Dementia: Anzac Day

Jennifer Tucker one of my fellow bloggers pointed out that today is Anzac Day.   Her moving Blog has reminded me how grateful I am for two Australians’ who helped to keep my dad safe as he served as a Tail Gunner in a 186 Squadron Lancaster Bomber Crew.  Sadly Johnny Gibb his Wireless Operator, from Melbourne, died in a flying accident shortly after the war.  His Skipper Eric Barton, from Sydney, came to England and met up with dad in the 90’s.  There was a Leader Article about Eric in an Australian newspaper in May 2015.   I tried to contact him through the newspaper a few years ago and failed.  How lovely it would be if this Blog gave me contact with him or his family.

My dad is third from the left in the photo below and Eric is to his right.

Dad and Bomber Crew 002

Jennifer has also posted a moving musical tribute to Anzacs which I have posted to my good music page as I forgot to update it on Friday after rather an eventful day.

I think my dad was looking down on me as I drafted this post: trying to keep us safe as he always did.  The streaming cold that has been troubling me for the last 24 hours has eased and Maureen has decided that it is time to come to bed, rather than remain on the sofa.  Hopefully we can all sleep safely in our beds as we could all those years ago thanks to all those who served alongside the Anzacs.

I have just woken up to finish this post after more refreshing sleep.  It’s much easier to rest when Maureen is tucked up safely in bed.  I’ve just remembered that my dad’s log book from the RAF remains in my desk drawer along with press cuttings and comments on the raids he went on.  I really must call in at the RAF Club and take advice on whether they would like these artefacts in their museum or they would be better placed closer to his base in Stradishall.

Dementia: Wrong Again?

 

Despite a thorough search I couldn’t find a bunch of my household keys yesterday . Therefore  I got up very early this morning determined to find them and realised that I also had misplaced a replacement set.  My first thought was that Maureen had stashed them away somewhere after being ‘locked in’ on Friday.

I searched high and low for about half an hour.  Then Maureen joined me and unearthed the replacement set under a cushion in our bedroom.  Just as I was about to give up I turned over a cushion in the dining room and found the missing keys.  I just wonder if you know who had put them there so she had an escape route if she found herself locked in again.  The strange thing is Maureen made only made a passing reference to her ordeal on Friday by suggesting that I wanted to ‘lock her in the garage in the dark’.  She hasn’t remarked on several keep sakes that are no longer on the dining room table: I doubt she will see their remains in the dustbin.

I can’t risk Maureen being needlessly scared out of her wits again by locking her in and being out of sight.  If I can’t prise her off the sofa I need to remain by her side or stay awake with the baby alarm close at hand.  It’s just too risky to let her go off wandering alone any longer as her road awareness is suspect.

I caught her as she slipped out of the back gate yesterday and gently ushered back into the warmth of the house.  Just to be on the safe side I will ask Occupational Therapy to do a capacity assessment on her road safety awareness to see if there is any way of her independence being preserved.

Now I wonder where that wife of mine has hidden that missing address book.

Dementia: A Very Lucky Break Indeed

Good fortune has shone on us this morning: we’ve had a very lucky break.  Maureen  woke up thinking of a school trip to Germany from over 60 years ago.  I have kept that conversation going to consign the events of yesterday afternoon to the dustbin: along with shattered keepsakes.

We were both tired yesterday after several nights of broken sleep.  When Maureen lay down to rest her eyes on the sofa I decided to rest upstairs in our bedroom.  I took the normal safety precautions before retiring: locked all external doors and removed keys to a place of safekeeping.  With the Baby Alarm set I soon drifted off to sleep reassured that I had minimised risks of the ‘Happy Wanderer’ going missing.  What I hadn’t counted on were the events that followed an hour or so later.

As the Baby Alarm kicked into action I heard Maureen screaming downstairs.  When I joined her she was running around the house saying she was ‘locked in’.  She ran from room to room hurling abuse at me and pulled the tablecloth off the dining room table shattering several keep sakes as they crashed to the floor.  Nothing I said made any difference as I was the ‘Bad Guy’ keeping her in prison.  There is no need to repeat the abuse she hurled at me until she lay on the sofa exhausted from her attempts to verbally remonstrate with her captor.  Another incident early this morning cast me in the role of hero rather than villain.

