Tag Archives: Distress

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: Real Suffering Verses Compassion

Mixed Dementia,

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!

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: Reviewing The Situation

Mixed Dementia, ,

Maureen is very shaky this morning.  She is more confused than ever and unsteady on her feet.  A small amount of lorazepam has given her much needed rest and some respite from her delusions.

I’m currently reviewing our situation.

Dementia: Coaching Needed!

Mixed Dementia, ,

 

Image result for Coach needed PictureA frequent lack of cognition, paranoia, hallucinations, and anger are now constant features of Maureen’s presentation.  Last night was a belter.  The old chestnut of finding the toilet and how to use it reappeared.  This was followed by a diatribe on my misdemeanors and shortcomings.  Then comfort was sought as I slept in the spare room as Maureen believed ‘the girls were gassing her as they didn’t like her’.  A  short while afterward I was forcefully told ‘I was not doing’my job’ as I encouraged her to get her own drink of water.

Maureen’s presentation is seen as par for the course for mixed dementia so a Care Coordinator is not needed.  Yet Trazodone has been prescribed ‘to make my life easier’.  Following my reluctance to administer, a planned admission to an Acute Mental Health Unit – the Konar Suite – was on the cards.   Now that is not seen as the way forward we are left with the Best Interest Meeting on Maureen’s future care and accommodation in four weeks time.

Our Key Worker is visiting this afternoon and I will ask him to clarify who is responsible for coaching me on how to resolve the recurrent ongoing challenges.  A meeting in four weeks time may be helpful to those who are concerned with the Mental Capacity Act but I need mentorship now!

Someone who doesn’t need coaching is a new carer we had yesterday:  she was excellent from the time she took Maureen’s arm when she met us on the street.  Maureen fell asleep shortly after she was nursed home and new Gir Saturday/ Sunday helped me to mop up from the flood that Maureen had caused by leaving the tap on with the plug in a sink.  Just another occasion when I’m wise after the event: plugs and sinks don’t mix when dementia is around!

Dementia: Diagnosis Needed

Mixed Dementia, ,

Posted at 4 am:

 

Image result for Type of Dementia Picture

 

Maureen needs to be seen by her GP this morning after another dreadful night.

She had just laid down on the sofa after ‘being on a boat’ for the last five hours.

She is awake now: looking for her mum and frightened about being left on her own

I am asking the GP’s advice on how to manage her current presentation.

I am also formally requesting a review of her diagnosis .

Is her dementia predominantly vascular, Alzheimer’s or something else?

A Best Interest Meeting in a month’s time is no help to me in the middle of the night.

We also both need to know if our coughs and colds are anything more sinister!