It’s normal for memory to be affected by stress, tiredness, certain illnesses and medicines. But if you’re becoming increasingly forgetful, particularly if you’re over the age of 65, it’s a good idea to talk to a GP about the early signs of dementia.
Dementia is a syndrome (a group of related symptoms) associated with an ongoing decline of brain functioning.
There are many different causes of dementia, and many different types – Alzheimer’s for example.
Take the contact details of a carer, family member or friend for the patient’s record
The GP might talk with the patient about making plans for the future, when you may not have the ability to make your own decisions anymore. This may seem far off and extreme, but it is better to make plans early than to regret not having made them later on. – See here for our advice on end of life planning
Yearly dementia review
Your GP will:
Ask you questions about – Your understanding of your condition – Mood and welfare – Your contact details
Review of your medication
Ask about any changes in behaviour
Discuss advance care planning
Talk to your carer about whether they need any support
Diagnosis
Symptoms
Memory loss
Problems with thinking speed
Loss of interest in previously enjoyed activities
Difficulty with language, such as using words incorrectly, or trouble speaking
Problems with understanding and judgement
Changes in mood and social interactions
Difficulty with movement and doing daily activities
Changes in personality (such as a loss of empathy and compassion)
Hallucinations seeing or hearing things that other people do not
Non-urgent advice:
If you, or somebody you know (particularly if aged over 65), start to experience some of these symptoms, you should make an appointment with a GP
Seeing your GP
Before your appointment
If you or somebody you know is having a doctor’s appointment to discuss a possible diagnosis of dementia, you may want to consider the following in advance of seeing the GP:
Bringing a friend or relative with you for support and to help you explain the situation
Your appointment
When you see your GP, they will:
Ask you about your symptoms and larger medical history
How your problems affect your daily life
Test your memory and cognitive abilities: – State the day, date, and year – Name some common objects (from pictures or as answers to questions) – Remember and repeat items to test concentration and short-term memory – Complete a drawing
They might also:
Request a blood test
Take a urine sample
Request a heart trace (ECG)
After your appointment, your doctor might refer you to a specialist who will conduct further tests and scans.
Support and resources
For dementia patients
Alzheimer’s Society has a search function to find local support in your area (transport, social groups, care homes etc.) – Click here to search
Learning disabilities can be difficult to describe because they are different for everyone that has them. In general, a learning disability is a condition that makes it harder for someone to learn, understand or do things.
People with a learning disability tend to take longer to learn and may need support to develop new skills, understand complicated information and interact with other people.
The learning disability register is a list of people who have a learning disability. Doctors use it to make sure that people with a learning disability get the right support in the right ways. Talk to your GP about joining the register.
You can ask to be added to the learning disability register by contacting your GP surgery. When talking to your GP, you could mention:
Tell them how your learning disability affects you in your daily life
Tell them about any disability benefits you receive
Tell them if you have a social worker
To join the register, you do not:
Have to take any tests
Need to be receiving support from social services
Have to receive any disability benefit payments
Advantages of being on the Learning Disability Register:
Reasonable Adjustments – Reasonable adjustments are small changes that can help people with a learning disability be treated equally. By law, you may ask for reasonable adjustments to be put in place. Examples of reasonable adjustments: – Staff who speak clearly and use easy words – A longer appointment – A hospital passport which tells people all about you – Support workers or family members with you – Quiet waiting rooms These are just some examples. You can talk to your GP about arranging reasonable adjustments that will best suit you.
Diabetes is a condition that causes a person’s blood sugar level to become too high. This is due to a problem with insulin – a hormone that helps your body use sugar for energy. Diabetes happens when:
Type 1 Diabetes is a lifelong condition where the body’s immune system attacks and destroys the cells that produce insulin. There is nothing you can do to prevent yourself or others developing type 1 diabetes. People with this type of diabetes will need to take insulin every day to keep their blood sugar levels under control.
Type 1 Diabetes is the less common type. Less than 10% of people with diabetes have Type 1.
Type 2 Diabetes
Type 2 Diabetes is where the body does not produce enough insulin, or the body’s cells do not react to insulin properly. This type of diabetes is often linked to being overweight or being from a Black African, African Caribbean and South Asian (Indian, Pakistani, Bangladeshi) background.
