Carers

All posts tagged Carers

When Mary Poppins came to visit

Published 21/08/2014 by damselwithadulcimer

Once mum had been bedridden for more than a week we began to get seriously concerned and made contact with the GP, who acted swiftly and put one of the Community Matrons in touch with me. Two days later she visited mum to assess her needs. We also decided that it was time for mum to have round the clock care and organised a roster of known and trusted people to stay with her overnight, whilst seeking out a new care agency that would be able to provide continuous daytime cover.

This was all in place when Sarah visited to carry out her assessment. She swiftly took charge, insisted mum mobilise to the bathroom and gave a few pointers to the carers. Mum will now be prompted to take in more fluids, as she is obviously dehydrated, and will be encouraged to try to eat a little more. Food will be given to her, rather than her deciding that she only wants bread and butter. She will also be encouraged to get out of bed, with lots of help. I was amazed when I watched Sarah escort her (plus Zimmer frame) along the hall as I was convinced that she was far too weak to manage. The difference between a health care professional is that they can employ the firmness that a daughter, who has been brought up to be obedient, cannot. Just like Mary Poppins, Sarah is firm … but kind.

Sarah demonstrated her skills and training when she told me that she would be in touch with the GP to ask for a home visit, would contact social services on our behalf, would arrange for bloods to be taken and would also contact the domiciliary podiatry service to arrange a visit. She has also ordered a hospital bed to be delivered next week, so I need to arrange for collection of mum’s double bed. Sarah is a far cry from Hattie Jacques’s matron in the Carry On films, but every bit as capable, knowledgeable and caring.

To complement her input there is also the new care agency. They carried out a thorough evaluation of mum’s medical needs and medication, a risk assessment of her home, wrote out a detailed daily care plan (which was also augmented with Sarah’s suggestions) and asked me about mum’s interests and the work she had done before she retired.

I’m feeling far more optimistic and reassured. Some of the weight and anxiety have been lifted off my shoulders thanks to Sarah and the girls from Insta Care

Infections and Hospitals

Published 13/08/2014 by damselwithadulcimer

It’s been a difficult time. When visiting mum a few weeks ago she was having trouble getting out of her chair; I put this down to a mobility problem and helped her up. The following day I had a phone call from Careline (the company that responds to her calls for help when she presses the button on her bracelet) telling me that she was again unable to get out of her chair. Knowing her afternoon carer would be there before me I let it go and hoped for the best. A little later my sister phoned to say that mum had pressed several times (in fact about 12 in total) and that I should go over. When I arrived she was in bed and four attempts at standing up proved futile, so I phoned for an ambulance. She was duly taken to A&E, diagnosed with a UTI and sent home with antibiotics. 72 hours later I had a phone call from a paramedic who was with mum, as she had again pressed for help numerous times. She was persuaded to go into hospital, diagnosed with a chest infection, and remained there for three days.

From our point of view, which was endorsed by her carers and other health care professionals, she really needed to be in a care home. My sister tried to persuade her of the benefits of one we had found not far from where she lives, and that would also allow her to take her cat, her ‘baby’. Still she dug in her heels and insisted she wanted to go home, so back home we went. I organised another assessment with her social worker for the following Monday and in spite of everything he pronounced that she still had capacity and could not be forced to go anywhere she didn’t want to go to. So the two of us continued to operate on high alert with our anxiety and stress levels building, wondering when the next fall or hospital admission would occur.

We didn’t have long to wait before the buzzer was pressed more and more frequently and she was again admitted and kept in for two nights. Her discharge home was not an easy one. She was delivered by patient transport, which was actually a man driving a minibus, and not a paramedic or somebody with any kind of medical training. She beckoned to me with a face like thunder and screamed that she had been waiting since 9 o’clock that morning – it was now about 2pm. I had to help her down to her waiting Zimmer frame, but she was not strong enough to use it to walk into the block and her own flat, so I had to dash back in again for her wheelchair. When I asked the driver if he could just make sure that she was steady until I got back, I was informed by one of the other passengers that he was ‘only the driver’.

By 4am the following day she was again calling for help; an ambulance was duly summoned but she remained at home. Since then she has been more tired and lethargic and when I visited earlier this week she didn’t even have the energy to get out of bed. On the advice of the Alzheimers Society we have bumped up her care so that somebody is with her throughout the night, and we are trying to arrange for care during the rest of the day. At least the presence of another person will stop the panicky demands on Careline, who are often unable to elicit a response because of her poor hearing, so feel they must send another ambulance. One major problem is that the response time can be up to four hours.

