I have decided to stay in Coventry a while longer. I want to see if I can bring about some changes in my mum’s Care Home and my brother’s Nursing Home.
I will pop in to see my mum again this morning. She was rather sleepy when I called in to see her yesterday. When she woke she asked me to give her a kiss and told me she loved me. She also asked me where Maureen was and then she amazed me by asking where Esme was – my youngest daughter.
When I call in this morning we are going dancing. I know if I call up Glen Miller, Frank Sinatra or Nat King Cole on my Lap Top mum’s feet will be tapping. I hope she is able to close her eyes and remember dancing the slow foxtrot with dad: they would have got a Ten from Len!
After lunch, I’m taking the music theme to my brother. He gave me lots of beautiful smiles yesterday as he sat alone in the dining room. I didn’t have my dancing partner with me so we couldn’t show him our attempts to remind him he was one of the best jivers in Coventry. Once I get the right music on this morning I wouldn’t be at all surprised if one of the carers partners him: Len would hold up a Ten if my brother gets out of his chair.
The news from Konar this morning is exceptional. Maureen sang along last night when Alfie Boa was on the TV: they get a Ten from Me. I’ve told them they can’t keep her as I really miss her lovely singing in the morning.
Today’s lesson from Dekyong is: ‘there is no enemy other than our delusions:’
I’m sending myself to Coventry shortly. It will be lovely to be with my mum and brother again and see how things are going in their Care Homes. If things go well I hope to have lunch with my eldest daughter, her husband, and her beautiful daughters. With luck, I might even spend time with my elder sister and her husband in the evening. I think my little sister is in Rome so I’m unlikely to catch up with her today.
The following song is my approach to Maureen being on the Konar Suite:
My Blog yesterday was full of good news as my day had been full of pleasant surprises. Today is a slightly a slightly different story but far from all gloom and doom.
My early morning swim – well mainly walking briskly in the water – went well. The banter in the Health Suite was louder than ever as a regular had returned from Teneriffe in good form.
Maureen was reluctant to leave the residents lounge when I arrived at the Konar Suite. She said there was ‘no point as I could not play the piano’. A member of staff told me she was fixated on waiting for her fish and chips. When I returned a short while afterward she gave me a beautiful smile and was happy to accompany me on a walk around the garden.
As we walked and talked Maureen shared her feelings about being on Konar. She told me that ‘none of the others liked her and were often laughing at her’. She also said that she ‘had been told she would never be allowed to go home’. I tried to reassure her on the popularity stakes and that her stay in hospital was temporary.
Maureen was really pleased that she was getting fresh air on such a beautiful day. We did four circuits of the garden walking at a brisk pace as we admired fruit trees and flowers. Lunch was being served as we entered the dining room and Maureen was happy to be led away for what appeared to be a very small meal.
I was rather concerned about Maureen’s thoughts: particularly that she would never be allowed home. Therefore, I logged my concerns by telephone in the afternoon. I also commented on the size of Maureen’s meal compared to what she eats at home. I was told that she had been served the normal sized portions and there was always the opportunity for seconds.
As it was such a lovely day I decided to take Maureen for a further walk in the afternoon. When I arrived she was sitting in the lounge looking very sad. Her face lit up when she saw me and we returned for a couple more circuits around the garden. As we took drinks in the Quiet Room Maureen told me she didn’t know where she was but suspected she might be in China. She said that she couldn’t understand some of the staff as they had a heavy accent -I have a similar problem!
Maureen’s options for tea were soup or a cheese sandwich. We hedged our bets: my chicken soup was reasonable; Maureen was served two slices of dry bread containing a slice of processed cheese. I ate my soup and a roll, Maureen only ate half of her food.
Maureen closed her eyes as she lay on a sofa and said ‘I don’t think we will come here again’. She explained how difficult she was finding it to make friends in a foreign country. As she drifted off to sleep I held her hand and reassured her that we would be moving on soon.
N.B. In my Partnership Approach with Konar, I have asked if it would help Maureen to settle if I didn’t visit for a period of time. They have encouraged me to keep visiting so she doesn’t feel deserted. As it is the weekend and likely to be quieter than ever I’m going to be the Activities Organiser today – if they let me!
Footnote: This is the second time that Maureen has thought that Grimsby Hospital is in a foreign country. When she had her stroke, three years ago, she was looked after by Spanish nurses. This time there a several staff from the Philippines working on Konar and her Consultant is from Egypt. It isn’t surprising that she doesn’t know where she is or is struggling to understand what some staff is saying to her: far from what the Doctor would order for someone who has problems with cognition!
