"General observations designed to help"
About: Tolworth Hospital / Memory clinic Tolworth Hospital Memory clinic KT6 7QU
Posted by NJT (as ),
These are general observations about the appointment at the memory clinic, not designed to complain or accuse but designed to help.
The visits are designed to measure the speed of degeneration of the patient over a specific period - in this case 6 months.
The format is a general chat followed by a series of tasks. The chat covers any issues there may be with the medication or general heath matters. As I understand it, it is the Memory Clinic Team who recommend which drug (if any) is prescribed. However, as there is no basic health check done - weight or blood pressure for example, I do not know if the doctor would pass any important medical changes on to the Team automatically or if it is the responsibility of the patient's family to inform them.
Next, any new behavioural developments are covered; this is where they system perhaps need to change.
Many patients may not remember they have done something 'silly' like forgotten where they live and been and been found by a good samaritan or got dressed after waking in the middle of the night because they have no idea what time of day it is. This is all expected to be relayed to the Team in front of the patient which causes a two-fold problem. Firstly, whilst the patient may not be able to remember the conversation in 15 mins time the feeling of embarrassment / anger / denial remains long afterwards and they have no idea why they are feeling that way. Secondly, relative will not always relate the severity of incidents to avoid their loved-one the embarrassment. A specific time should be set aside without the patient in the room for the relatives to voice serious concerns, discuss behavioural issues or address specific worries.
The tasks are exactly the same each time - the responses noted and compared to previous visits.
What day / season / date is it?
Giving the name of an everyday items watch / pen / table.
Being asked to remember words for later recall.
Reading a line of text then writing a line and spelling a specific word out loud.
In this case the patient's skill's with writing and spelling was an issue before the Alzheimers so not really a good indication of the deterioration. Without a full history of the patient's abilities before the onset of the illness the collation of data for what ever future statistical use seems redundant.
I understand the purpose of the appointments to officially record the patient's deterioration in this case the tasks show the condition had slightly worsened which was the first thing the patient's family said at the beginning of the appointment. However, I do feel it is a wasted opportunity to gather general data on this illness that may be of some use to future research.