Elderly and frail parents living alone – problems with local GP

embraer170

My elderly parents live alone in a rural area. My mother has a variety of long-term serious health issues, is severed depressed and physically frail (and unable to walk more than a few metres). She has now been showing some early signs of dementia identified by my father and my mother’s carer who comes a few hours most days.

Recently, there have been lots of difficulties with her GP. In the past year or so, I have observed a few ridiculous discussions with him (where I think he was borderline inappropriate) but ignored. Now, he fully refuses to acknowledge the signs of dementia and thinks she is absolutely fine.

This led to the below letter (quite a few inaccuracies in it but I won't get into that now) from the GP basically kicking my mother out of the practise. It is a small village with only one medical practise. I have contacted all GPs in nearby towns, which would be 20-30 mins drive (also very difficult for people in their 80s and 90s) and they are all refusing new patients.

What are my options. Can a GP just kick out a patient? 

NSAman

Find a new doctor simple as. I know it’s difficult, but someone will take her on. You need to be pro-active in your mother and fathers care.

when they reach this time of life it gets much more difficult for them. Someone HAS to be there to attend to them and honestly, fight for them. I am lucky I have a sibling who fights for my mothers care, I am currently home on vacation giving him a break and visiting hospitals consultants and generally fighting her corner.

the new health centres (mothers doc retired) basically have no clue who their patients are. In my experience and my siblings experience, they don’t really care. In out, charge, if something’s wrong call an ambulance.

while I understand the health service is crap in Ireland, doctors should really take time with patients. Nowadays, that time is so short due to lack of GP’s. It still doesn’t give then the right to dismiss fears and not take proper time, care and attention.

unless mum is very demanding and rubbing the doctor up the wrong way, his comments in the letter seem inappropriate…I.e. you need too much of my time.

EchoIndia

A GP cannot just dismiss a public patient from their practice, so your mother should remain a patient of their doctor until such time as another GP takes her on. That said, you may well want to find another practice for her, if the "bedside manner" of the current GP is not what it should be. However, and while it might not be something that you want to hear, another GP will most likely not be willing to make referrals that he/she considers unnecessary, especially for a very elderly patient. While the current GP's letter may be somewhat blunt in nature, I think you need to look past that and consider whether at least some of what he says is broadly valid. My own parents are of similar age and to a large extent we are working to manage the gradual deterioration in their health and physical capacity and finding ways of supporting them that are not always about diagnosing and treating a condition, in the way that might be done with a younger person.

embraer170

Thank you both for the replies, much appreciated.

I live abroad and come back for holidays and occasional weekend trips, so I do what I can in those time (no siblings at home unfortunately). My mom has a carer we pay for who comes most days, but the doctor has also been very rude to her.

My parents pay thousands a year for their VHI (a very high % of their total pension). What is the point in doing that if the local GP refuses to a referral to a specialist for something like signs of dementia (which we are all noticing).

I don't think I am am in denial about my parents terrible health state (and where that will end sooner rather than later) but I would have that they have a somewhat comfortable existence, which the GP's behaviour is making more difficult. Most recently, he fully missed a urinary tract infection, which they only picked up in hospital.

I guess I will continue calling GPs and begging them.

EchoIndia

The area HSE public health nurse would be worth speaking to, if not already involved. VHI cover is all well and good but much of what your parents need probably sits within the public health service. Of course the capacity may be stretched but don't be put off by people saying the Irish health service is "crap".