It is possible to argue that stroke has been beneficial for M on one front: it has brought dementia out into the open.  There is no doubt now that M has dementia of one form or another.  It matters not what type of dementia: the important thing is functional capacity and that is declining.

M’s recovery from stroke has been exceptional.  The loss of visual field is the only obvious physical change, nothing else is apparent.  This major implication is where dementia is clear even to those who still stray into denial.  Despite a Consultant telling M that she should surrender her driving licence she still has ambitions to return to sitting behind the steering wheel.  M shows her inability to retain information by suggesting that a second opinion might make it possible to sit a test to get her licence back.

Stroke is now a complicating factor alongside M’s dementia.  She is due to go to the Stroke Clinic with  a month or so and Cardiac Clinic later in the year.  Such arrangements are standard procedure following stroke.  However, when dementia is prevalent they complicate things without any potential benefit.  It seem to me there is a pragmatic way forward that I will attempt to set in motion this morning.

Attending hospital will distress Maureen with little potential benefit.  Her G P spent a long period in Elderly Medicine and he is the best person to manage her ongoing care.  His intervention following the last visit to the Cardiac Clinic prevented mayhem.

The Locum Consultant suggested blood pressure monitoring 3 times a day for a week: a recipe for increasing M’s.  He failed to take into consideration the patient and the impact of his harsh regime.  Fortunately, M’s G P introduced sanity into monitoring her B P and it is now within acceptable limits.

It seems sensible that once dementia has been diagnosed  it should be the driver in patient monitoring.  Why introduce factors within their care programme that will add to distress and confusion.? Thankfully, I am optimistic M’s G P will agree to  monitor her basic functions.  He always takes into account that M is not just another person attending his Clinic: she has dementia.