The Times Magazine 45like only my mum could. But she couldn’t
follow my thread. I could no longer reach her.
I sobbed into my husband’s arms, spluttering,
“I’ve lost her. I’ve lost her.”
Slowly I’m adjusting to this new person.
Keeping Mum happy in the moment is the
aim now. She tells us she feels perfectly
normal, which is comforting in some ways.
She has never used the word dementia and
calls it her “memory problem”. What she
inwardly feels we will never know.
I’ve discovered that while she can’t bear to
be patronised, she still enjoys a gentle teasing.
She titters when my brother-in-law reminds
her that his name is Gordon, not Ginger (her
dog). When she can’t remember a character’s
name in her beloved Coronation Street, I’ll
make light of it by saying, “I’ll know it’s
serious when you forget Ken Barlow.”
Things escalated a couple of weeks before
Christmas when Mum tripped and broke her
arm in three places, while walking Ginger
(not Gordon). Her legs “wouldn’t do what
I told them to”. Between my sister and I, we
became her nurses, feeding, bathing and often
sleeping next to her. “I never thought I’d getlike this,” are the words Mum said the most.
She now can’t walk very far, her car has
been sold and my sister has become her carer.
If she’s alone for more than a few minutes
Mum gets anxious. She recently struggled to
write the words “Happy Birthday” on my son’s
18th card and her vocabulary is increasingly
dwindling. Where we used to talk for hours on
the phone, planning our next weekend away,
it’s sometimes a slog to chat beyond the
weather. When she is with us it’s a struggle to
meaningfully fill her endless Groundhog Days.
Helen Payton, a dementia adviser to the
Alzheimer’s Society, lost her own mother to
the disease. “That person is there in front of
you, but they are different. It is like a living
bereavement.” She runs support programmes
for carers, to help deal with emotions from
guilt to stress. Payton tells me something
that resonates, which is that small, thoughtful
gestures are important. “The emotional
memory becomes much stronger than the
factual memory. My mum didn’t remember
where we’d been, but she knew she’d had
a good time.”
It would be easy to let Mum sit on the
sofa, watching afternoon quiz shows – she’s
partial to anything hosted by Bradley Walsh.
But the other week I took her to the cinema
to see West Side Story, the original of which
we’d watched together many times when
I was little. I got the surprise of my life. She
remembered every word to every song and
I confess to tearing up as she mouthed along
to Maria (her name is Maria and this is her
song). She is also perfectly content with a visit
to M&S, where she will buy outfits we will
later return and enjoy a teacake in the café.
Very recently a neighbour told me she only
realised one of her relatives had dementia
because his family simply stopped including
him in group photographs that they posted on
Facebook. There is still a mountain of stigma
around this illness, ironic given that it is likely
to touch most of us in some way in the future.
I do not want my mum to disappear. On my
sons’ insistence we are taking Nanna to Malta
in July, so they can experience her motherland
with her before she forgets it. I’ve warned her
she’d better not repeat last year’s adventure,
when my sister and I lost her, on a day out to
a fort near Valletta. We made the mistake of
leaving her at the reception for ten minutes,
as she was tired. She wasn’t there when we got
back. After a search involving every member
of staff and a golf buggy, my sister spotted her
walking into town in the far distance. Fred,
the buggy driver, sprang into action, put his
foot down and scooped her up. “Where the
hell have you been?” she berated us. Minutes
later, while my heart was still pounding, she
was happily eating an ice cream. nFor advice, contact alzheimers.org.ukSTEP 1 Perform this test on someone else.
(GP assessment of cognition patient examination)1 Name and address for subsequent recall
State to the patient, “I am going to give you a
name and address. After I have said it, I want
you to repeat it. Remember this name and
address because I am going to ask you to
tell it to me again in a few minutes:
John Brown, 42 West Street, Kensington.”
(a maximum of 4 attempts should be allowed
but do not score yet).2 Time orientation
What is the date? (accept exact only).3 Clock drawing (visuospatial functioning)
a) Draw a circle for the patient.
Ask the patient to mark in all the numbers
to indicate the hours of a clock (correct
spacing required).
For one point, the numbers 12, 3, 6, and 9
should be in the correct quadrants of the
circle and the other numbers should be
approximately correctly placed.b) Ask the patient to mark in hands to
show 10 minutes past 11 o’clock (11.10).
For a correct response, the hands should
be pointing to the 11 and the 2, but do not
penalise if the respondent fails to distinguish
the long and short hands.4 Information
Ask the patient, “Can you tell me something
that happened in the news recently?”
(recently = in the last week).
If a general answer is given, such as “war”,
“a lot of rain”, ask for details. If unable
to give details, the answer should be
scored as incorrect.5 Recall
Ask the patient, “What was the name and
address I asked you to remember?” Scoreone point for each of the five components
they get right.(1) John. (2) Brown. (3) 42.
(4) West Street. (5) Kensington.GPCOG Patient Score = /9
If patient scores 9, no significant cognitive impairment.
If patient scores 5-8, more information required.
Proceed to step 2.
If patient scores 0-4, cognitive impairment is indicated.
Seek medical diagnosis.STEP 2 Answer these questions yourself.
(GP assessment of cognition informant interview)Answer these questions “compared
to a few years ago”
l Does the patient have more trouble
remembering things that have
happened recently?
Yes = 0; no = 1
l Does he or she have more trouble
recalling conversations a few days later?
Yes = 0; no = 1
l When speaking, does the patient have
more difficulty in finding the right word or
tend to use the wrong words more often?
Yes = 0; no = 1
l Is the patient less able to manage
money and financial affairs (eg paying
bills, budgeting)?
Yes = 0; no = 1
l Is the patient less able to manage his
or her medication independently?
Yes = 0; no = 1
l Does the patient need more assistance
with transport (either private or public)?
Yes = 0; no = 1Score 1 point for each “no” answerInformant Score = /6
If patient scores 0-3, cognitive impairment is indicated.Take the GP’s dementia test