Dementia: GIGO

The support we have received from professional staff in the last few days to has once again been exceptional.  We are very fortunate to have skilled staff from Navigo and Focus Adult Social Care at the end of the phone 24/7.  If within an hour of a 4 am telephone call Rapid Response Nurses, and Mental Health Nurses, are on your doorstep you really count your blessings that you live in North East Lincolnshire!

It will be a few days before we know if an infection has been behind significant changes in Maureen’s presentation.  The Home Treatment Team have determined that we need a Doctor’s Review of her condition.  This is likely to take place towards the end of the week when antibiotics will be kicking in to address any evidence of infection – if indeed she has one.

In the 12 months since I was told that Maureen had moderate to severe dementia, her presentation has changed fundamentally.  When you are close to someone you don’t always notice small incremental changes that are significant to the occasional observer. That became obvious when two members of the HTT  saw her on Thursday and made it clear she needed to be reviewed by their doctor.

I’m pretty sure that Maureen’s presentation at the moment is not helped by the contribution we all make towards GIGO:

  • A tired husband is no use to her at all.
  • Family members who are too busy to call or visit.
  • Professional staff who are treating the condition and not the person.

We all have a simple choice – change our approach or the garbage of hallucinations and challenging behaviour may well continue.

I made a start at the weekend with some simple changes to my approach to being Maureen’s Care Partner by:

  • Having no carers at the weekend because they were unknown quantities.
  • Keeping all doors unlocked except when we were sleeping.
  • Resting most of the time when Maureen slept.
  • Accepting Maureen’s reality unless it was dangerous.
  • Listening rather than talking.
  • Observing rather than initiating activity
  • Providing all the TLC I could muster.
  • Updating family members and the Home Treatment Team on the situation.

It is early days but changing my input has led to positive changes in Maureen’s presentation.  Phone calls from two family members were also just ‘what the doctor ordered’: less garbage is better for all of us!

Dementia: I’m Not Counting My Chickens

Image result for I'm Not Counting My Chickens pictureMaureen seems more settled after a Lorazepam induced rest.  It’s early days so I’m not counting my chickens before they’ve hatched.  I will share further detail on Monday when I next post.

Sincere thanks to all of our supporters -have a good weekend.

Dementia: I Hope It’s A UTI

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I’m posting this blog shortly after midnight.   I woke a short time ago to find Maureen standing in the kitchen talking to a vacuum cleaner that she has wrapped in a blanket. Several assessments will take place later on this morning to try to establish what is behind significant changes in her presentation that began to emerge yesterday.

Once again, I count my blessings that we live in North East Lincolnshire where telephone assistance is available 24/7.  I’m keeping my fingers crossed that a UTI and lack of sleep are behind her presentation.  I’m also hoping that the little girl in our vacuum cleaner continues to provide Maureen with comfort.

Updates will follow

 4.20 am  I’m hoping that a Mental Health Nurse from The Konar Suite will be here shortly to assess whether medication might help to calm Maureen down – I have never seen her like this before!

4.40 am  Just received confirmation from the Mental Health Nurse that Rapid Response is on the way to conduct a physical assessment of Maureen.

Dementia: We Will Miss Glen Campbell

I needed a song for Maureen this morning as she feels deserted by her family.  She knows that they are all busy but can’t understand the lack of meaningful contact.

Every morning I sing her songs to Maureen’s to let her know how much she means to me. Today, knowing that Glen Campbell had just passed away I searched amongst our vinyl for an appropriate song from him.  Our records are not in alphabetical order and I was just about to give up when I found this number on a Country Album:

My Admiral Nurse has always encouraged me to fight winnable battles and I have now accepted that trying to get family members to change their ways is a lost cause.  My focus has shifted to telling Maureen how much she means to me and Glen did the trick this morning.

I would like to pass on my sincere thanks to Glen’s family for sharing their journey so openly.  The following number epitomises the brave way they all faced dementia:

 

Dementia: Dealing With The Care Crisis

 

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Yesterday Susan Macaulay asked a very pertinent question:

Renovations are stressful for anyone – living with dementia or not. I’m wondering what the purpose of this reno is…? Not that it seems it can be stopped now, in mid stream 😦’

I’m sure this is a question that is on the tip of the tongue of many of my followers.  There are two simple reasons for the renovations that are taking place:

  1. To protect Maureen’s Best Interests.
  2. To attempt to address the crisis in Social Care.

Some time ago a decision was made that it was in Maureen’s Best Interest for her to remain at home.  Therefore, I decided our house needed renovation to ensure it was adequate for all future eventualities.

