

[KangarooKenny]

But them not engaging with SS would be an indicator too.

[Wombat27A]

The GP has now been round. Apparently, it was not very easy but the GP conducted the tests & the results were as expected. Doing blood tests too.

Thanks all. 🙏👍