Caring

All posts tagged Caring

Happy pills are here again…

Published 13/08/2014 by damselwithadulcimer

It’s been a long journey since mum broke her hip nearly eighteen months ago, and was then diagnosed with Vascular Dementia earlier this year. At one time I used to visit once a week and we would generally go for a pub lunch or afternoon tea, now I visit twice a week and have trouble finding things to talk about. As time goes on she has less and less interest in the outside world, friends and family and no longer follows her beloved soaps on the telly. Her frailty and disability mean that leaving the flat involves a great deal of effort. An able bodied person would feel tired contemplating the difficulty of getting her ouside and into the car.

Initially Careline, with its accompanying red buttoned bracelet was a safety back up; now it is pressed with increasing regularity and ambulances arrive and paramedics pick mum up from the floor when she has fallen and persuade her to go to hospital when they think it necessary. There are the other occasions when she summons help but can’t hear the responder at the other end, so of course they send in the emergency services as a precaution – what mum refers to as the army and the navy arriving. We’ve given up dashing over when Careline phone telling us that mum has been buzzing: we are aware of our physical and mental weaknesses and the need to try to conserve our strength. As she still refuses to move to residential care, we remain on alert, anxious and worried what each day will bring.

When we were visiting every day after mum’s discharge from hospital with a repaired hip, we soon realised that we couldn’t carry on indefinitely. The almost daily hospital visits, plus more than three weeks of going to her home every day (in my case remaining until she was safely in bed at night) began to take their toll. So we scaled back, in my case to twice a week as I have already mentioned.

I could feel myself becoming tired, ratty, irritable and tearful, but believed I needed to do my best for my mother. Whenever I felt exhausted it somehow never seemed like exhaustion when I moved on to the next level of even greater fatigue. For some months I (who rarely have trouble sleeping) have been suffering from various degrees of insomnia.

I gleefully pounced on the opportunity of taking a course of stress management workshops provided by my local Carers organisation. Believe me it is easy to do the theory, but trying to practise positive thinking, flip the negativity and fit in relaxing meditations is not as easy as you want it to be. We all bonded well and it was therapeutic to discuss our caring roles and their challenges with others in a similar position.

I also attended dementia awareness workshops, which will lead to another regular support group. In addition I have been seeing a counsellor for about a year and trying to work through problems that go back to my childhood and are now compounded with everything else happening in my life.

The final straw was when I needed to visit my GP at the weekend and the waterworks welled up again. She insisted on anti-depressants and I didn’t argue. If they take the edge off the anxiety and the stress I don’t care. This hamster is unable to climb out of her wheel at present, so she keeps whirring round and round and swallows her pills like the good little girl mummy taught her to be.

 

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.

Crisis Calls Again

Published 14/07/2014 by damselwithadulcimer

Whilst out shopping on Saturday afternoon I took a phone call from Careline (the company that my mum buzzes through to when she needs help or has a fall). They told me that she was having difficulty getting out of her chair and had asked for assistance. I explained that it would probably take about an hour to drive across London and by the time I got to her home her carer would be due to make her afternoon visit. Sometime later my sister phoned to tell me that the carer was very concerned as our mum was feeling dizzy. So I packed a small bag and headed out, unprepared for the traffic jam, which did nothing to alleviate my worries.

On arriving at mum’s I found her in bed and it took us four attempts, at intervals of a few minutes between them, for her to be able to stand and keep her balance. Whilst she was resting before the fourth effort I dialled 999 and requested an ambulance. Once she was up and seated in her armchair, which seemed like an extra long walk with the Zimmer frame as far as she was concerned, she seemed fine and we chatted about the past. In the meantime my sister also phoned back to tell me she was leaving her friend’s house (in Hampshire) and wondered whether she should also come over. She decided she would and arrived before the ambulance, which turned up nearly four hours after I had placed the original phone call. I’m not casting aspersions or complaining as I made it clear that it wasn’t an emergency visit, but that I believed mum needed to be seen by professionals. I knew it was fruitless to try to contact a locum via her GP’s surgery. From experience I know that a doctor would be reluctant to make a house call, even for a disabled octogenarian, and would try to persuade us to take her to the hospital. Has said medical person ever met my intransigent, stubborn, single-minded mother?

The paramedics were absolutely fantastic. They tried to calm two stressed not-so-young daughters, explained how we should try to look at things from mum’s point of view and not our own. Pointed out that she probably had mental capability (which they later confirmed was true) and reinforced the stress awareness training, which I am currently undergoing. The upshot is that if she wants to remain at home, whatever the risks, she has every right to stay there. She has no idea how we worry and anticipate the worst (another aspect of my workshop that I am trying to put into practice). Do not project your fears onto events that you cannot control and that may or may not happen.

They eventually turned their attention to a sleeping mother, who reacted by telling the two of us to go home and leave her alone. She even suggested that we be locked away in the ambulance. Finally she agreed to be taken to A&E, with my sister driving behind the paramedics. I was so tired that I was unable to go anywhere, so agreed to remain behind and cat sit for my mum’s beloved Millie. So around 1am I crawled into mum’s bed and tried to sleep. Would you be able to close your eyes for long under the circumstances? The flat is like a sauna, and the temperature must hover around the high 20s, even in the summer. Every time I dozed I was woken by something: the rain, sounds of other people entering the block, the cat jumping in and out of the window. I seemed to be checking the clock every hour until my sister phoned around 7am to tell me that they were coming home.

Once back she informed me that mum had been diagnosed with another UTI and this could possibly be affecting her blood pressure. Although mum’s is always on the low side, it was not adapting when she raised herself to her feet, causing the dizzy spells. They have also recommended that her doctor refers her for a CT scan, just to assess her brain activity.

So two women finally left their mother in bed at around 9.30am yesterday morning and drove to their respective homes, bleary eyed and concerned for their mother’s safety. We will still try to persuade her (very gently, no bullying or cajoling) of the merits of a residential home where there will be somebody to care for her round the clock. Is this for her own benefit and safety or is it so that we can drop our vigilance and stress levels? Who can say? I’m sure I worry far more about her now than I did about my children when they were growing up.

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.