Start of dementia? Where to get tests?

[ElsieandMavis]

My ex-partner (early 60s) has confided in me that he is struggling remembering how to do things.
Does anyone know what we need to do to get him tested to see if it is just normal ageing or something more sinister?
He has private medical insurance so we wouldn’t necessarily need to go via the NHS.
Thanks.

Make a gp appointment, take a list of examples things he’s forgetting or getting confused with.

Is it even possible to see a GP these days?

Of course it is make an appointment asap

If you have private healthcare, you want a referral to a geriatric psychiatrist.

If he has dementia, a diagnosis of the specific type of dementia is important because some of them can be treated by drugs that significantly delay the rate of decline. This can mean the difference between maintaining a good quality of life and independence for years as opposed to a swift decline over a matter of months. There are many different types of dementia (Alzheimers, vascular dementia, pick's disease, Lewy Body dementia) so it is important to get a correct diagnosis. It's not just about treatment because they present differently so it's good to know what is coming in terms of symptoms and future management.

The NHS is all about money saving these days so tend to just do a behavioural assessment together with a memory test. In fact for a complete picture and accurate diagnosis you need as well as those things an MRI scan and blood tests.

You maybe able to speak to the GP on the phone if you state all your concerns.

GP will likely refer your DH to a memory clinic who will arrange memory tests.

This is what I did with a family member recently. The GP was prepared to speak to me on behalf of family member - but this may have been down to unique circumstances.

Apologies- just seen ex partner not dh.

Or, alzheimers society may be able to offer advice.

GP appointment first. Lots of easily treatable things can cause similar problems (thyroid issues, low B12/folate, low vitamin D, low iron etc)

Also @ElsieandMavis if he suspectsn the start of dementia, he should look into setting up a lasting power of attorney if he has someone who will take on that role for him (adult children, siblings, partner etc).

There are two types -health and finance. The finance is particularly important because if he loses mental capacity, no one can pay his bills or touch his money without a court order.

A lasting power of attorney can only be set up whilst the person still has the mental factulty to choose to do it and consent - once the dementia progresses it's too late - and then the relatives are into the mess, cost and delay that is an application to the Court of Protection.

Thanks, that’s really helpful. His father died of vascular dementia in his late 60s but I don’t think that is genetic.

Thanks. The thought of it is terrifying.

Yes, that’s a good point but I wonder if the GP will do those sort of tests when the NHS is so stretched. Maybe a private GP would be a better option?

NHS GP first, then private if needed. Seems sensible

@ElsieandMavis

The GP should be willing to do blood tests - so I'd get your ex to start with the GP first to rule out other stuff and get the process going. He may have better luck anyway because he's young for dementia

The point I was making is that these days (And I've seen this in action) when you have someone with memory loss, there is a cost-saving tendancy to just ask them a few questions and the memory clinic, assess the behaviour and diagnose Alzheimers AND then tell the patient there are no drugs suitable for them because of their age/other drugs they are taking blah blah blah just to save money.

They avoid doing MRI/brain scans for the costs.

Many of the dementia drugs are very expensive and there seems to be an attitude of 'they are old, they will die soon, who cares, no need to spend money on that'. It's brutal.

We went privately and best decision ever.

I initially went to the GP with my mum, and they did a short test called the MoCA memory test. (Her score was well below the acceptable level.) The doctor then referred her for a scan, and while we were waiting for that, a more in-depth memory test was done at home.

You can find the MoCA test online, it would at least give you an idea.

no need to be facetious. You have private healthcare according to your op!

Not facetious at all. I thought you meant an NHS GP.

There's a six month wait for the memory clinic in our area on the NHS.
Even then, most just seem to get discharged with a diagnosis and a fistful of leaflets.
Agree, make sure wills are up to date and POA is in place asap.

Thanks. Do you know whether there are private memory clinics?

At this point you have no idea what the issue is, GP is a good first point of call.

And yes, it is perfectly possible to see a GP, and have what are very basic blood tests done.

If your partner is aware of forgetting things, but you haven't noticed any changes in your partner then it makes dementia a lot less likely.

So you need to start at the beginning rather than leaping to conclusions.

There are a number of things that can cause this that are not necessarily dementia.

It's often referred to as "brain fog" and can be caused by thyroid problems, post viral syndromes, not enough sleep, depression etc.

He should see a gp because at least some of those are fixable.

Thanks, that’s a good point. I’m just worried about being fobbed off by the NHS GP due to financial constraints so not getting the best diagnostics and treatment available.

It is worth seeing the GP to get things started - they may be able to put your mind at rest v quickly, they may find it is nothing to do with dementia at all, you may still be directed to memory clinic.

At any point you can always ask if having whatever it is done privately would speed things along.

Thanks. Do you know whether there are private memory clinics?

No. A memory clinic is an NHS clearing house 'gateway' for dementia diagnosis in reality.

A 'private memory clinic' is seeing a consultant geriatric psychiatrist.

What do you think they do at a memory clinic exactly?

Most private old age psychiatrists would require a referral from GP anywhere so it really is the place to start even if you want private care.

I have to say you seem quite negative about the option of NHS care but depending on where you live you may be surprised. Maybe I'm lucky but it's easy for me to see an NHS GP of my choice and they have been fantastic at plugging me into local NHS secondary care for various physical and mental health needs. As someone pointed out, memory clinics (where cognitive testing, bloods, head scans etc. are carried out) are NHS run and in recent years have had a lot of funding compared to other NHS services. Of course, if you are not getting anywhere with the NHS you have the option of private insurance, although there are often limits to what insurance covers (check the small print on how long, for instance, they would pay for an expensive medication) and premiums would go up.

Requested blood tests from the NHS GP but there is a month wait for blood tests at the moment.