The local crisis in Social Care grows as the year progresses.  Our Main Care Agency had a 48% turn around in staff last year.  They are forever short of staff and making unreasonable demands on carers:  one of our ‘Girls’ is six months pregnant and it is not unusual for her to work an 11-hour shift without a break with no time for travel between calls.  This Agency recruited 8 additional staff a couple weeks ago and 7 of them have now left.

Within Residential Care, it is the same story: a shortage of staff and high turnover of personnel.  Last week I enquired how things were at a Care Home where Maureen had stayed in the past and was told by an ex-member of staff ‘they have all left’.  A familiar tale of staff following their Managers who attempt to move on to better things at neighbouring homes.

Having a Sun Room along with a self-contained shower room will give all sorts of options for the future.  It will make it easier for family members or live in carers to stay and provide the support. that both of us are likely to need in the future.

‘Rain stopped play’ on the Building Site yesterday and gave us both a much-needed break from the stress of renovations.  If the weather forecast is right our Sun Room will really take shape in the next week as the shell of the building will be completed and watertight.  Although yesterday’s deluge would have tested any building!

Thank you for raising questions about the renovations Susan and I hope I am covering as many bases as possible as the crisis in Social Care progresses by the day.  I’m sure if I have overlooked anything kind readers of this Blog will let me know!

Maureen is in good form this morning waving, singing and clapping after every tune on YouTube.  It’s still pouring down so I just had to play this one:

Hey, Kate Swaffer I know you are a big fan of Willie but do you know who is playing the piano on this number?

Dementia: Totally Bemused

Image result for Totally Bemused elderly woman pictureMaureen seems totally bemused this morning.  It isn’t unusual if she is unsure who I am but when she is failing to recognise her late daughter from the usual photograph that’s  a significant change in her presentation.  I’m not sure from her comments if she remembered who The Songbird was when I played her normal set on YouTube this morning and she’s the ‘Special One’ as far as grandchildren are concerned.

Our builders have prepared well for today’s deluge.  They managed to summon a roofer to make sure that the rain won’t get in this morning.  Getting him here at short notice was no picnic but a relatively straightforward challenge compared to what I might face today.  Thankfully, the rain brings room for optimism: the absence of workmen could help Maureen to settle down a little!

 

Dementia: ‘Living On A Building Site’

After an extremely challenging weekend, I will be seeking immediate help this morning. Maureen is finding it difficult to cope with ‘living on a building site’ and we need to find a way of easing her distress.  I am also feeling unwell and need to consult my  G P about my general well-being.

It is not surprising that Maureen is distressed by her surroundings:

She just wanted to get away yesterday – when exit via the back garden was impossible she took to the road for over an hour:

None of us could predict how Maureen would react to building work taking place and completion is several weeks away.  Maureen wants to see our Key Worker this morning ‘as he promised her that she could go home soon’.  As he is is on holiday for a week I will be contacting the Duty Worker at Focus Adult Social Work to request a home visit.

I will also be seeking a review of the ultimatum I have been given to choose between my Admiral Nurse and Support Worker at The Alzheimer’s Society: this is not the time to require me to reduce my support network!

 

 

Dementia: Changes Ahead

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Maureen’s enthusiasm for the trip to Nottingham dwindled in the final hour before departure yesterday.  When our chauffeur arrived she was adamant that she didn’t want to see her sister: ‘she was cold and her sister should be coming to see her’.  When I saw that my efforts to shift her from the sofa were causing distress I paid our ‘Black Van Man’ a token cancellation fee and bade him farewell.

Although I was disappointed that our away day didn’t happen I’m pleased with what I achieved with an ‘extra day’ on my hands.  It gave me the opportunity to clarify three important matters.

  1.  In future, I will be using the Alzheimer’s Society for support.
  2.  It is legitimate to ask carers to undertake domestic duties.
  3. Maureen will be consulted in the development of our Sun Room.

