An exploration of the UK unpaid carer's world

GP appointment 15 September 2015      hidden page   

Notes to GP - 17 Sept & 24 August 2015 below       Links added  & emboldened text changed since.


A & T H  Written by the former.                              

1      I have rash-looking patches in waist region.                                                         Sun damage.


Pulled Teresa forward from end of bed two days ago - an hour later, pain level 9 in lower back -need referral to OTs re equipment, please. Can take Ibuprofen as last resort if pain persists. Nothing taken yet. Worst when rising after sitting. Micturation pain. Little back or Mict pain at night.


Have experienced problems with the Hereford Memory Service (HMS) as seen on many webpages of my creation.  Not given to GP - the link here.

The problem concerns my involvement in Teresa's care and the Dementia Triangle of practitioner, caree and carer 

                                  Not given to GP - the link here     

proves my point. After a long time without acknowledgement, a meeting is in the offing.

There are elements of OCD involved but this is for info only. Need to establish normal interaction with HMS before referral, if I take that step with you later.


Need to talk about Teresa having no little or no Oramorph for long periods and should there be a residual amount to keep topping up? Oramorph syringe to discuss.   Paracetamol has been reduced. See page 2  --  not included


Teresa's pain-killers (page 2 --  not included) may not be the cause of her almost-inertia in the mornings. Ages in the bathroom again. Have just changed Cross Roads from 9-10 to 10 -11 - pointless coming just to wash up and peel potatoes 9-10.


Urinary hesitancy - UH

Teresa went for ten days without Mirtazapine and UH seemed to be less of a problem. Now that ithas returned after a week on M, what do you suggest? I recognise it is a very short test period.


Teresa needs-assessment via Adult Wellbeing is about to take place. It may well overlap onto my carer needs. Both sets of needs are hard to quantify. Perhaps time today will allow a two-minute discussion. 


Thanks for asking re recent holiday. It took place at the disability hotel in Porthcawl here. It was good for us both. More to the point, it was a revelation in terms of equipment which is why OTs are on this list.


Teresa's weight a week ago was 52 kg- no change, I believe. The long-awaited dietician session is on Friday 25 Sept, thank you.

Page 2 --  not included  --  describes Teresa's recent medication. _                               Page 1/2    2 --  not included


Dear Dr L                                                                                                                                      17 Sept 2015

In round-times this morning:

Teresa in agony - right leg and desperate for commode.  5ml Oraphorm.  Managed the bed-transfer task with a complicated manoeuvre but wrenched my back again.  Having two incidents to deal with affected my judgement and I called an ambulance.  Warned Rachel of the situation in case taken.

The paramedic was here 30  mins and was patient etc re not taking me to hospital.  I had imagined he would have given me medication.

Confirmed situation with Rachel.  The next 40 mins spent going through 18 pages of Adult Wellbeing doc prior to Teresa being assessed on Friday. 

Started this email.  Relating all this on the phone impracticable.


From appointment notes 15 Sept

Pulled Teresa forward from end of bed two days ago – an hour later, pain level 9 in lower back - need referral to OTs re equipment, please.

8 Thanks for asking re recent holiday. It took place at the disability hotel in Porthcawl. It was good for us both. More to the point, it was a revelation in terms of equipment which is why OTs are on this list.


The main point of this email is to ensure that I have the right equipment to deal with situations of this order.  The biggest problem with the NHS is waiting time.  Six months and your several phone calls just to put a dietician in front of Teresa. 

Mrs JL has acted well beyond the call of duty in several situations and OTs are no exception.  I hope I won't need to invoke the services of my new case worker Miss SP.  When you make the the OT referall could it please be marked urgent.  I cannot wait weeks and weeks.  My appetite for disability equipment has been heightened by the Porthcawl trip here.  

In readiness for the asssessment, I had several  days previously made the following notes on the FACE Overview Assessment V7:

Current risk of harm/injury to your carer

Mrs H cannot conceptualise.  Husband has stated current and potential situational risk.  There is the danger that if a proper risk assessment is not carried out relative to both parties, great harm could ensue.  For example, if husband is  lifting, turning etc his wife and his back injury worsens, his wife could fall.  In that event, husband could exacerbate the back damage trying to rescue her.  He then falls  .  .  .  .  .  .  ..


