Tag Archives: Good Practise

Dementia: Distract and Redirect With Helium

This morning I have used helium to distract and redirect Maureen.  Half an hour into her birthday she was crying that she wanted her mum.  I tried to console her for a while before encouraging her to seek further sleep.

Once she was in the land of the nod I fetched a helium filled balloon with ‘Happy Birthday’ on it from my car.  She stirred when I came back in the house and was very pleased to be reminded that it was her birthday.  I then decided to begin the birthday celebrations by calling up appropriate songs on YouTube.

The early morning birthday party continued for a couple of hours.  I’m not sure how we will spend the rest of the day.  I have suggested visiting family but her understandable reaction has been: ‘why should I go and see them, they should be coming to see me?’

I very flattered by Maureen’s thoughts that she just wants to spend the day with me.  However, I hope we are able to catch up with some people who are never too busy to show Maureen how much they love her!

Footnote: I have blanked out Maureen’s face following safeguarding advice.

Dementia: Dreams and Reality

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The times I really feel out of my depth here is when Maureen wakes up after a sleep.  Yesterday was a prime example of my struggle on this front as she awoke from her afternoon nap convinced that ‘her sister was missing in the water’.  It was one of those occasions when I decided it was advisable to challenge her reality by telling her that she had probably been dreaming as we hadn’t seen her sister for months.  I even suggested that she should make a phone call to confirm that her sibling was safely at home in Nottingham.  She replied that this would be pointless as she didn’t know where we were herself!

Our Key Worker contacted me yesterday to touch base after being on leave for over a week.  He was obviously concerned about the early morning events and wondered if such episodes were becoming more frequent.  He has also raised concerns about the back up that would be available for Our Night Sitter with my plans for her to be on duty for 48 hours in mid-August so that I can go to the Buddhist Centre in Pocklington. Therefore, we have agreed to have a catch-up meeting on Friday morning.

I’m very conscious that my Blog is becoming a place where I concentrate on the extremes of Maureen’s presentation.  The events of Monday morning meant that I didn’t share a very positive experience from Sunday morning.  With an LP by Roy Orbison on the deck, I decided to try a little art therapy.  As Maureen sang along with Roy she even added the ‘GRHH’ in Pretty Woman:

She coloured in a picture for a while and even wrote me a message. Unfortunately, the book that we were using has gone missing, so I can’t share her work. What was interesting was her that phonetic spelling of my name as ‘Parl’ and you as ‘yoo’.  I’m out of my depth trying to draw any conclusions from her writing.  What I do know is that playing familiar music in the background seemed to encourage Maureen to participate in new activities and is a strategy worth repeating.

 

 

Dementia: Having It Off

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After a very disturbed night, at silly ‘o’clock, I have decided to have a day off.

Girl Sunday will cook today’s lunch and it’s ready made pizza for tea.

All social media is being switched off for the next 24 hours.

I’m about to try to get some more sleep.

Have a good day.

Dementia: I Got Them Off!

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I’m counting my blessings following some positive developments this week, culminating in ‘getting them off Maureen’ this morning.

Our New Girls are both excellent additions to our team of carers and our Agencies are on board with sending the same people each week.  Our builders are making good progress and scaffolding is now a feature of our back garden.  Any fears about the impact of the work on Maureen have been dispelled as her interest has grown with workmen being around.  In house ‘building stimulation therapy’ goes on throughout the day with benefits to us all: stimulation for Maureen and a greater understanding of dementia for our builders.

Our New Girls are both excellent additions to our team of carers and our Agencies are on board with sending the same people each week.  The builders are making good progress and scaffolding is now a feature of our back garden.  Any fears about the impact of the work on Maureen have been dispelled as her interest has grown with workmen being around.  In house ‘building stimulation therapy’ goes on throughout the day with benefits to us all: stimulation for Maureen and a greater understanding of dementia for our builders.