Yesterday was a good day full of really pleasant surprises. During my early morning swim, I resumed chatting to a woman I had spoken to the previous week. From my routine in the water, she had gathered that I was addressing the consequences of hip replacement and she was doing the same. As we chatted we realised our paths had crossed on a previous occasion when Maureen had taken her on a hike around the Boating Lake as I exercised at the Leisure Centre. Maggie was another excellent carer lost to the cause because as she put it: ‘it was costing me money to work for that Agency’. She had decided to call it a day three years ago as she was fed up of the minimum wage, irregular hours and no time or payment for travelling between calls.
I could hardly believe my eyes when I popped in to see my dear wife shortly before noon. She was fast asleep lying on a bed in a room that she had refused to enter on the previous day. She stirred as soon as she saw me and gave me a beautiful smile. When I saw the clothes she was wearing I was amazed: a pair of new trousers that she had sworn were not hers for a couple of years were being worn. Then it got even better when she held out a hand with beautifully manicured nails varnished to perfection.
Maureen was eager to tell me so many things that she had been doing since my last visit. She had clearly been fascinated by ‘a man who could read the stars’. This man had been to University and his ability to read the solar system had clearly fascinated her. Then she mentioned that she had been involved in craft activities. She told me she had made a cushion cover that she had kindly given to a young boy. In some ways, she regretted her generosity as she would have liked me to have seen her handiwork.
As we sat chatting in Maureen’s room a member of staff arrived and asked me if I would like to stay to lunch. I would have been proud if I had served the chicken hot pot that arrived – it was gorgeous. Maureen had fish although she ate it, she told me it wasn’t quite as good as my cooking. The sweets that arrived were lovely Maureen chose bananas and custard and I had a chocolate sponge with a similar sauce. Our meal would have done credit to a four-star hotel.
Shortly after lunch staff ran a check on Maureen’s vitals and she passed with flying colours. I suggested that it might have been a time when Maureen would have consented to the outstanding ECG but unfortunately, the doctor was unavailable to carry out this assessment.
It would be risky to suggest Maureen is settling on Konar but yesterday was full of pleasant surprises. She remains concerned that her independence is often under threat and resents being told when to take her medication or have a wash and change her clothes. This is a familiar tale that challenges us all as we try to provide the support that Maureen needs and without challenging her independence.
The good news from Konar this morning is that Maureen slept through the night in her room from 8 ‘o’ clock! I didn’t do as well as that but after a couple of hours in the afternoon managed 6 further hours in bed. I’m sure as we both get the rest we need we will be both in a much better position to make sensible choices on our journey!
After discussions with staff on the Konar Suite yesterday I’m feeling a lot happier.
It seems likely that Maureen will lack capacity about her health and welfare needs.
Best Interest decisions may well feature in Maureen’s Treatment Plan.
There will a partnership approach to the development of her Treatment Plan.
We have agreed; I’m the expert on Maureen: they are Specialists in Dementia.
Maureen’s reluctance to take her prescribed medication or have an ECG continues.
At night Maureen continues to sleep in a chair in the company of staff.
She told me she doesn’t like her room and finds the bed uncomfortable.
When I offered to sit in her room with her yesterday she declined.
I’ve just spoken to the Konar Suite and once again Maureen slept in a chair in the lounge last night. The good news is that she has been in her her bed for the last hour. My sleep isn’t much better.
I’ve been up from the early hours putting furniture in our Sun Room. It looks great now with vinyl flooring down a few plants delicately placed alongside a table and a couple of chairs. It will be interesting to see what Maureen makes of it when she is home. I will post some photographs of my work tomorrow.
On Wednesday your Key Worker takes you out for coffee and cake.
He leaves you to a strange place where there are lots of other people.
At night you sleep on a couch in a large room.
In the morning you are surrounded by people you don’t know.
On Thursday night you again sleep on a couch.
On Friday morning your husband – pops in to see you.
He rescues you on Friday evening from a noisy incident in a social area.
You wake up alone on a bed around midnight.
You make your way to the lounge to sleep on a couch.
Your husband returns in the morning for a short visit.
Two unknown women arrive and take you to a strange place.
You are surrounded by strangers and have no idea where you are.
Your husband arrives the next day and can’t explain what is going on.
You think you are on a Cruise Ship.
He returns in the evening with some sandwiches.
On Monday morning a Doctor wants to chat with you but you refuse to talk to him
Your husband arrives shortly before noon.
You think you are in a Market and have bought some vegetables.
You have lunch with your husband in a small lounge.
You ask him to take you home but he is unable to help you.
A short while later your husband has gone and you don’t know why.
