My mum is getting mean and grumpy. Is dementia to blame?

My mother is in her late 70s and has started to behave strangely – nothing dramatic, but not how she’d have behaved in the past. She says hurtful things and doesn’t seem to care, for instance. Her memory seems fine but could it be some early form of dementia?

Not all behavioural changes in the elderly will be due to an underlying pathological condition – they are just getting older, grumpier and more impatient.

Personalities develop over time, and people can change opinions and lose inhibitions without there being a medical cause.

That said, there is something called frontotemporal dementia, a rare type of the disease which damages the area of the brain that controls the personality, emotions and behaviour.

Often the first noticeable features of someone with this form of dementia would be a change in personality or behaviour that includes losing inhibitions, losing empathy for others, appearing unfeeling and/or struggling to perform tasks they used to.

Memory isn’t generally affected until later on in the illness.

As with any form of dementia, it is usually noticed by family and friends rather than the patient. This makes it hard to seek a diagnosis or treatment if they can’t see something is wrong.

Like many types of the condition it is very difficult to spot in the early stages, so it would be a case of monitoring the situation. A GP may be able to refer them to a specialist dementia service, but of course the patient themselves has to be on board with that.

I would always recommend that before dementia is diagnosed that families seek a lasting power of attorney via gov.uk while their relative is still competent and has the capacity to do so. Having someone the patient trusts to make decisions for them can take away a lot of stress in important healthcare matters.

I WAS diagnosed with kidney stones after I went to the doctor having noticed blood in my urine. My GP says he isn’t concerned but I’m still passing blood. I for one am worried – can you help put my mind at ease?

Blood in the urine is always a reason to see a doctor, who can quickly arrange tests and a prostate exam.

The most common reason for anyone to have blood in the urine would be an infection of the bladder or kidneys, so tests for these would always be done and antibiotics offered if needed.

But in one in five cases it can be a symptom of bladder cancer.

If there is no infection, then a fast-track assessment at the hospital should be arranged.

This would involve a cystoscopy – a camera inserted into the urethra that can see inside the bladder and identify tumours.

Other causes of blood in the urine commonly include kidney or bladder stones, prostate trouble or as a side effect of other bleeding problems – such as taking blood thinners to reduce the risk of blood clots and heart attacks.

Once bladder cancer is ruled out, specialists may undertake other tests and scans to locate the cause. If kidney stones are found, the treatment will depend on the size of the stones and the symptoms experienced. For some people they will be removed, while for others no treatment is entirely appropriate and the stones would just be monitored with regular scanning.

MY husband and I had the flu jab last weekend and we have been feeling lethargic, nauseous and dizzy ever since. I rang the GP but they could offer no advice. Do you think we’ve suffered an allergic reaction, or could it have given us flu? We are aged 87 and 89.

IT is not uncommon for people to say they feel ill after a flu jab. Generally there can be mild side effects which include a raised temperature, muscle aches and a sore pain in the arm at the site of the injection.

This is basically a sign that the immune system is kicking into action, and it does pass – although the older we get the longer these things tend to last.

An allergic reaction would be very severe and occur within minutes of the jab. It’s important to note that this is rare.

Some people who have had a serious reaction in the past or have an allergy to eggs – because of the residual proteins found in the medicine – usually avoid having a flu jab.

It’s vital to know the flu vaccine doesn’t contain a live virus. It is instead just inactive or ‘dead’ parts of the virus that your immune system can respond to without actually leading to developing the illness.

Lethargy, nausea and giddiness are general symptoms of a virus. At this time of year there are lots of winter bugs going around, including flu and Covid, which can cause general malaise. The waiting room of a GP surgery, by its nature, is a place where infections are picked up. So getting ill after visiting one for a jab is just an unfortunate coincidence.

But anyone with viral symptoms persisting after two weeks should speak to their GP – particularly someone elderly.

For those who have not had their jab yet, do not let the fear of side effects put you off. It is a dangerous virus – it killed about 15,000 people last year, and three-quarters of them were aged over 80.

It’s not just HRT – therapy can ease the menopause too

Last week the NHS published new guidelines suggesting that talking therapy could be a treatment option for menopausal women, to help combat some of the symptoms.

It caused outrage – with some saying it minimises the severity of the menopause, and others arguing that the only appropriate treatment is hormone replacement therapy (HRT).

I disagree. This is a vital step for menopause management. Talking therapy, also known as cognitive behavioural therapy, is based on the concept that your negative thoughts can trap you in a negative cycle – both mentally and physically. Talking can help tackle overwhelming issues in a more positive way.

It is already used to reduce the painful symptoms of conditions such as irritable bowel syndrome and chronic pain. And, crucially, studies show it helps to combat menopause symptoms, particularly stress, low mood and sleep problems.

HRT is not the only menopause treatment. I hope that talking therapy will soon be recognised as an effective option, too.

Hidden misery of male incontinence 

Male incontinence is an issue that is rarely talked about, while women get TV adverts about it.

I find that surprising, as it affects about one in three men over the age of 65 and can have a massive impact on their lives.

Research carried out by the Dispose With Dignity group, which is campaigning to get sanitary bins in men’s toilets across the country, suggests eight out of ten men with urinary incontinence feel anxious about leaving the house.

A third said they found it hard to locate a sanitary bin to dispose of incontinence products such as pads. I think this is a problem we struggle to discuss openly, so I want to know what you think.

Are you a man who suffers from incontinence? And do you feel like your issues are being taken seriously?

Please send me an email to the address on the right.