We are still working on the idea of residential care, but not sure how on earth we will manage it, especially if she is too weak to get out of bed and walk to the car. In addition the home will initially only assess her during the day and overnight. It is apparent to everybody but her that she needs to be looked after in a caring environment where there are skilled people, friendly faces and nutritious meals. Where there will be somebody to reassure her when she gets worried and confused and above all where she will be in a place of safety. We haven’t given up hope yet, but we have to contend with her independent stubborn streak that makes her too obstinate for her own good.

Mothers and Daughters: in Sickness and in Health

Published 16/08/2013 by damselwithadulcimer

Five months ago my mother did what every daughter dreads; she fell and broke her hip (the precise medical term is a fracture of the neck of the femur).  Our experience of the National Health Service was very different from the headline revelations in the newspapers at the time.

She was initially taken by ambulance to her local hospital, and was then transferred a few hours later to St Mary’s in Paddington for surgery.  We made jokes that the hospital transport was in conjunction with DHL, but she arrived safely, was not lost in transit and arrived on time. In spite of tales of doom to the contrary, the operation to pin her hip took place on a Saturday, she survived the weekend and by the following Monday she was being attended by physiotherapists attempting to re-mobilise her.  It was a slow process, but she was eventually discharged from hospital two weeks after her initial admission with a package of three home carers per day. The local council in conjunction with the hospital also supplied a frame around the lavatory, a commode for use in the bedroom (to save walking to the bathroom at night) and fitted a rail to the side of the bed.  The Zimmer frame that came home with her was a godsend.

The hard work began once she was back in her own flat, which is luckily on the ground floor.  The first carer arrived around 7.30am on the day after discharge.  Unfortunately mum was not completely wide awake when the bell rang and she managed to fall on her way to opening the front door.  The paramedics were again summoned but no damage had been done so she wasn’t taken back to hospital.

From then on the daily visits were shared by the three carers: one in the morning to help her up, get washed and dressed (initially it was just to change one nightdress for another one), get her something to eat and prompt her to take her medication.  The lunchtime carer saw to food and medication, and the evening carer took charge of a strip wash and change of night-clothes, as well as reminding her to take her pills.  In addition my sister and I visited every day for more than three weeks, fussing over her like mother hens and attending to every other need, and probably doing far more than we should.  We actually overdid what was necessary and encouraged more dependency than we should have, but that wasn’t apparent until sometime further down the line.

One thing we soon became aware of is of how dedicated the home carers are.  They are paid disgustingly: not much more than the minimum wage and do not receive any payment when travelling between jobs.  The majority rely on public transport and some of them work 12 hours a day just to earn enough to live on.  The media is now drawing attention to the practice by many companies of zero hours contracts; most of these carers, who are employed by agencies, fall into that category.  Our capitalist society values productivity and financial gain over care and compassion.  In a country where the older population is outgrowing the younger members of the community this is a sorry state of affairs that should be addressed at government level.  Most of us will become old or infirm in later life and the value attached to human beings and the care they need is far more important than money made, squandered or gambled by bankers and businesses.  Every housebound elderly person is or was somebody’s mother or father, aunt or uncle, brother or sister and deserves to be treated as a person who matters and should be regarded with dignity and respect.

In addition to the package outlined above, mum was also assigned a care coordinator (as part of the re-enablement service) and received weekly visits from a physiotherapist.  Unfortunately my stubborn, Taurian mother disregarded a lot of what the healthcare professional told her and neglected to do her exercises unless nagged.  The result is that after five months she has still not regained full mobility in her right leg and remains dependent on us.  After five months, journeys outside of the home are a struggle that exhaust her and tire us.  She insists that her legs work, when they obviously don’t, hates using the two sticks that have been provided and insists that she can walk better with one.  Although her GP and her physiotherapist have patiently explained the benefits to her, her mobility and her balance of using the pair, it is an uphill battle.  She flatly refused to use the three-wheeled walker that was supplied and argues against going out in the portable wheelchair that I acquired from a friend.

Thanks to healthier diets and better healthcare we are all living longer.  Older daughters (and sons), such as my sister and myself, will fall into the roles of our parent’s carers as long as we are fit and healthy enough to do so.  Twenty-first century parent/child role reversal seems to be here to stay.