The above events can only have increased Maureen’s level of confusion. I would contend that any attempt to assess her within Konar’s 72-hour target would be short-sighted!
I got a distinct feeling that I was ‘Battling Giants’ yesterday – a position that Gladwell explores in his book ‘David & Goliath -Underdogs, Misfits and the Art of Battling Giants’. In my early dealings with staff at the Konar Suite, I was in despair with haunting memories of a professional belief in ‘chemical imbalance’from my time as a patient at Harrison House. Fortunately, late on a Sunday evening the Head of the Unit appeared and eased my troubled mind.
My memories had been sparked by a meeting with two Nurses from the Konar, with one taking notes on a Lap Top. When I heard that Maureen would be seen by a Consultant in the morning and he might prescribe medication then my concerns intensified. I wondered how on earth anyone could assess Maureen’s needs when she had been in Konar for such a short period of time?
It wasn’t just the informal gear the Head of Unit was wearing that impressed me; it was her compassion and sincerity. Along with: ‘if you have any concerns at any time then ask my staff to contact me’. She assured me that ‘Konar was not in the business of medicating anyone for the sake of it and the priority was to assess Maureen’s needs’.
David knows that Goliath can always use the Mental Capacity Act to assert what is in Maureen’s Best Interest. However, he is reassured by extracts from Konar’s Misson Statement:
‘What Services do we offer:
Konar provides an evidence-based, high quality, individualised service …….
Our Aim is:
To provide person-centered care, addressing the whole persons needs including body, mind, emotion, and spirit.
To work with carers where appropriate ensuring they are included in all aspects of care, future needs, and treatment.’
I’m reassured that Maureen is in good hands at Konar: my initial panic has ebbed. As David, I have a Mission Statement and a friend indeed whenever I have concerns!
Today’s Buddhist teaching has great relevance to my thoughts this morning:
When I popped into Alderlea to warm Maureen’s toes yesterday she was sitting at a table, with a fellow resident, having breakfast. I watched her for a while and chatted to a Senior Carer who remembered me as Phil Collins the guy who had checked out the Care Home of her previous employer. I could see that Maureen’s hair was glistening and guessed correctly that she had been in the shower. The Senior told me how Maureen had returned from personal care holding the hand of the carer.
When Maureen saw me she smiled and said ‘here’s Paul and is Barrie there’. It didn’t take me long to figure out that she was expecting us to catch a bus so that she could go home to Nottingham to be with her her birth family. I was relieved that she had no idea of what lay ahead: admission to another strange place -the Konar Suite.
I used the thermal socks that I had bought as a distraction and left her newly found carer friend to check that they were the right size as I headed for the exit. As I drove home I reflected how within the space of three nights my wife had become a dependent child – a shadow of the woman I know!
I was very reassured when I heard the news that Maureen’s transfer to Konar had gone well. How kind of The Head of the Home Treatment Team to let me know that Maureen had been moved by people who knew her. Similar kindness was shown by a Nurse from Konar who phoned to tell me that Maureen had settled down to being on the Ward.
I am meeting a member of staff from Konar this morning to help them develop a Care Plan for Maureen. Although I’m inclined to accept their advice about when to visit my wife. However, I’m concerned that delaying things could leave her feeling abandoned in a strange and frightening environment: that’s compassion rather than suffering!
I’m sure some readers of this Blog wonder what led me to change my mind about Care Homes and the Konar Suite? Why had someone who hardly has a good word to say about Care Homes and was unconvinced about the Konar Suite changed his mind?
When I look back there were three main reasons. Firstly, professional staff who I have a great deal of respect for continued to ask me to review my thinking. Secondly, when Maureen told me ‘she didn’t know where or who she was and had no idea what was going on’. Thirdly, when she handed me this crumpled photograph and told me it was a bill:
As you can see I’ve straightened it out now: hence the distortions. I wasn’t upset that it was one of our wedding photos. What concerned me was that I had stood it on our mantelpiece on our Wedding Anniversary to try to remind Maureen that we were married. I had played Wedding Dayby the BeeGees every morning and told her how proud I was that she was my wife. I had told her how much I loved her as the Brothers Gibb had sung this beautiful song. I had put my hand next to hers as the music played so our wedding rings were touching. Although she may have grasped what I was talking about at that time, this photograph became a bill: that was the Tipping Point
The news from AlderleaCare Home is that Maureen thinks she is in ‘Marks and Sparks’ trying to find the train station. She is sleeping on a sofa just like she does at home and was still in the land of nod when I checked up on her early this morning. I’m off to the Leisure Centre again shortly; to swim and then revitalise in the Health Suite.
Dementia: Sharing The Good Times 