Dear LPG,

I have a relative who has been in a care home for about a year and a half now. 

Dementia is a big part of the problem and things are getting gradually worse. I visit regularly, and I have noticed that my patient is sleeping more, and a lot less responsive to my conversation and questions these days, although on some occasions I see traits of the person that I once knew, and I know that he is responding to me in spite of his lack of speech.  The one brief but comprehendible response that I am really aware of is that I am understood when I speak.  I can see changing facial expression, comprehendible responses to basic questions, and the odd smile when I talk to him.

Another aspect of being his responsible family member are the days when we get a call from the care home informing us that he is on his way to hospital. They are becoming more frequent too, but I continue to choose to be there when this happens.  In fact, I have no doubt that there are certain patients that the nursing staff at A & E see so often that they recognise them, and that at the moment, I and my patient are included there. 

During a recent visit there was the usual wait to see a doctor once the nurses had dealt with the checking of blood pressure etc., and when the doctor finally arrived he began to talk to me about the condition of the patient. The doctor and I were talking in the third person about details of his medical history which, if he could hear, I felt that he did not need to be reminded of, and so I mentioned this and asked if we could step outside the cubicle to have the discussion. 

The doctor insisted that we continue to talk in the patient’s presence which I felt really unfair having explained my reasons not to do so, and he then showed slight displeasure because of my reluctance to answer as loudly and clearly as I would have out of earshot. 

I know that he hears more than he can communicate, and with little else to do but think, I worry that this is just giving my vulnerable family member more depressing thoughts to dwell on while he is trapped with little else to think about.

I want to stress that on other occasions the staff have responded to similar requests that I have made with more respect, and wonder if I am the only person who has accompanied a vulnerable patient into hospital and made this request?  I understand that the doctors work under great pressure but surely my request has to be part of a consideration that constitutes what is known as a doctor’s bedside manner? 

JB, New Cross.