I awoke around 1 am and checked Maureen’s whereabouts and found her locked in the downstairs utility room.  It took me a while to coach her on how to undo the bolt on the door and I managed to usher my very frightened wife upstairs to bed.  We have slept together relatively peacefully until 7 am apart from or two difficult moments where I have to reassure her until she returned to the land of nod.

There is no evidence of the ‘smashing time’ Maureen had yesterday unless you look in the dustbin.  It seems likely that the emotional scars have healed with the school trip at the forefront of Maureen’s mind.  If the weather holds we will make it to the car boot sale down the road this morning and resume our search for additional vinyl.  Maureen dreams of her school trip to Germany could not have come at a better time: a very lucky break indeed!

Footnote: Sincere thanks to family members and professional staff who gave me support in my hour of need yesterday.  You will be pleased to hear Maureen is back this morning: I hope ‘Mrs Dementia’ is taking a few days off!

 

Dementia: A Good Day But A Bad Night

We had one of the best days we have had for a while yesterday.  I feared the worse when Mary arrived four hours early for her ‘sit’ at 9.30 am.  However the inefficiency of the Care Agency created an opportunity that Maureen rose to and really made a difference to her day.  She accompanied me to my hospital appointment and felt really pleased that she had been with me for my consultation rather than being left sat at home with Mary.  Following the good news that an operation on my shoulder wasn’t imminent the look of joy on  Maureen’s face was palpable.

Two other positive things happened yesterday afternoon.  Firstly, Maureen accompanied  me on a trip to Lidl to stock up on provisions.  Secondly, a  new pump was fitted to our central heating boiler and we had hot water and heating once again.  However, our luck didn’t continue and we were in for a bad night.

I had to switch on the baby alarm  at 10.30 pm as Maureen wanted to stay on the sofa.  I heard her come upstairs and shut her bedroom door a while later.  At 2am she was up and concerned about ‘all the people in the house who kept coming into her bedroom’.  Then she has woken several times wondering if it was time to get up. I made tea at 5 am but that has been another failed attempt to settle her.

I think I might try something a little different today and suggest a day trip of some kind.  I’m hoping a change of scenery will have a beneficial effect for both of us.

Dementia: A Stitch In Time

Maureen was on the offensive for quite some time after I returned from my Buddhist Meditation Class last night.  The only way I could escape from her abusive vitriol was to go to bed. Just before retiring I plugged in the Baby Monitor that I had bought earlier in the week.  A couple of hours later the monitor crackled into action as I heard Maureen moaning downstairs.  I rushed down and found Maureen lying on the sofa complaining that her throat and mouth were causing her significant discomfort.

My status as a ‘deserter’ soon changed as I became Maureen’s nurse and tea boy.  The hostilities of a couple of hours earlier were forgotten as I attempted to ease her discomfort.  After a while I attempted to persuade her to go upstairs to bed.  Once in the bedroom anxiety surfaced again with ‘they will take my clothes off and bite me’: the old fears about brutality in the bedroom.

I think Maureen felt safe with me beside her in bed.  Those who know her history have warned me to be very careful in case mistaken identity surfaces. We have slept relatively peacefully together with a natural break around 3 am when Maureen wondered if it was time to get up and expressed concern that ‘people were taking her car’.

I need to think a little more on how to respond to the ‘deserter’ accusations. The Baby Monitor saved my bacon as I could get out of the firing line without putting Maureen at risk.  I will read around and chat to one or two people this morning on how I take the heat out of the situation when Mrs Dementia is on the prowl.

Decision time looms for me this afternoon about the tear in my rotator cuff.  I’m hoping Maureen will accompany to my appointment with the Consultant.  Once again our social worker has helped to give Maureen options as a carer will be here for the afternoon shift, just in case she prefers to stay at home:  when you receive confirmation E Mails close to midnight you really appreciate the level of professional support you are receiving

Dementia: The Side Effects Of Depression

I am not sure there are many people who would say that they feel fortunate to have had depressive episodes in their life:  particularly, when the last one, four and a half years ago, led to being Sectioned and incarcerated in a Mental Health Unit.  However, I can genuinely say I am glad I have had such an experience along with a diagnosis of ‘a chemical imbalance needing medication for the rest of my life’.