As a Care Partner for someone with vascular dementia you are always walking a tightrope: ‘you think you’ve got it then it changes’ as Maureen’s Care Coordinator often said.  Girl Thursday found herself in that position yesterday just as she was about to ease Maureen into the shower she backed out.  I managed to carry on her sterling efforts early this morning and ‘got them off, Maureen’. and accompanied her into the shower.

Many thanks to all those people who suggested how to resolve Maureen’s reluctance to take a shower and change her clothes: particularly The Dementia Sherpa. – one of her suggestions was the turning point in bringing this long running saga to a positive conclusion.  There is also a helpful article in the Alzheimer’s Reading Room on how to deal with a reluctance to take a shower.

It’s Maureen’s birthday on Wednesday and I’m really not sure how to celebrate the passing of another year.  As always she would prefer spending the day quietly together.  It is reassuring that family accepts that now dementia is a factor they need to be circumspect about how they handle her special day.

Today’s Good Music page expresses my gratitude to those who have helped us to have a good week.  Who better to express our thanks than The Scaffold!

Footnote: Maureen took off her own socks and as things developed this morning!

 

Dementia: Reviewing Our Routines

I have always found it difficult to settle down after a holiday.  Sometimes I have really struggled to get back into my old routines after a short break in the sun.  My Respite Break has left me with a feeling of uncertainty about where to pick up the reins of being a Care Partner for Maureen.  Therefore, I have decided to draw on the work of two fellow bloggers to help me review my routines:

Henri’s post on ‘How to have a good day’ is giving me a creative start for my mornings.

Christy Turner (Dementia Sherpa) has posted a helpful approach to communication:

We both slept well again last night.  The new sleeping arrangements are clearly paying off.  However, Maureen woke in the night with familiar concerns about being left by herself and then said: ‘I wish someone would adopt me but I suppose I’m too old for that’.  When she woke a couple of hours later she said ‘will someone please help me’ as she couldn’t remember where the bathroom was.

Maureen’s Carers have also been encouraged to review their routines.  Our Key Worker has revised our Support Plans emphasising the importance of taking Maureen out for walks and engaging her in stimulating activities.

It will be interesting to see how Maureen reacts to the new routines.  I’m optimistic that her thoughts on adoption will fade as we all seek to engage her in positive pursuits!

 

Dementia: A Piece Of Cake

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Shortly after 2 pm yesterday, our Key Worker eased Maureen into Alderlea Care Home with the prospect of coffee and cake.  Her trust in him is well founded.  It is lovely to watch his person-centred approach, which has clearly won the trust of someone who is often suspicious of the motives of professional staff.  We are very fortunate to have a Key Worker who is passionate about ensuring Maureen remains at home!

From what I have seen so far Maureen is in good hands at Alderlea Care Home for the next week.  My reception when I turned up unannounced yesterday morning was first class.  Despite being in the throes of a busy morning everyone I came into contact with made time for me and gave me positive vibes about the place.

One of my shortcomings is that first impressions count with me and the last time I popped into Alderlea I didn’t like the look or the feel of the place.  In retrospect, my judgement may have been coloured by seeing a dear old friend who had become a shadow of herself.  Sadly this beautiful lady has passed away as have my memories of being shocked by her decline.  Yesterday, I saw the place through different eyes: somewhere full of potential for my dear wife to have a positive experience.

The room allocated for Maureen has been nicely decorated and has the view of a garden that she will be able to walk around whenever she needs fresh air.  Alderlea is very spacious and there are lots of areas to explore and plenty of places to sit including a large conservatory.

Before I bade our Key Worker farewell yesterday and thanked him for his support I outlined how I saw how our Support Plan needed review:

  • Respite breaks every 4 weeks ( something I have been reluctant to accept)!
  • Carers to focus on stimulation and activity rather than providing a sitting service
  • Carers to provide lunch at the weekend.

I will be with the early birds at the Leisure Centre shortly to loosen up this old body of mine.  On my return, I will begin to make some headway in another mountain of paperwork and take action on some pressing matters.  I will leave Alderlea to it for the coming week confident that they are well qualified, as a Home that specialises in dementia, to look after Maureen: I know they will contact me if they need to!

