DR ELLIE CANNON: My mum is getting mean and grumpy. Is dementia to blame?

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

Not all behavioral changes in the elderly will be the result of an underlying pathological condition; they just get older, grumpier and more impatient.

Personalities develop over time, and people can change their opinions and lose inhibitions without any medical cause.

That said, there is such a thing as frontotemporal dementia, a rare form of the disease that damages the area of ​​the brain that controls personality, emotions and behavior.

Often the first noticeable features of someone with this form of dementia are a change in personality or behavior, including losing inhibitions, losing empathy for others, appearing callous, and/or having difficulty performing tasks they used to do.

Memory is usually only affected later in the disease.

As with any form of dementia, it is usually noticed by family and friends and not by the patient. This makes it difficult to seek a diagnosis or treatment if they don’t see anything is wrong.

Like many types of conditions, it is very difficult to recognize in the early stages, so it would be a matter of monitoring the situation. A GP can possibly refer them to a specialized dementia service, but the patient must of course agree to this.

I would always recommend that families, before being diagnosed with dementia, apply for Enduring Power of Attorney via gov.uk while their relative is still competent and able to do so. Having someone the patient trusts to make decisions for them can take a lot of the stress out of important healthcare matters.

I was diagnosed with kidney stones after going to the doctor because I noticed blood in my urine. My doctor says he’s not worried, but I’m still bleeding. In any case, I’m worried. Can you help reassure me?

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

The most common reason for someone to have blood in the urine is an infection of the bladder or kidneys, so tests for this should always be carried out and antibiotics offered if necessary.

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

If there is no infection, an expedited assessment in hospital should be arranged.

This would require a cystoscopy – a camera inserted into the urethra that can look into the bladder and identify tumors.

Other causes of blood in the urine often include kidney or bladder stones, prostate problems, 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 has been ruled out, specialists can perform other tests and scans to determine the cause. If kidney stones are found, treatment will depend on the size of the stones and the symptoms experienced. For some people they are removed, while for others no treatment is completely suitable and the stones are only controlled by regular scanning.

MY husband and I had the flu shot last weekend and since then we have been feeling lethargic, nauseous and dizzy. I called the doctor, but he could not give me any advice. Do you think we had an allergic reaction, or could this have given us the flu? We are 87 and 89 years old.

It’s not unusual for people to say they feel sick after getting a flu shot. In general, mild side effects may occur, including increased temperature, muscle aches, and an aching soreness in the arm at the injection site.

This is actually a sign of the immune system kicking in, and it goes away – although the older we get, the longer these things last.

An allergic reaction would be very serious and occur within minutes of the injection. It is important to note that this is rare.

Some people who have had a severe reaction in the past or are allergic to eggs – due to the residual proteins in the drug – typically avoid a flu shot.

It is vital to know that the flu vaccine does not contain live virus. Instead, it is only the inactive or ‘dead’ parts of the virus that your immune system can respond to without actually leading to the development of the disease.

Lethargy, nausea and dizziness are common symptoms of a virus. There are many winter bugs in circulation at this time of year, including flu and Covid, which can cause general malaise. The waiting room of a general practice is by nature a place where infections are collected. So getting sick after visiting one is just an unfortunate coincidence.

But anyone with viral symptoms that persist after two weeks should talk to their doctor, especially someone elderly.

For those who haven’t had their jab yet, don’t be put off by the fear of side effects. It is a dangerous virus; last year, about 15,000 people died, and three-quarters of them were over 80 years old.

It’s not just about HRT – therapy can also ease menopause

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

It caused outrage – with some saying it minimizes the severity of menopause, while others claimed the only suitable treatment is hormone replacement therapy (HRT).

I do not agree. This is an essential step for menopause management. Talk therapy, also called cognitive behavioral 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 problems 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 combat the symptoms of menopause, especially stress, low mood and sleep problems.

HRT is not the only menopause treatment. I hope that talk therapy will soon be recognized as an effective option as well.

Hidden misery of male incontinence

Male incontinence is a problem that is rarely talked about, while women get TV ads about it.

I find this surprising, as around one in three men over the age of 65 suffer from it and it can have a huge impact on their lives.

Research carried out by the Dispose With Dignity group, which campaigns for sanitary waste bins to be installed in men’s toilets across the country, suggests that eight in 10 men with urinary incontinence worry about leaving the house.

A third said they found it difficult to find a sanitary bin where they could dispose of incontinence products such as sanitary towels. I think this is an issue that is difficult for us to discuss openly, so I want to know what you think.

Are you a man who suffers from incontinence? And do you feel that your problems are taken seriously?

Send me an email to the address on the right.