Tag Archives: Confusion

Dementia: Picking Your Battles

Mixed Dementia, ,

Image result for Picking Your Battles with dementia picture

I have been waging a battle all week to get Maureen out of the Konar Suite ASAP.  It has disappointed me that she remains in an Acute Mental Health Unit a week after her assessment has been completed.  Patience does not come easily to me in circumstances like this.

Maureen will be discharged from hospital on Friday.  I’m confident that the Best Interest Meeting will agree that she can return home.  The only stumbling block could be the time it might take to put an adequate Care Package in place.

It didn’t take the social worker from the Hospital Discharge Team and me to agree upon common ground yesterday: the importance of picking your battles.  Therefore, if Maureen wants to wear a slipper on one foot and a shoe on the other that is her right.  If she wants to wear the same clothes for several days and nights that is fine.  She has the right to make choices and it is our problem if we don’t like them.  As Maureen said to me shortly after my arrival yesterday: ‘if they ask me if I want to have my hair cut again, I’ll ask them if they would like me to cut their head off’.

Maureen thought I was her ex-husband when I was with her yesterday.  She was hostile to me during the whole of my visit.  I was warned this might well happen as her dementia progresses.  The only solution when she is in this mode is to walk away: her early life would have been much happier if her ex-husband had done the same!

Dementia: I Need ‘A Fiver Deal’

Mixed Dementia,

Image result for A Fiver Deal PictureWhen I was Supply Teaching in this area I heard from secondary school pupils how easy it was to get ‘a fiver deal’.  I got to know the names of local drug dealers and their patches. I know where to get my own fix this morning to help me cope with the events of yesterday.

Maureen continues to languish in the Konar Suite.  She is not ‘settled’ there – she is frightened – and can’t understand why she can’t come home.

On Monday I spent several hours trying to speed up her discharge.  our concerns were seen as valid and reasonable. Consequently, the meeting was brought forward until today.  My mobile rang early yesterday morning with the news that the meeting could not take place until Friday.

I need something to take my mind of how the interpretation of the Mental Capacity Act mitigates against person-centered care.  As I posted yesterday we are dealing with a machine driven by a tick box culture.

My fiver deal this morning will be my monthly trim, carried out by Polly, who shares my surname. She will use number 6 and  4 clippers – she knows what I want.

Polly is struggling to sleep at the moment. She is worried she will forget her steps when she performs a waltz for the first time at a charity event on Saturday evening.  Polly will always get TEN from me as she knows how to be person-centered.

My fiver deal with Polly includes a £1 tip!

No prizes for guessing where Maureen slept last night.  A member of staff has just confirmed that ‘she slept with us in the lounge’: she is so ‘settled’ in the Konar Suite that she is afraid to sleep alone in her room!

 

Dementia: A Flaming Success

Mixed Dementia,

As you will see the Bonfire Party on the Konar Suite was a flaming success.  The food was exceptional: a real credit to the catering staff.

My reservations about Maureen being assessed on the Konar Suite were ill-conceived.  They do not see medication as the only solution to mental illness or radical changes in the presentation of someone with dementia.  It is refreshing to see such a compassionate approach to assessment.

Maureen has been traumatised by her experiences of the last seventeen days: 

  • Her current reality would reduce anyone to tears.
  • She is very frightened.
  • She is totally bewildered by being detained in an Acute Mental Health Unit.
  • Her ordeal needs to come to an end sooner rather than later.

I have asked to meet with her Consultant this morning.

 

 

Dementia: We Have It All

Mixed Dementia,

Maureen’s reality was palpable yesterday.  Even one of my One Pot Specials made little impact on being surrounded by Chinese people who have taken over her life.  She can’t understand most of them; as they shout out their instructions to her.  None of them are friendly and she doesn’t understand why they don’t go back to their own country to find work.

I decided to flag up Maureen’s reality to a member of staff.  This also gave me an opportunity to clarify the nature of today’s meeting and what might lay ahead.  When I returned to Maureen she was listening to Cat Woman, as we later christened her, wax lyrical about her pet.  This gave me an opportunity for distraction as we both laughed about some people thinking their pets loved them.  It also gave me an opportunity to tell Maureen how she is the most important person in my life despite my pleasure from watching wild animals in our garden.