Things have to become pretty bad when you have suicidal thoughts that you act upon. Taking 90 paracetamol is pretty drastic action and you need to be lucky to get away without any long term consequences: that is down to the prompt action of Maureen.  I  was also fortunate the side effects of the prescribed solution ‘mirtazapine’ made me feel worse.  That encouraged me to think about what had happened and where my suicidal feelings had come from.  This morning I have an appointment with Paul Martin who helped me to put my depressive episodes into perspective.

Paul along with many others sees depression as a response to environment.  He helped me to see that it was my environment that was the problem: not a chemical imbalance.  His thinking is supported by the likes of Irving Kirsch and Peter Kinderman .  In fact Irving has proved that antidepressants are little better than a placebo for treating mild to moderate depression.  Peter has argued long and hard for a new way of treating depression; with talking therapy the solution rather than medication.

My appointment with Paul this morning could not have come at a better time; as once again my environment has the capacity to impact upon my mental well-being.  The pressures of being a Care Partner are well documented: they are life shortening. Yesterday Maureen articulated once again her disappointment about being left with carers while I went out on my own.  Maureen’s reactions are par for the course as empathy goes out of the window with dementia progresses.  If I respond to her feelings of desertion I compromise plans to help me develop a life of my own.  I could easily put off returning to   Buddhist Meditation Classes tonight or even delay my long awaited day trip to see family in Coventry on Monday.

It is fortunate that Paul’s initial training was as a Mental Health Nurse often working with patients diagnosed with dementia..  He understands my dilemma of attempting to have a life of my own alongside being a Care Partner for someone who lacks any semblance of empathy..  None of this is anything to get depressed about: the issue is once again is how to respond to challenges in my environment.

One of my initial conversations with Paul this morning will be about sleep, as I’m really struggling to drop off when I’ve been woken in the night.  Maureen was up and about three times last night. Getting back to sleep after easing her distress is becoming increasingly difficult.  As always Paul will have something up his sleeve to help me on this front.  I just hope his solutions bring to an end sleep deprivation and consequent exhaustion: I’m well aware of the dangers if my sleep deficit continues.

I’m also aware that dementia and lack of empathy go hand in hand.  Pandering to Maureen’s fears of desertion will not help: they are part and parcel of the condition.

 

Dementia: Sounding The Alarm

 

Maureen’s presentation from 3 am this morning has been rather alarming.  She woke me up saying that someone was in her car yet gain.  I managed to console her with a cup of tea and empathy over her concerns.  I left her downstairs sleeping on the sofa as I went back to bed.

At 6 am I heard the front door open and hot-footed it downstairs.  Something of a lucky escape as I had not removed the key or set the bell on the door.  Maureen looked terrified as she told me she didn’t know where she was.  I offered to make her a cup of tea in an effort to help her get her bearings.  It took half an hour or so before I was sure she knew who I was.

We had an early breakfast together and made idle chat.  When I asked Maureen if she wanted any bread she offered to do the necessary.  Her efforts were a sobering reminder of the incredible decline in her functional capacity.  I had to perform a rescue operation to have anything that resembled a jam sandwich.  Maureen has now gone back to sleep she seems distraught possibly by her awareness of her lack of functional ability.

The bell on the front door will now remain on as an early warning whenever it is opened.  I think it is likely that Maureen has the back door key in her pocket.  Mary today’s carer has just arrived and I need to hot-foot it to Argos to buy a sound and motion alarm to reduce potential risks a little further.  That’s the easy one: I need help with how to address Maureen’s declining functional capacity –  I’m well aware that the more I do for her the less she will be able to do

Dementia: Moving Forward

In one of my latter professional posts with Coventry City Council my Line Manager often outlined our ‘Working Position’ to a specific issues.  Maureen’s presentation has changed considerably during the last few weeks and to use Bill Malley’s approach our ‘Working Position’ is outlined below:

  • From today we will have 18 hours of carer sits a week.
  • Maureen does not have the capacity to determine her care needs
  • Additional sits will be organised to allow me to visit family in Coventry on the 25th of April.
  • I will not encourage Maureen to move outside her comfort zone.
  • Our priority is to avoid agitation and keep Maureen calm.
  • I will encourage family to visit as often as possible but to come in small numbers.
  • I will discourage Maureen from going out on her own and trail her if she tries to wander off.
  • I will attempt to get Maureen to carry the GPS Tracker whenever we go out.
  • I will get a Sound and Movement Monitor tomorrow for those occasions when Maureen chooses to sleep downstairs.
  • The Home Treatment Team will remain on standby: available to be utilised whenever needed.
  • Lorazepam is only to be offered when all else fails and Maureen remains agitated.