It is difficult to keep track of the medics etc who attend but I do remember key points.  About eight months ago, a DN was told about the bed-lift problem and said she would arrange for a suitable strap to be delivered.  When I realised that the strap had not been dealt with, I found a substitute. It may be inadequate.  There are so many incompetent branches of the NHS to deal with that I get fed up following up and/or complaining.  In future, people who make promises will be asked to put them into our diary.

If that DN had done her job, the strap and training would have been in place and the present situation would have been of much less or no magnitude.  I trust this email will find the right readership.  I hesitate before pressing the send button as there have been other issues with DNs and I had hoped not to complain again.

If previous visits by OTs had been effective there would have been a turntable in place.  No proper risk assessment had been carried out.  Surely, there are special routines for specific situations.  Hip socket problems are not rare.


Looking forward to an OT visit very soon and to be told, as I mentioned to you, what is in the cupboard.

I do not intend to phone you later but if you need more info - 07952 060 505.

Thank you once more.


Notes to GP - 24 August 2015

     Teresa and I need your attention please.  As this is likely to be one of numerous requests on your return, my needs are less urgent.  Teresa has been in fair health considering the sheer extent of her ailments. 

     For several months until early July, she was able to be on parade c 1000.  This has regressed to 1330 and worse. A main reason is that she now (possibly) suffers from urinary hesitancy.   There seems to be more stops than starts.  She is generally occupied for an hour including once a night (sometimes twice).  No sign of constipation.  She drinks plenty of water.

    The dementia dimension seems fairly stable with only occasional lapses of memory and loss of FTD word-retrieval.  Hereford Memory Service has recently conducted an assessment. 

     However, I am worried about her weight.  She seems more frail.  You and I spoke in March and June re dietician advice viz Laura Samuels.  Still nothing   You have masses to do.  We leave for a second visit to a disability hotel on Weds 2 Sept returning Thurs 10.  It’s probably able to provide the correct scales. If not done before we return, can we please repeat the Ross hospital venture of weighing her?


My OCD of 2011 may be said to be at a canter and the reins are difficult to hold.  There is overlap from Teresa’s problems.  As stated, she is commode-occupied for an hour once a night, sometimes twice.   During this time she constantly snorts.  Says she’s fighting for breath.  Such sleep-pattern ensures we are both exhausted.   

     My suspected OCD manifests recently in the 2gether domain  [link here not included]  The Hereford Memory Service (HMS) received a request from me in mid-July.  It cited the Triangle of Care for Dementia   [link here  not included]   in which carer, caree and HMS all work together for caree’s improved health.  Request denied via a third party.

The key issues are abbreviated as follows:

  1. Lack of a proper response in early and mid-July 

  2. No response until the recent intervention of a third party whom I had asked to be involved

  3. HMS has communicated important information via the third-party - entirely unprofessional

  4. Lack of thought and, more precisely, lack of proper investigation resulting from 2.  

  5. I had resorted to demanding a meeting. Only very recently has this been recognised.       

     The new Team Manager is Mrs Jodie Thomas – 01432 845731.  Perhaps Vicki as carer lead could phone her.  Mrs Thomas can confirm that HMS has been inundated with web-pages.

      I say above my needs are not urgent.  That’s shorthand for nothing can be done until mid-September as two HMS managers to be involved in a meeting are on holiday. If the meeting is satisfactory, I hope to return to normal.  What is normal?  The Internet is full of carer stories like mine. Their authors suffer as much.

     The phoning-in regimen in HMS/CBT context will not be adopted now and I will wait for the outcome of the meeting. If negative, I hope to discuss if there is a need for yet more CBT or whatever.  If HMS may be involved a plus point is that it has further insight into my condition.  However, you might recommend an org or individual separate from HMS.

     The phoning-in regimen will not be adopted re Teresa as it sounds like a new prescription item.  I will phone on Tuesday morning re the dressing detailed overleaf and request a nurse.  If you need to see the skin problem, do please write to that effect on the sheet.

overleaf -- not shown here

pagetop here    for pasting     GP appointment 15 September 2015 and Notes to GP - 17 Sept & 24 August 2015  here