Alzheimer's Society

If you have dementia or if you are worried about someone else, it would be wise to consult the GP as soon as possible about any health worries. Treating even minor complaints can make a considerable difference to a person's well-being and their ability to cope. If you think that you may have dementia but have not been diagnosed, our information sheet Diagnosis and assessment may be of help.

• General advice on ways of preventing illness and keeping people fit and well
• Medical advice and treatment
• A referral to specialist help and other services

Visiting the doctor

People with dementia often find it helpful if someone they trust accompanies them to the surgery. A close friend or member of the family may be able to help explain the symptoms to the GP and remember afterwards what was said.

Later on, it makes even more sense for a carer to accompany the person to provide support. It also means that everyone involved is clear about what is happening.

Sometimes people with dementia prefer to see their GP alone, or their friend or carer may be unable to go with them. If this is the case, it may be possible for the carer to talk to the GP afterwards about any practical matters, providing no confidences are broken between the person with dementia and their GP.

Tips

• Write down beforehand the points you want to discuss. It can be difficult to remember everything you want to say during a consultation.
• Make a note of anything important the doctor says. You might want to write down any medical terms that are used, for example.
• If there is anything you do not understand, ask the doctor to explain in simpler language.
• If you come from a different background or culture from the GP, mention any relevant customs, attitudes or beliefs. This can help the GP in assessing an illness and in deciding on appropriate treatment and services.
• If you are the carer, don't talk to the doctor over the person's head as though they weren't there. If you feel you need to talk to the doctor on your own make a separate appointment.

When to see the GP

Someone who has dementia should see their GP as soon as they feel unwell or there are concerns about their health.

They should also see their GP if they suddenly become more confused or agitated, or if there are any worrying changes in their behaviour. This could 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 and distress. These conditions usually respond to treatment.

They should also see the GP if they feel miserable anxious, restless, if there have been marked changes in their sleeping or eating patterns, or if they become very withdrawn. Any of these can be a sign of depression which is particularly common during the early stages of dementia. The GP may consider prescribing antidepressant medication, counselling or other forms of support. See the Alzheimer's Society information sheet, Depression.

If at any time you feel that a specialist opinion is needed, ask the GP. The GP is usually the only person who can refer to a specialist.

Services

The GP can also refer to other health professionals such as community nurses and suggest helpful services. For more information on help and support available from the NHS see the Society information sheet, How health professionals can help.

Other services such as home care, meals on wheels, sitting services and residential care are available through social services. If you have not already done so, ask for an assessment by social services. The GP can refer you or you can contact social services direct. Their number will be in the local telephone directory under the name of your local authority. For more information see the Society information sheet, Community care assessment.

Advice on medication

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.

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. Make sure the doctor knows about any other medicines that are being taken, whether prescribed or over-thecounter, since the interaction of certain drugs can produce unpleasant and sometimes dangerous effects.

Find out too whether it is safe to drink any alcohol while taking the medication.

Generally speaking, the fewer drugs prescribed for people with dementia the better. Some drugs may make it harder to cope by causing confusion or other problems. It is also the case that older people usually need lower doses of drugs than younger people.

Drugs for dementia

Drugs are now available that can sometimes temporarily slow down the progression of symptoms of Alzheimer's disease. The first prescription must be given by a specialist, although subsequent prescriptions can be issued by the GP. These drugs are only prescribed to people with a diagnosis of Alzheimer's disease who are assessed as being likely to benefit from them.

Anyone who has been diagnosed with Alzheimer's disease or who is suspected of having Alzheimer's should be referred to a specialist as soon as possible so that they can be assessed to see if medication might help. For more details, see the Society information sheet, Drug treatments for Alzheimer's disease: Aricept, Exelon, Reminyl and Ebixa.

A separate fact sheet on Ebixa, a drug which treats people in the middle and later stages of the Alzheimer's disease, is also available.

Changing doctors

If the GP seems uninterested, unhelpful or unsympathetic, there may be another doctor in the practice whom 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, you can arrange to change doctors, providing another doctor is willing to take you on. It may be quite difficult to change doctors in some areas. Your local primary care trust can advise you (your GP surgery or citizens advice bureau will have the address) or telephone NHS Direct on 0845 4647.

Carers' needs

If you are caring for someone with dementia you may 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 and discuss any problems you may be experiencing. For more information see the Society advice sheet, Carers: looking after yourself.

Information sheet 425

Last updated: January 2003
Last reviewed: January 2003