 

Dementia: ‘Listen To Carers’

As Carers Week draws to a close Beth Britton makes a salutary point: ‘Listen To Carers’. This extract from her blog, D4Dementia, is reproduced with her kind permission:

‘My interview with Havas Lynx where I talk about the wealth of knowledge and experience carers have and the importance of capturing that

The challenge for all of us, however, is to find ways of capturing carer knowledge – at every juncture of a carer’s life – to benefit others, be they family carers or professionals. And if you are a health or social care professional, NEVER consider yourself more learned or accomplished than a family carer, be they a current or former family carer. That unique pull of circumstances and emotions creates a rarefied learning experience that really is – both positively and sometimes negatively – second to none’.

I consider myself very fortunate that our Key Worker always stresses the importance of ‘being led by me’.  He made this point again yesterday when I was asserting Maureen’s presentation is often a reaction rather than evidence of progression of dementia: time will tell if I’m really getting my message across!

Dementia: Positive Risk Taking In PJ’s Paid Off

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When Maureen woke in despair yesterday I knew I had to pull out all the stops to try to shift her mindset.  I went for it throughout the day and my positive risk taking paid off with a beautiful climax in the evening.  It took me a while to decide whether to go for it as Maureen sat in clothes that were all inside out with pants on top of her pyjama bottoms.  However, I thought in for a penny and got more than a pound.

Maureen is transformed this morning after seeing her aunt and uncle.  She can’t stop thanking me for taking her to see them.  Seeing her with those who loved and looked after her as a little girl is priceless.  Listening to them they reminisce about the good old days is heartening. The amazing thing is my misreading of a crucial matter – I was frequently trying to steer the conversation away from Maureen’s parents for fear that her relatives would confirm they were dead: Maureen assures me she was on the same mission!

Wearing PJ bottoms paid off earlier in the day when Maureen had popped out by herself.  I heard the locked front door open as I was in the bathroom.  Maureen had scarpered before I could get some clothes on but I soon found her a short distance away being steered back home by some locals who had spotted her unusual attire.  I caught up with them as they were about to phone 101 about the lady with a key in hand who was looking for ‘her friend Paul who would have her dinner on.’

I’m not sure if there is a moral to this story apart from you never know what you are going to get with vascular dementia particularly if you are dressed appropriately.  One thing for sure we need to pop into the local Spa Store more often as the assistants there gave Maureen such a lovely start to the day yesterday.  They helped her to choose which cordial to buy and gave her so much more.   As she offered them a £10 note she had them in stitches as she bantered with me about all sorts of things.

All staff at our local Spa Store are dementia friendly and such support in the local community makes a real difference to our lives.  I’m just wondering if we pop down there shortly if it would distract Maureen from her current focus of us ‘getting a move on or we will miss the bus to take us back home.’

Dementia: The Second Great Escape

Image result for The Great Escape pictureYesterday the weather prevented me from responding to my mum’s inevitable plea:  ‘have you come to take me out?’  As plans for the ‘Great Escape’ were being formulated the heavens opened and the rain stopped play.  When I returned in the afternoon for a second strike mum was fast asleep in an armchair in the lounge of her Care Home, so I left her to rest.

When I called to see my brother earlier in the day he was asleep in a chair in his Nursing Home.  They roused him after my arrival as it was time for lunch.   Following ten minutes of lovely smiles and friendly wordless gestures, I left him to be spoon fed his lunch.

I have no doubt that my mum and brother are being well looked after in their respective homes.  They are both popular residents and staff go the extra mile to meet their needs. I know that Maureen will be getting similar treatment in Ashgrove:  her carers were really pleased to see her when we dropped her off last week.   I also realise if I go to see her today she will pose the same question as my mum: ‘have you come to take me out (home)?’

