Tag - community care - Fading from Memory

Tag - community care

Thursday 25 January 2007

Compromised

By MP on Thursday 25 January 2007, 17:05 - Journal

Well,

I got a reply to my email to Lana, the case manager, but she says there is nothing more she can do. I wonder. Could there be another nursing service? How much would it cost? Would it be any better? Is there some way the family can try to pick up the process when the nurses drop out?

Something that worries me a little is that she mentioned that Dr Humerus told her about dad's 'injured' rib. Of course, we signed away patient confidentiality when we agreed to let social services help us. The doctor is free to tell Lana anything she thinks she ought to know. But pretty soon the story will get around to everyone and will, possibly, be used to our disadvantage. I wish I had never mentioned it to Dr Humerus now. I am sure I didn't need to.

The social services are a mixed blessing. Instead of just thinking about how to deal with mum and dad, I now also spend rather a lot of time thinking about how to deal with the social services. We seem to have entered phase 2.

The first phase was characterised by them offering services which we didn't ask for, in place of those that we did request. The argument was that until mum and dad were 'comfortable' and 'familiar' with their careworkers, nothing else such as food preparation and other services would be accepted by them. What happened was that mum and dad simply got confused because they could see no reason why they needed companionship from strangers.

The current phase is different. The unwanted services have been withdrawn, and the originally requested ones - food and cleaning - have been instigated and are working well. The other difference is that instead of getting more than we asked for, we are getting less. I think we have come up against the limits of the system. We get the folllowing:

cleaning - two hours per week (one visit)
food preparation - two hours per week (over two visits)
day care - ten hours per week (over two days)
medicine - five visits a week

The two changes just about to take effect are that the food preparation will be extended to three hours over three visits and the medicine will revert to seven days a week.

I suppose the other services that we need to mention are those that we do ourselves:

shopping
weekend evening meals
bills and financial tasks
lawn mowing (contracted out)
laundry
minor repairs

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Monday 22 January 2007

Sunny day, clouded mind

By MP on Monday 22 January 2007, 14:41 - Journal

I spoke to dad by phone today. He seemed much vaguer than normal:

'Dad, it's Mike. Why aren't you at day care today?'
'At what?'
'Day care.'
'Day care?'
'Yes. Echelon.' This is the name of the place.
'Oh, yes. I, I don't know. Maybe, maybe I overslept.'
'No, you didn't, because you called me at eight o'clock this morning.'
'Did I?'
'Yes.'
'Well, I go on a Wednesday.'
'You go on Wednesdays and Mondays, too.'
'Do I? When did that start?'
'Quite a long time ago.'
'It's very hot here.' This seemed to signal lack of interest in the subject of day care.
'Yes. Dad, you were worried about getting your pacemaker checked. The appointment has been fixed for next month.'
'My pacemaker?'
'Yes, you called about it this morning.'
'Oh, yes. You're looking after that are you?'
'Yeah, just leave that to me.'
'It's very hot here. Is it hot where you are?'
'Yes, it is.'
'It's very hot here.'
'There's nothing I can do about that.'

Well, at least he laughed at that.

I am a bit concerned at his apparent recent mental decline. If I look for reasons, I might blame the reduction of the Aricept dosage from seven days a week to five. Since the nurses now come more or less at lunch time (to catch mum in a 'waking' state) they have skipped Mondays and Wednesday visits, because dad is not there to mediate. Consequently, both mum and dad are getting a lower weekly dosage. Would such a reduction have a noticeable effect? I shall ask Dr Humerus tomorrow when I see her with mum.

Off on a tangent...

I mentioned dad's apparent loss of clarity, such as it was, to Rachel later on. She said that dad had called her earlier in the day and had appeared quite coherent. He wanted to ask her if they still made soap the old way, because he couldn't get used to this 'new stuff', meaning the sorbolene that I had installed in place of the drying, grey veined bars of soap that once lurked in all corners of the bathroom, laundry and kitchen. A few days ago he had tried to persuade me to switch him and mum back to good old bars of soap, but I'd resisted on that occasion. Today, Rachel did as I would have done, and conceded to him. We'll have to find other ways to use up the approximately two litres of sorbolene that I had positioned around the house.

