If you are caring for someone with dementia you should consult the GP as soon as possible if you are worried about any aspect of the person's health. It is important that they should not suffer any unnecessary pain or discomfort. The GP may offer advice or treatment or refer the person for further specialist help or other services.
It is important to consult the GP promptly if the person with dementia seems unwell. As they themselves may not be able to tell you just what the matter is, you may need to pass on any helpful information to the GP. Often treating even very minor complaints can make a considerable difference to the person's well-being and their ability to cope.
You also need to get in touch with the GP as soon as possible if there is any sudden inexplicable increase in the person's confusion or agitation, or any worrying change in their mood or behaviour as this may be a sign that they are ill. Many physical conditions ranging from chest and urinary infections to infected leg ulcers and constipation can cause additional confusion or distress which will usually diminish once the condition has been treated.
In addition, depression, which is particularly common in the early stages of dementia, may mean that the person is very withdrawn, agitated or miserable. Depression does often lift after a time but if not the GP may consider antidepressant medication.
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If you feel a specialist opinion is needed on any aspect of the person s health ask the GP. The GP is usually the only person who can refer to a specialist.
It is also important to ask the GP's advice on ways of preventing illness and keeping the person with dementia fit and well. The GP may arrange to see you both on a regular basis or you could make an appointment whenever there are problems or decisions that you wish to discuss.
The GP may be able to refer the person to a professional such as a community nurse, or suggest helpful services. Some services are available through local specialists. You will usually need a referral from your GP.
Many services, however, are only available through social services. Ask social services for an assessment of needs if you have not already done so. Your GP can refer you or you can refer yourself.
Ask the GP about any prescribed medication. You need to know what each drug is for, how it should be taken, what the effects are likely to be and whether there are any side-effects to watch out for.
Make sure the doctor knows if the person is taking any other medicines, whether prescribed or over-the-counter, since the interaction of certain drugs can produce unpleasant and sometimes dangerous effects.
Find out too whether it is safe for the person to drink any alcohol while taking the drugs.Generally speaking, the fewer drugs prescribed for people with dementia the better. Some drugs may make it harder for the person to cope by causing additional confusion or other problems. In general older people need lower doses of drugs than younger people. If any drug does appear to be having an adverse effect contact the GP straight away. The drug may need changing or the dose altering.
A good relationship with the person's GP is important for all concerned. You will be able to provide the GP with helpful information about the person and you will feel confident about contacting the GP as soon as problems arise.
If you have a different GP from the person with dementia and if you have not met, it may be helpful to write to the GP explaining the situation. They will then know who you are if you accompany the person to the surgery or if you ask for a separate appointment.
In any consultation it is important that both the GP and carer treat the person with dementia as an individual and do not discuss matters over their head. If you find it difficult to talk openly in front of the person ask if you can have a separate appointment to discuss matters in more detail. Ask for a double appointment if you think it may take some time.
If you and the person with dementia come from a very different background and culture from the GP it will help if you explain any relevant customs, attitudes or beliefs that the GP may be unaware of. This could assist the GP in assessing the person with dementia and in suggesting appropriate services.
If you want the GP to visit the person at home try to telephone the surgery before l0am to help the doctor to plan the day. Be quite clear as to why you consider a visit is important. If you have difficulty in convincing the receptionist ask to be put through to the doctor so that you can explain the situation and ask for advice.
If you have moved home to look after someone with dementia or if they have moved to live with you, one or other of you is likely to need a new doctor. You can get a list of local doctors from the local health authority. The address will be in your telephone book. If you have difficulty in finding a doctor to take either of you on, you should inform the health authority. They have powers to ensure that everyone is registered with a GP.
If the person's GP does not appear to be very interested, or if they are unhelpful or unsympathetic, there may be another doctor in the practice that you could see. Make some tactful enquiries of the receptionist. If you are very dissatisfied with the GP and there is no one else in the practice you would prefer them to see, you can arrange for them to change doctors, providing another doctor is willing to take them on. Simply accompany them to the new doctor's surgery. They will need to sign their medical card or a form provided by the receptionist. It may be quite difficult to change doctors in some areas.
If you have a complaint about the GP do try to sort it out on a personal level as soon as possible. There may have been a misunderstanding or the GP may have been feeling particularly harassed at a certain time. If you are unable to do this and you wish t to take further action contact your health authority as soon as possible and they will advise you what steps you can take (the address will be in the phone book). You can also ask your local community health council (CHC) for advice on making a complaint.
The address will be in the telephone book.
As a carer you will be under considerable physical and emotional stress. You must be careful not to neglect your own health and well-being. You should see your own GP on a regular basis to check up on your health. Make sure that your doctor is also kept up to date on any stresses and problems you experience as a carer.
November 1997
Page Text supplied by The Alzheimer's Disease Society of Great Britain