pip review mandatory consideration information

Also

A quick question as I do not know if the website offers this service but am I allowed to post a sample of my MR for someone to have a look at? My grammar and spelling aren't good and I want to know if what I put is OK?

Thanks

Hi

With regards to PIP 'mixing with other people', is there a precise definition of what they mean by 'overwhelming psychological distress'?
My mum is horrified at the thought of mixing with people because due to her IBS, she unfortunately soiled herself on a previous occasion and wasn't able to conceal it and has been terrified of going to places ever since, especially if there's no guarantee of easy toilet access.

Thanks

Hi

I have pasted below my responses for the mandatory consideration. There are only four categories that I am challenging, each of which my mum scored 0 apart from moving around in which she scored 10. Please forgive the bad grammar and odd spelling mistake- it is not the final copy.
Apart form your feedback on the below, there are other categories in which my mum has been awarded points fairly and don't wish to challenge them however I am aware that they will review everything. In that case, what do you advise I put for these categories? A sentence explaining I agree with the decision?

Thanks in advance for all your hard work.

Mobility
Planning and following a journey
My low mood and anxiety make planning and following a journey very difficult. Leaving the house fills me with a sense of dread. Getting on and off public transport is both very painful and humiliating. When I have had to do so in the past, it was so painful that I thought I was going to pass out. In addition, I have been verbally abused by members of the public for being too slow and it is not possible to take my time to sit down and stand up on public transport as the drivers never give me enough time. If the bus takes a diversion, I panic because I don't know where I am going, and I have such poor mobility that if the bus drops me off further from my destination, I may not be able to make it. To undertake a journey safely, I am accompanied by my daughter who drives me to medical appointments at the doctors and hospital. With her supervision, I do not panic and if there are any accidents as a result of my IBS, I know I can get home safely and quickly to change. This equates to 4 points.

Moving around
In your decision, you state that I can move using an aid or appliance more than 20 metres but less than 50 metres. In fact,  I can only walk from my seat in the living room to the downstairs toilet (maximum of 10 metres) using a walking stick. However, I could never go any further. I have emphysema, and severely reduced lung capacity which means even simple tasks like walking very short distances render me breathless. Even with such small distances, I have put in place perching stools and railing for safety as I have on several occasions become dizzy and fallen, resulting in me having to seek medical attention. There is one next to the downstairs toilet, as when I am in the process of sitting down and standing up, this is when I am most likely to fall. This is the case on a good day. On bad days (roughly 3-4 days out of 7), I can hardly walk a few metres without having to stop. It can take several minutes to stand up once I have been on the toilet.  My fibromyalgia causes sudden stiffness in the leg exacerbating the chronic pain that already exists due to advanced osteoarthritis and osteoporosis (see GP notes). (12 points)

Daily Living

Mixing with other people.
In your decision, you state that I can engage with other people unaided. Unfortunately, this has not been the case for several years now. As explained in the PIP review form, I have a diagnosis of anxiety and depression. When I am very anxious, my heart rate increases rapidly and I hyperventilate. My lungs are already damaged due to the emphysema, so any situation which triggers my heart rate can lead to wheezing and a tightening in the chest. These episodes are extremely frightening, and I often think I may have a heart attack. The situation is made even worse by my IBS (Irritable Bowel Syndrome). As described in my PIP review form, a common side effect of IBS is that when I get very anxious or have a panic attack, I begin to produce involuntary bowel movements. Although I wear pads, it is not always possible to conceal the odour. If I mix with strangers, there is no guarantee that I would have access to a toilet to get changed, or be able to reach it and I am terrified of soiling myself which has happened previously. It is for this reason that I need social support to be able to engage with other people (normally my daughter). The effects of the gabapentalin and co-codamol  induce a 'fog' which means I have difficulty concentrating, lose my train of thought and lose track of what others are saying, rendering interaction very difficult. I am currently taking Venlafaxine at 150mg per day (see GP summary) and I have been referred for Cognitive Behaviour Therapy by my GP however the waitlist is very long. During our telephone conversation on the (INSERT DATE)..........., I was not asked any questions about how my anxiety, depression or IBS affected my ability to mix with people. I believe that the evidence I have supplied and the testimonial supports my claim that I need social support to be able to engage with other people. (4 points)

Managing Treatments
To manage my fibromyalgia and osteoporosis I have to complete a series of strength exercises each day, some of which include lying on my back on the floor (to strengthen my leg muscles). In order to do this, my daughter has to be present to supervise me through the process. Due to the fibromyalgia and osteoporosis, I am not able to roll onto my side to help myself get up and I do not have enough strength to be able to lift myself from the supine position. Without the supervision of my daughter, I would not be able to do the exercises, as I would be at significant risk of injuring myself, and as I am immobile for most of the day, the muscles muscles would become even weaker and. The exercises take at least 30 minutes per day on a good day but up to an hour on a bad day which occurs on average three days out of 7.Similarly, the effects of the co-codamol and gabapentin tire me out and leave me in a bit of a mental fog. I fall asleep easily and end up losing track of time and forgetting completely whether I have taken my medication. As explained in my PIP Review Form, it is for this reason, I have a dosette box and a timer next to my chair in the living room. The timer is loud enough that even if I am asleep, I am woken up and can only take the medication released by the dosette box to prevent taking too much or too little. In addition, my daughter checks the dosette box and fills it up on a weekly basis. Sometimes, due to my low mood, I switch off the alarm and still forget to take the pills. As I need supervision and assistance to be able to manage therapy totalling more than 3.5 hours a week, but less than 7, this corresponds to 4 points.