We are fortunate to have been  be supported by professional staff who have moved very quickly to review our Care Plan.  Maureen has been treated with respect and compassion throughout a period of mental health assessment: staff have concentrated on the person rather than the condition.

It is not possible to note all the acts of kindness that have been shown towards us in the last few days but I want to share some memorable moments.  Firstly, Natalie a Mental Health Nurse worked tirelessly to build up solid rapport with an agitated Maureen: including listening to Maeve on YouTube.  Her emotional  reaction to Songbird and others meant so much to Maureen.  Then Dr Kokton was the epitome of warmth and sincerity: at one stage she sat on the floor as she engaged Maureen on challenging matters concerning her mental state.  Sue our social worker was a model of empathy yesterday: at one time holding Maureen’s hand as she reassured her that it didn’t matter if she had forgotten events when she had been behaving out of character.  I could go on and apologies to all the staff I have failed to mention who have been working on the front-line or in the background during this challenging period in our lives.  When things are more settled I will record my thanks for the excellent support we continue to receive from staff within NAVIGO ( Mental Health) and Social Services.

N.B. I may well post more later as Maureen woke at 3 am this morning.

Dementia enabling care, design, and services

Yet another illuminating article from Kate Swaffer.

Kate Swaffer (she/her) Kaurna Country's avatar

Screen Shot 2016-04-18 at 6.27.57 pmWritten for and published first for The Aged Care Report Card and their news site RetireNCare on Apr 11, 2016, is my article below:

We need dementia enabling.

The time is now that the aged and dementia care sector not only provides us with better residential care, but the whole sector finds a new way to support us to live, not only to die. 

“Recently I had the pleasure to meet Lauren Todorovic who founded Aged Care Report Card. After a lot of discussion, she asked me if I would be interested in writing for RetireNCare, and as an activist and advocate for people with dementia and those in residential aged care, this was definitely too good an opportunity to pass up!

Part of the vision of the Aged Care Report Card appears to be to highlight what is happening in the aged care sector, but not only to promote the great things happening…

View original post 739 more words

Dementia: Looking Back Looking Ahead (Week 14)

There is little doubt that I have found recent changes in Maureen’s presentation extremely challenging.  On occasions exhaustion has led me to make decisions that have been questionable in the cold light of day.  Thankfully my requests for increases in my Support Package have been heeded and I start this week with an air of optimism.

It is important to acknowledge the generosity of the Local Authority and its mantra to ‘look after their carers’.  I am well aware that fellow carers around the country would give their right arm for the level of support that is available to carers in North East Lincolnshire.  I can almost hear them saying ‘what else does he want?’  My answer is quite simple: the energy to continue to be a supportive Care Partner and time to have some life of my own.

None of us can predict how Maureen’s presentation will pan out in the short or long term. What I now have in place is six three hour carer sits and opportunities for day trips to see family.  I have also had positive discussion with our social worker about overnight stays so that I can have mini breaks from my caring duties.

I have to tread carefully to make the best of the new Care Plan.  If I rush things and panic  Maureen then the additional support on offer will be counterproductive. There were considerable repercussions when I went to see my daughter in London and the last thing we need is a repeat of those events.  However, if I lose any more contact with my own family and become totally isolated resentment is likely to creep in.  Therefore the Local Authority’s generosity has to be matched with resolve on my behalf: they have created windows of opportunity it’s up to me to make my way through them!

Opportunity knocks today when our social worker visits this morning.  As Sue often says ‘we need to work Maureen’: recognition of the person rather than deferring to the condition.  It will be interesting to hear Maureen’s view of her needs and how she wants to maintain her independence within th.