This is the most common type of diabetes. You can check your risk of getting type 2 diabetes with Diabetes UK’s ‘Know your risk’ questionnaire.
High risk diabetes checks and clinics
If you have had a blood test with us for an unrelated condition, you may be called in for an appointment to discuss risk of diabetes depending on your results. This appointment will usually be with a Healthcare Assistant or a pharmacist who specialises in diabetes. In this appointment you will:
Talk about your lifestyle (diet, alcohol intake, exercise, smoking etc.)
Following the results, they may then send you to hospital for further assessment
After a diabetes diagnosis
If you get a diabetes diagnosis, your GP will make an appointment to talk about:
What your diagnosis means for your health
Whether you need to make medicine
Your diet and exercise
Making lifestyle changes if necessary (reducing alcohol intake and quitting smoking)
You will also be invited to regular check ups to monitor your condition. These will include:
Foot checks. These are extremely important for patients with diabetes as they are more likely to have serious foot problems which could lead to amputations.
Diabetes UK Helpline -Talk with highly trained advisors regarding any questions about diabetes, or just to have a chat about how you are coping. – Email helpline@diabetes.org.uk or call 0345 123 2399*
Healthy eating with diabetes – Key information about eating with diabetes. Recipes, meal plans and dietary information available.
Ealing diabetes service – Local support servive including telephone/email advice, home visits, education sessions and GP support
NHS Talking Therapies – Providing advice and support for those with long-term health conditions
Visit Diabetes UK for more support and information
Blood pressure and the heart
Blood pressure and the heart
Around 1 in 4 adults in the UK have high blood pressure. The symptoms are rarely noticeable but the consequences can be very serious – such as heart attacks or strokes.
The only way to find out if your blood pressure is high is to have your blood pressure checked.
Blood pressure is the force at which your heart pumps blood around your body. You need a certain amount of pressure to get the blood moving around your body.
Your arteries are the tubes that carry blood from your heart to the rest of your body. Arteries are normally stretchy, so that they can cope with your blood pressure going up and down. But when your blood pressure is high, your arteries lose their stretchiness, and become stiff and narrow. The narrowing makes it easier for fatty material to build up. If there is build up in the arteries to your brain or heart, this could result in a stroke or heart attack.
What are the risks of high blood pressure?
Very high blood pressure puts extra strain on your blood vessels, heart and other organs. If your blood pressure is constantly high, you could be at increased risk of a number of serious and life-threatening conditions such as:
Heart disease
Heart attacks
Heart failure
Strokes
Kidney disease
Who is at risk of high blood pressure?
You are more at risk of high blood pressure if you:
Are overweight
Eat too much salt and do not eat enough fruit and vegetables
Do not exercise enough
Drink too much alcohol or coffee (or other caffeine-based drinks)
Smoke
Have a lot of stress
Are over 65 years old
Have a relative with high blood pressure
Are of black African or Black Caribbean descent
Reducing your risk of high blood pressure
Lifestyle changes to reduce blood pressure
Stop smoking
Reduce your alcohol intake
Lose weight if you are overweight
Exercise regularly
Some people with high blood pressure may also need to take medicine(s) to stop their blood pressure getting too high.
Checking your blood pressure
High blood pressure is often symptomless, so the only way to know if you have it is to have a blood pressure test. It is recommended that adults over the age of 40 get theirs tested at least once every 5 years. You can get your blood pressure tested:
At your GP surgery – we have a health kiosk at the surgery and welcome people to use it regularly
At some pharmacies
As part of your NHS Health Check
By yourself with a home blood pressure monitor.
What your GP can do
Ambulatory Blood Pressure Monitor (ABPM)
Your GP may suggest 24-hour or ambulatory blood pressure monitoring (ABPM) if they think you may have high blood pressure. ABPM tests your blood pressure regularly over 24 hours, by using a cuff attached to a portable device that’s worn on your waist.
You can continue with your daily activities during this time.
Electrocardiogram (ECG)
If your doctor is concerned about your heart, they may suggest an Electrocardiogram (ECG). This may be done by a specialist at a hospital or by your GP at the surgery.