Unfortunately, the wifi signal is poor in Konar.  That means we are not able to indulge in one of our daily pleasures.  When I got home I  put Wille and Keith on YouTube to remind myself how fortunate I am – we still have it all!

Dementia: A Rapid Response

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Image result for a very rapid response picture

I became very concerned when I visited Maureen yesterday morning.  It didn’t worry when she told me she was waiting to tell her Aunty that she had dropped her son at school.   She was clearly delighted that she had solved the heating problems in the school with a friendly chat with the caretaker.  Maureen was time-traveling; talking about something that could have happened over fifty years ago. What concerned me was how she was feeling about being on the Konar Suite.

Maureen told me in a number of ways that she felt she was being treated as if she was stupid.  She said she was absolutely fed up of being told what to do: when to change her clothes, how to dress when to take her tablets etc.  To an extent, this is a familiar tale that is sometimes repeated when she is at home.  However, what concerned me was her feelings that she would have to stay in the hospital forever if she didn’t toe the line.

I thought it was important staff for on Konar to hear her concerns.  Their response was impressive with a Nurse hearing her concerns who then asked the Ward Consultant to pop in for a chat.  This gave Maureen a chance to vent her concerns and although we heard ‘they are getting to know her’ and ‘nobody likes being in hospital’  I’m optimistic they will take her concerns on board.

Maureen contends that she has done nothing wrong and cannot understand why she is being detained.  She accepts that she has problems with recollecting recent events but doesn’t consider she is a danger to the general public.  I’m not sure that she has grasped that the Consultant is going to put his Treatment Plan before us on Friday.  She just wants to go home and get on with her life.  Unfortunately, it is not going to be quite that simple and my understanding is that the process for discharge from Konar to wherever will take some time.

 

Dementia: One Day At A Time

Mixed Dementia

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!

Dementia: Imagine

Mixed Dementia

Imagine:

  • 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!

Dementia: Battling Giants

Mixed Dementia, ,

Image result for David and Goliath picture

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!

 

 

 

Dementia: The Tipping Point

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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 Day by 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: Our Pocket Rocket

Mixed Dementia, ,

Image result for Little Miss Pocket Rocket pictureShe won’t be with us today our Pocket Rocket.  I was tempted to call her Little Miss Dynamite until  I heard what a Senior from her Care Agency called her.  She will be back tomorrow and Friday so she will then have been with us for four days this week.

Our PR generally has Maureen in the palm of her hand but yesterday she was sent to Coventry during the early part of her shift.  Maureen ignored her greeting when she walked in the door and appeared to be sulking during the early part of her shift.  When I returned home after my shopping mission all was fine and dandy; with the girls busy as music played in the background.  With five minutes of her shift remaining the PR enticed Maureen upstairs to make sure she was well clad for the rest of the day.  How on earth she managed to get Maureen into sensible gear in that time I will never know – it can take me half an hour!

I haven’t a nickname for today’s Girl Wednesday. She used to be a regular until she changed her shift pattern.   She is another excellent carer who always encouraged me not to pander to Maureen.  I always welcomed such gentle guidance from an old hand.  It will be interesting to hear what she makes of Maureen’s presentation today as she hasn’t seen her for a couple of months.

I clearly need to eat my word this morning after another challenging night.  It was after midnight before Maureen dropped off.   It looks as though she is getting used to Lorazepam – half a tablet no longer has the impact it previously had.  I will get our GP’s advice on upping the dose.  I will also contact our Key Worker to request a couple of Night Sits to see if that can help us through this challenging period.

My Admiral Nurse is expecting my phone call today and this will give me an opportunity to discuss the prospect of Maureen going into the Konar Suite – there are no beds available at the moment.  I’m fully aware that Maureen might need ongoing medication and that could be the outcome of a stay on the KS.  Despite my reservations about medication being the answer, I’m impressed by NAViGO’s attempts to help patients understand bthe:

Image result for konar suite grimsby picture