Sun greeted me as I returned to Cleethorpes this morning after leaving Coventry as dawn was breaking.  Despite driving over 100 miles I feel in good form after almost a week’s Respite Break.  I can see no reason for Maureen to stay in Ashgrove any longer and when I pop in to see her a little later I know that rain cannot frustrate today’s Great Escape!

 

 

 

 

Dementia: Early Diagnosis

Excellent news from:

AoFNHSS Hi Res

‘Dementia diagnosis in Cumbria now four times faster thanks to ‘virtual clinics’

‘New virtual clinics in the Memory Matters team at Cumbria Partnership NHS Foundation Trust means patients suspected of having dementia are able to be diagnosed four times faster than before.

This is because the whole referral to diagnosis process has been streamlined.

David Storm Senior Clinical Services Manager explained: “Staff in the Memory Matters team at Carleton Clinic Carlisle have been piloting Virtual Clinics since early in 2015. There have been radical changes in how the team works. Previously patients who were referred to the team by their GPs went through a long diagnosis process which included being seen initially by a mental health nurse for assessment, tests and brain scans requested, then sometimes a substantial wait for a follow up 45 minute appointment with a Psychiatrist.

In the Virtual Clinics new referrals are screened, the patient is then seen for a full assessment by a nurse including elements previously done by a Psychiatrist. A brain scan is then requested, together with other assessments with the person and their family. The ‘virtual’ part is next; the nurse will present the case – without the patient, to the Psychiatrist and Memory Matters team, so all the experts needed are in the same room. An in-depth discussion is held which takes into account the patient, their family and carers, as well as all the assessment results. A diagnosis and appropriate treatment plan is made based on the information at hand. The diagnosis is usually given to the patient by the same nurse they have seen at the initial assessment which makes the patient feel more comfortable.

Virtual Clinics have now been rolled out across Cumbria. The new diagnosis process means that the patient is being seen by less people and the process is speeded up. This is incredibly important considering the increasing numbers of people with dementia in the county; the number of people being referred for diagnosis has nearly doubled in the last year*.

Dr Darren Reynolds Consultant Psychiatrist said” More patients are seen in much less time. Nurses carry out high level assessments, share knowledge and there is a much better outcome for the patient”.

Helen Todd, Senior Nurse in the community mental health team said: “The Memory Matters team continually challenge themselves on how they can keep improving and what they can do better. Referrals have increased by almost 200% in the past 12 months and a diagnosis is now given 4 x quicker than previously. There is a much better use of resources within the team and no there was no need to recruit any extra staff so we are far more efficient. Now there are no waiting lists and patients are seen within 15 days. Also because of the team’s #seethePERSON project, which focusses on the person behind the illness – all people referred are seen from their perspective, placing Dementia into the context of their life as a whole and focussing on improving quality life, not just the symptoms which benefits both patients and families”.

Feedback from GPs is very positive. Some comments were “Great idea, no negatives from me!” “It has been great – patients seen quickly, tested and given a management plan.” “I think it’s working well. Same nurse equals consistent assessments. We couldn’t get this detail in primary care without investing lots of time. Allows Consultants to see the more complex”.

Footnote.  The above article is another example of the Academy sharing Fabulous Stuff.

Yesterday:  I caught up with some good folk from Navigo to thank them for their support over the years.  Just by chance,  I had the good fortune of catching up with a Crisis Worker who asked me if I remembered him.   At first,  I confused him with another member of staff,  then I recalled some advice he gave me that was fundamental to moving on from depressive episodes: ‘never go to bed without having plans for the next day’.  Anyone who has ever had depression will know how scary it is to wake up in the morning and have no idea how you are going to fill your day!

I also made good progress on a number of domestic issues that have been hanging around for a while.  Hopefully, this will mean that I’m a little more relaxed when Maureen comes home from Ashgrove Care Home on Monday afternoon.

This morning:  After another early start to the day, I have already taken in both the Fureys and the Highwaymen in concert and will be leaving shortly to join the early birds at Cleethorpes Leisure Centre