An ECG is a simple test that can be used to check your heart’s rhythm and electrical activity. Sensors attached to the skin are used to detect the electrical signals produced by your heart each time it beats. These signals are recorded by a machine and are looked at by a doctor to see if they’re unusual. ECGs can help detect arrhythmias, coronary heart disease or heart attacks.
Further resources and information
Arthritis
Arthritis
Arthritis is a common condition that causes painful swelling of the joint. Millions of people in the UK have arthritis or similar conditions that affect the joints. Arthritis can affect people of all ages.
There is no cure for arthritis, but treatments have gotten much better in recent years. For many types of arthritis there is a clear benefit in starting treatment at an early stage.
There are many different types of arthritis. Some you may have heard of (like gout and lupus) and others probably not. The two most common types of arthritis are:
Osteoarthritis arthritis
Osteoarthritis starts with the roughening of cartilage (the strong tissue that protects your joints and bones). When this happens, the body tries to ‘repair’ the damage to make up for the loss of the substance. This can then cause:
Tiny bits of extra bone to grow at the ends of a bone within a joint.
An increase in the amount of fluid inside the joint.
The joint capsule to stretch, and lose its shape.
Rheumatoid arthritis
Rheumatoid arthritis is less common than osteoarthritis. In rheumatoid arthritis, the body’s immune system targets affected joints, which leads to pain and swelling.
The outer covering of the joint is the first place affected. This can then spread across the joint, leading to further swelling and a change in the joint’s shape. This may cause the bone and cartilage to break down. People with rheumatoid arthritis can also develop problems with other tissues and organs in their body.
Symptoms of arthritis
Symptoms can vary depending on what type of arthritis you have.
If you are experiencing any of the following you should go see your GP:
Joint pain, tenderness and stiffness
Inflammation in and around the joints
Restricted movement of the joints
Warm red skin over the affected joint
Weakness and muscle wasting
What your GP can do
If your GP thinks you have arthritis, they may:
Prescribe medicines to help with pain and discomfort
Suggest gentle exercise to keep your joints active
Asthma is a common lung condition that causes occasional breathing difficulties. It affects people of all ages and often starts in childhood, but it can also develop for the first time in adults.
There’s currently no cure, but there are treatments that can help keep the symptoms under control so it does not have a big impact on your life.
You should see a GP if you think you or your child may have asthma, or you have asthma and are finding it hard to control.
Every asthma patient gets an annual health check, usually with one of our pharmacists who specialise in asthma. This review is a chance to talk about how to manage your symptoms better and lower your risk of an asthma attack.
Your asthma review could involve:
Checking your lung function with peak flow or spirometry tests
Your GP surgery will invite you for an annual asthma review. Most people go for an asthma review at least once a year, but if you have difficult or severe asthma, you may need to go for an asthma review more often.
If you suspect that you or your child may have asthma, you should make an appointment with your GP to discuss available options to treat and ease your symptoms. They may do or suggest some of the following:
Ask you about your medical history, symptoms and what triggers them
Refer you to a hospital or clinic for further tests – This may be a combination of tests, as there is no one test that can diagnose asthma
Further information and resources
Asthma + Lung UK has a helpline where you can talk to experts about anything to do with your condition. They can be contacted via: – Phone: 0300 222 5800 – Email:helpline@asthmaandlung.org.uk – WhatsApp: 07378 606 728
A booklet for eating well for healthier lungs is available here
Cancer
Cancer
What is cancer?
Cancer is a condition where cells in a specific part of the body grow and reproduce uncontrollably. The cancerous cells can invade and destroy surrounding healthy tissue, including organs.
Cancer sometimes begins in one part of the body before spreading to other areas.
1 in 2 people will develop some form of cancer during their lifetime.
There are more than 200 different types of cancer, and each is diagnosed and treated in a particular way. In the UK, the most common types of cancer are:
Early diagnosis is vital in beating cancer. Different types of cancer have different symptoms. There are certain signs and symptoms that you should be aware of:
Cancer screening is a test that looks for early signs of cancer in people without symptoms. It can help spot cancers at an early stage, when treatment is more likely to be successful.
If you are registered with a GP, you will be automatically invited for the relevant screenings when you are eligible. These are done based on your recorded sex at your surgery. For transgender and non-binary people, any hormones or surgeries you’ve had will impact which screenings are for you. Please see here for more information.