I am surprised that so many of the social services' suggestions don't work:

sorbolene doesn't get used
the shower stool is placed outside the shower cubicle when dad showers, mum simply doesn't shower
the cat food dispenser is usually emptied, separated, and misplaced
signs get taken down without being read
food left around the house is just as likely to be secreted away or given to the cats
etc

Meanwhile the basics, house cleaning and food preparation, seem to be working quite well.

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Wednesday 6 December 2006

Small world

By MP on Wednesday 6 December 2006, 16:50 - Journal

Mum was still in bed when I arrived at 11:30, and never really made it to the land of the living all day. She at least answered the door and let me into the house. At my encouragement she agreed that getting dressed was better than going back to bed. She seemed on the verge of getting angry, confused and not in the best of health. Her hair was all skewiff and she had a scratched and bloodshot eye.

Meals on wheels arrived a little late and mum sat down to disturb her food - breakfast of shepherd's pie. Time was ticking away, we had to be out of the house by 12:30 so that the cleaning careworker, Alison, could get to work unimpeded by mum's restrictions and caveats. At 12:23 I managed to get mum equipped with jacket and handbag, out the door and into the car, all the time keeping my eye on the other car parked outside the house. Making sure mum was strapped into her seat, I armed the central locking and dashed over to talk to the driver of the other car who was, as I expected, Alison. A quick briefing on the house and then we were away.

It was very hard work keeping mum entertained for two hours with her in this semi-irritable, semi-conscious state. We looked in at the pet store, the sweet shop, the electronics shop (for spy cameras and the like - mum enjoyed seeing herself on 'TV'). We had a slow cup of coffee at the usual cafe, and made a raid on the supermarket.

It was so pleasant to arrive home to a house smelling of anti-bacterial cleaning substances and soap powder, not rotting food and dandruff. Mum's disoriented state served us well; she was unable to see that the house had been transformed in under two hours: floors shone, sinks and bathroom gleamed, bedsheets rotated slowly in the washing machine. New sheets and pillow cases had been fitted to her bed.

Mum had been in a tight little world of her own ever since waking. She seemed more uncertain - both on her feet and of where she was. She had staggered as she got out of my car, and leaned against its side for support. Perhaps this was orthostatic hypotension. She was not unduly distressed, just a little dizzy, She seemed to focus only on things a foot or so away from her, hear nothing other than what was said right into her face. Her small world.

Dad and Rachel arrived home within the next half hour, and we all had afternoon tea and cake (the third of the day for mum).

Two notable coincidences today: Alison recognised the photographs of Cassie around the house - her son goes to the same school and it turns out she is friendly with Regan. The waiter who served mum and I our afternoon tea at the cafe this afternoon was the same one who served Rachel and I, in a different restaurant in a different part of town, on Friday. Small world indeed.

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Monday 4 December 2006

A good day

By MP on Monday 4 December 2006, 23:19 - Journal

Just like Friday, everything has gone according to plan today. The new careworker, Jenny slipped into the role as effortlessly as Carol, and was welcomed, just as we'd hoped, as a long-lost friend. She prepared sandwiches for mum and dad, washed down by tea and fruit juices. I slipped away before she did.

Later in the evening I returned to the house and found mum and dad happily watching TV. They both seemed in very good spirits. This echoes Rachel's observation, made earlier in the day, that mum seemed quite happy having spent the day at home while dad was away at day care.

The visit to day care seemed to go OK for dad. There was no outing, and the format was slightly different to what he has grown accustomed to on Wednesdays. I am sure he'll settle in just as well.

I also managed to solve a couple of computer problems; one for dad, one for myself. The problem dad had is indicative of his waning skills and comprehension. His diagnosis of the problem, given to me over the phone, was that he 'couldn't do a thing' with the computer. It sounded to me as if it had locked up or crashed into some non-Windows state. No. What he showed me was that one of the fields in his Calendar program was full of the character C, like this:

CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC

He couldn't understand what was wrong. Furthermore, he couldn't understand that the solution to the problem was to click on the field and hold down the DEL key. He no longer remembers the DEL key!

My problem was that I could not get all the machines I visit during my rounds (home, office, friend's offices, Greg's place) to access the WebCam in dad's room. The solution to this has been to set up the server to work with Java clients rather than Javascript clients. Now all machines appear to work properly.

That's all for today.

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