Memory loss worse than I realised

[deltapanda]

My grandfather is 91 and I am his only close relative. I had been noticing some memory issues for a while but was in denial it was anything unusual for his age. Two things recently have now got me very concerned, and while I’m trying to navigate his surgery’s system to get him a GP appointment (not easy) I wonder if there is anything more urgent I should be doing and wondered if anyone could advise please.

Firstly he was showing me old photos of me as a child, but they are my cousin and the difference would normally be clear. I didn’t say anything to avoid upsetting him but alarm bells went off.

Then this week I called him and he rang me back an hour later, apparently completely unaware we had spoken a short while before.

We had a conversation about how it was my birthday the following day and I was not surprised he completely forgot it on the day. Again I didn’t say anything as it would have really upset him to have thought he missed it.

He lives independently but happens to have a friend staying with him at the moment so I’m not so worried he is unsafe right now. We speak daily but the quality of conversation has really gone downhill in recent weeks.

This decline has been swift. Is the GP the best port of call, which could take a few weeks, or should I be moving faster on this?

Yes GP , worth checking bloods and urine too to make sure everything ok on that front

Very rapid decline could be an acute and treatable medical problem rather than dementia. So it's worth getting a GP check ASAP.

Sudden decline in memory could be due to a UTI so it would be worth checking that out. I thought a UTI might be the reason for my mother's apparently sudden decline in memory (we knew she had early stage dementia). She saw the GP but did not have a UTI, she had just reached the point when she could no longer mask her memory problems. She was not offered any treatment for her dementia.

Thank you for the replies, I will try again with the GP on Monday and get him seen asap. He has a good relationship with a particular doctor but her availability can be scarce as she is only there two days a week.

I would contact his GP surgery and say you have concerns and would like a phone conversation with a doctor about them. Ask in that for both a urine test to be done to rule out a UTI, and for him to be booked in for the memory test, which in my experience is the first stage of the dementia diagnosis pathway.

Dementia can advance in 'steps' where there'll be a sudden drop in capacity, so this may be what's happened. Avoid correcting him if you can, eg don't tell him it's your cousin not you in the photo, as you did.

Planning wise, I would think ahead to how you might get more help if he needs it. Would he be better with carers coming in at home or in a care home where you could visit? If he has savings above about 14K he'll have to contribute towards that, but if not it can be state funded. His local adult social services team are the first point of contact there to ask to get him assessed.

Have you got Power of Attorney forms signed for him? If not, this is your second job, after getting him checked for a UTI. Do not pay anyone to do the forms for you. They can be downloaded from gov UK and are straight forward to fill in. They cost just £82 each (one for health and welfare, one for property and finance).

If he's not keen/doesn't want to bother, just reassure him that they don't have to be used, if he is well. They are 'jusr in case' forms, just in case he ever needs your help.

Best of luck.

Thank you Holes, one thing is there are things I would like the doctor to know that I wouldn’t want to make him feel self-conscious about (like the examples above) so was wondering how I can do that so will ask them for advice.

I have sorted the finance LPA, but made a small mistake on the health and wellbeing one so need to do that again unfortunately.

Are you able to accompany him to the GP visit? It is extremely unlikely your grandfather will remember what is said, so you will end up none the wiser if he goes alone.

In terms of getting info to the doctor without making your grandfather feel uncomfortable, a good option is to write a short note of your concerns which can be passed to the doctor at the start of the appointment.

By the way as long as your grandfather gives his permission the GP can share info with you, you don't need to worry about not yet having Health & Welfare LPA. I never had H&W, just finance, and all my mother's doctors readily shared info with me because she'd given permission.

I wrote to my parents doctor - an old fashioned letter - before they went in for an appointment telling him key facts that I knew they wouldn't share - probably wouldn't even remember - to help the gp understand what we were dealing with. Their first doctor refused to talk to me, but the second doctor was fantastic and supported me, in supporting them, brilliantly.

Well done on getting the LPAs done. It should be easy to sort the health one - we did the same. It's so easy to make a simple mistake on those forms.

Yes I will be with him at the appointment, a letter is a really good idea. Thanks.

Small update, I managed to get him to the GP this week and slipped her a note with some examples of his recent memory loss and she read it while we talked - him saying he was fine and had no issues, of course. We redid a memory test he did six months ago and his answers seemed slightly worse to me although she didn’t pass any comment.

We’re going for bloods in a few weeks and she mentioned a potential appointment with a hospital psychiatrist dependant on results. So we’ll see.

Well done supporting your grandad, is it just you or are there other relatives around to help / do POA etc?

Well done on getting him to the GP. You're doing your best for him and that's all you can do.

Did they do a urine test on him? If he has a UTI, that is how to pick it up

Thanks for your interest - long story but it is just me who is able to step up in this role, there is no other immediate family.

The GP didn’t suggest water infection so I went with it, but I am sorry I didn’t push for it. My nan (his wife) had dementia when she was alive and water infections would knock her sideways. I’ll see about getting back to the surgery.

For UTIs, ask for a culture rather than just a dip test. The latter isn't accurate enough for the little grumbly ones that are common in older people.

Thanks, this is so useful. I’m noticing even with myself or DCs now, visits to the GP start with ‘what is it you want me to do’ rather than ‘you’re the doctor, I don’t know can you give me a steer here’. How any older person is expected to navigate this all without an advocate is beyond me.

I have no idea. Ive been supporting two elderly relatives over the last couple of years and I really don’t know just how they would have coped otherwise.