Cancer screening is for people with no symptoms at all. If you have symptoms, don’t wait for a screening invitation – tell your doctor as soon as possible.
Reducing your risk of cancer
Making some simple changes to your lifestyle can reduce your risk of developing cancer:
Accurately diagnosing cancer can take weeks or months. As cancer often develops slowly over several years, waiting for a few weeks will not usually impact on the effectiveness of treatment.
Support, resources and further information
There are lots of charities devoted to specific types of cancer, but Macmillan has some great general resources and sources of support for people diagnosed or looking after somebody with cancer. Their resources come in all sorts of easy to read and understand formats such as booklets, blogs, podcasts, audiobooks and more.
The best way to lose weight is to eat a healthy reduced-calorie diet and exercise regularly. Your GP can suggest safe and healthy diets for you to follow as well as recommend local weight management programmes with group meetings or online support if you feel you would benefit from that.
Eating well
Sometimes it can be hard to make sure we are eating healthily as we get distracted with work, family, friends and just grab whatever is easiest and cheapest. But eating the right food is key in losing weight. Some tips for eating a healthy, calorie-reduced diet are:
To lose weight healthily:
Eat five portions of fruit and vegetables every day
Drink plenty of fluids
Base meals on higher fibre starchy foods like potatoes, bread, rice or pasta
Eat some beans, pulses, fish, eggs, meat and other protein
The NHS Digital Weight Management Programme supports adults living with obesity who also have a diagnosis of diabetes and/or hypertension, to manage their weight and improve their health. It is a free 12-week online course that people can access via a smartphone or computer.
Your GP may refer you to it if:
Over 18
You have a BMI greater than 30 – This threshold will be lowered to 27.5 for those from black, Asian, and ethnic minority backgrounds, because people from these ethnic backgrounds are at an increased risk of conditions such as Type 2 diabetes at a lower BMI.
Taking up running can seem like a scary prospect, especially if you feel out of shape or unfit. NHS Couch to 5K will help you gradually work up towards running 5km in just 9 weeks. Couch to 5K works because it starts with a mix of running and walking to gradually build up your fitness and stamina. Week 1 involves running for just a minute at a time, creating realistic expectations and making the challenge feel achievable right from the start.
If you are looking to run or jog in a more social setting, then Parkrun is for you. These are weekly group events held at 9am on a Saturday and you can treat it as a run, a jog, or even just a walk and a chat!
Being underweight could mean you’re missing out on vitamins and minerals. This could lead to health problems such as a weak immune system and bone fractures.
Please speak to a GP if you have lost weight suddenly and/or unintentionally as this could be a sign of something more serious.
Just because you are looking to gain weight doesn’t mean you should stop exercising! Building muscle through strength training and yoga is really useful when looking to gain weight. It can also increase your appetite which will also hep with weight gain.
Care planning is a crucial part of your well-being and healthcare. As you get older, your needs and conditions will change and it is important that you take action and prepare yourself for the future. Your GP and other Healthcare professionals are here to help you.
Care planning is an annual checkup offered to patients aged 75 years or more, as well as patients who are younger but frail and needing extra support or care.
These appointments take at least half an hour. It is a good idea to bring a Carer or relative with you who may be able to also ask questions on your behalf.
Urine contains waste products that are filtered out of the body. Your doctor or other health professional may ask for a urine sample to help diagnose or rule out health conditions. If it contains anything unusual, this may indicate an underlying health condition such as:
Pregnancy
Organ function (kidney or other)
Infection of the urinary tract
Diabetes
Collecting a Urine Sample
Your doctor or another healthcare professional should give you a container and explain how you should collect the urine sample. The types of urine sample you might be asked for include a random specimen, first morning specimen or timed collection. Ensure that you are clear on the instructions given to you by your doctor before you leave your appointment and do the test.
If you can’t hand your urine sample in within an hour, you should keep it in the fridge at around 4C (39F) for no longer than 24 hours. Put the container of urine in a sealed plastic bag first. If the urine sample isn’t kept in a fridge, the bacteria in it can multiply. If this happens, it could affect the test results.
My results
Please see here for information about and when and how to expect the results of your urine sample.