I’m meeting the Manager of the Alzheimer’s Society this morning to look at a clock that might help Maureen to regain some concept of time.  This will also be an opportunity to explore the nature of the support that will be available in the future.

When Girl Friday (Maureen’s Hairdresser) arrives at ten she will encourage her to have one of her ‘Pamper Days’.  There will be plenty of other tasks in the diary if Maureen says she prefers my company in the shower.

The roof tiles for our Sun Room arrived yesterday and will be ready to be put in place next week.   Following a number of discussions with our builders, we have revised our plans for this extension to our house.  The last thing Maureen needs at the moment is anything that necessitates changes to her normal routines, without her consent!

The clarification that has now taken place will ease my workload along with the potential for Carer Burnout.   If we are also able to build short holidays into our routine, the need for a Respite Break with Maureen going into a Care Home has to be called into question – that would be a change really worth shouting about!

 

 

Dementia: ‘It’s The Noise Stupid!’

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Almost as soon as the builders started work yesterday Maureen yelled at them to ‘shut up’.  Her verbal retort to their banging and sawing helped me to ‘wise’ up on what was behind yesterday’s anxiety – I immediately thought: ‘it’s the noise stupid!’

It didn’t take long to persuade Maureen to escape from our noisy building site.  Once she was out in the peaceful surroundings, and the genuine warmth of folk around the local Market Square, she was a changed woman so we made hay while the sun shone:

  • We sought out our friendly greengrocer who knows us from Freeman Street Market.  He set the scene by telling Maureen how pleased he was to see her.
  • We then popped into a newly opened travel shop to explore a possible trip to the Isle of Man.  They were dementia friendly and handled Maureen’s questions positively.
  • Our final call was to a Beauty Salon to book a Pamper Day for Maureen next week.  We got to know the owner when her husband was a patient on the Stroke Ward at Grimsby Hospital at the same time as Maureen.  She understood the need for flexibility in the arrangements that were made.

When we returned home, a high spirited Maureen bantered with our builders about using a rubber hammer in future.  She then fell asleep on the sofa and woke as our Key Worker arrived to check on how we were doing.  She woke up in tears and told him: ‘they had broken their promise to allow her to go home’.

Our Key Worker stayed for over an hour as he was about to leave I managed to have a quiet word with to request an assessment of  Maureen’s condition.  I had to emphasise that I was not seeking another pointless Memory Test.  Therefore, he offered to make a referral to Occupational Therapy.  Their assessment should provide the base line for good practice in the future by all and sundry: including her Care Partner!

Our builders have warned me that today is going to be an extremely noisy day so we will be leaving to visit Maureen’s sister in Nottingham very soon.  The only noise Maureen will hear in the next couple of hours will be the purr of the engine from our chauffeur driven Volvo and my chatter as we hold hands on the on the back seat!

Reasons To Be Cheerful

Maureen is so excited about the prospect of seeing her sister today.  I’m ecstatic that we have slept together for the second night running.  I realise it’s dangerous to count your chickens when dementia is around but if I didn’t accentuate the positives Maureen would be after me!

Dementia: Seeking Help

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I have never seen Maureen as frightened as she was yesterday.  It was a while before she told me that ‘she didn’t know me and was frightened about being locked in the house’.   I think there is a distinct possibility that she has become distressed by witnessing our back garden becoming a building site.  Her comments about ‘two heads being better than one and not being consulted on the plans for our Sun Room’ are revealing and justified.

I was warned that embarking on a building project was a risky venture.  Our builders are now in their 5th week of being on site and could well be here for a similar amount of time.   They are dementia friendly and very happy to work with us to minimise Maureen’s distress as well as achieving a positive outcome.

The graphic below accompanies a recent article by Leeanne Chames who stresses the importance of carers reaching out for help.  I began that process yesterday seeking advice from Admiral Nursing and the Alzheimer’s Society on how we might make the best use of our extended home.  I will also seek guidance from our Key Worker this afternoon on how we could go about reviewing my approach to supporting Maureen.

The irony about Maureen’s distress yesterday that she currently remains asleep in the marital bed.  She climbed in beside me shortly after midnight and she has never been the sort of person who would sleep with strangers.  The more I witness changes in Maureen’s behaviour the less I understand what is actually behind her presentation!