Yesterday was a challenging day here  to put it mildly.  The morning went relatively well and I managed to move a few things forward.  An early morning chat with my supportive local chemist helped me to put one or two things into context.  Y had been away for a few days and I had missed her analytical understanding of the dementia.  She is always generous with her time and her empathy and warmth is always a good start to the day.  Y has helped me to place dementia as brain injury rather than link the condition with mental health.  We have also arrived at a position that M is not ill she is recovering from stroke.

I moved on from my conversation with Y wondering if my efforts to sort out the clothing crisis were ill conceived.  Perhaps once again my understanding of M’s reality was rather naive: clothes in themselves are not the issue they are a vehicle for expressing some other emotion.  Nevertheless, perhaps having less choice and throwing away unwanted items would be good for both of us.  Y helped me to see that endless searches for underwear were probably a waste of time and repair was more likely to be a viable solution to the bra crisis than replacement: a small amount of cotton and a skilled seamstress could double the current amount of support available.

On return from an positive exploration with local stores about returning unwanted garments all seemed well.  M and a new carer were chatting away: getting on like a house on fire.  An hour later following an unintentional doze I found M upstairs completely disorientated.  I am not sure how long she had been in that state but long enough to let the vegetables I was boiling, to go with fish pie that was in the oven to burn.

M’s behaviour was unlike anything I could recall.  Her disorientation was significant with confusion over time and real concern about about our safety with the windows open.  I tried, and failed, to distract her with encouragement to sit at the dining table as food was about to be served.  She was reluctant to sit at her normal place and sat on a stool at the opposite side of the table.  A strange atmosphere clouded what is normal a pleasant occasion as we sit down and eat together.  I wondered if the considerable heat of the day was having an impact on M’s presentation and kept the cool drinks flowing.

I was so concerned about M’s presentation that I asked a neighbour to pop round and check my take on things.  M showed some confusion about who K was, despite talking to her over the fence a couple of days ago.  Things did not go well as K asked M if she remembered her.  M stormed off with recriminations about an occasion when she didn’t remember things still being used against her.  She banged the door; fled into the lounge and lay down on the sofa.  A hour or so later she decided to go for a walk and made it clear she didn’t want my company.

Whilst M slept I managed to speak to her G P about my concerns and a home visit was suggested which I welcomed.  Unfortunately, the length of her walk meant that his plans were frustrated and I was advised to take her to Accident and Emergency if I continued to be concerned.  The possibilities of TIA’s had crossed my mind and hospital might be the best place to try to find out what was going on.

I have to break off in writing now as M  has just woken and is moaning.  I have massaged her cold left foot and given her a drink of water.  She is not clear who I am and is talking about things I have said and is not attributing them to me.  I have to keep a close by after the vents of yesterday.  More later I hope …….so will add and edit later.

i am back after a short comforting 15 minutes with M.  In some ways this is the best place to be as I am only a partition wall away from her head so I can pick up signs of distress and try to provide an immediate response.  However, all of this is akin to risk management of trying to work out the best way of spending my time.  So I have to try to make some sense out of yesterday to ‘Be Prepared’ for today.

I have no idea what is going to happen today or how M will present.  At best I will react to her presentation in an appropriate manner and respect her reality.  A hard task in itself on a hot day with a long shift ahead.  What I simply have to make clear is that she is my sole priority and I am here to meet her needs.  M needs to know that she can depend on me to compensate for the capacities that she no longer has.  My focus has to be on providing the prompts that will help her to enjoy her day.

Although I have no idea what today will bring yesterday gave me an opportunity to welcome a star player back into my support team and make a couple of additional signings.  The season began following stroke and fixtures piled in once dementia became the opponent.  I hope readers will forgive the football analogies: this is an opportunity to play fantasy football as I would have loved career in professional football.  Confession out of the way and I move on.

I have already mentioned that Y was back after a short holiday.  In addition I mentioned K’s unfortunate intervention but that does not mean she is on the transfer list.  Throughout the day i popped round to see K for counsel and her sharp mind helped me at several crisis points, as did M her husbands helpful contribution.  However, the ‘man of the match’ has to go to A who in his first outing tracked M down and brought her back in his car.

Team building is one of my stronger points with positive achievements at that level in my professional career.  One of my strengths has always been to spot talent: recruit the individual concerned and make sure they continue to flourish.  Talent spotting has to be a high priority for us as we have no immediate family less than a couple of hours away so recruiting local talent is critical.  My role is to pick a team for the day that has the skills to respond to Maureen’s presentation.  I have to admit that I have no idea what is going on here for most of the time but I will Be Prepared do my best to continue to put the right team out on the day.