Sunday 25 April 2010

turbulence ahead

I had a phone call on Thursday to tell me that Mum had "had a fall" just outside her room and was on her way to hospital to be x-rayed. I was tempted to get in the car straight away but I was advised to wait until the results were in. It turned out that there were no broken bones and Mum was back by the evening. I resolved to drive over on Friday.

I arrived in the early afternoon, and found Mum quite happy and not suffering any pain. Sitting in the Lounge, we had a cheerful conversation with a few of the other residents. Mum's face darkened a couple of times when she told me that she hadn't fallen but had "been pushed over by two girls". It was clear to me that she was referencing a childhood story that she repeats frequently, but the Home had launched an investigation into the incident on the basis of Mum's allegation. I was able to add some context there, hopefully saving them some trouble.

Life in the household is very calm these days. A couple of the more troublesome residents have moved on (one died, the other was placed in another home), and the atmosphere has noticeably improved. The staff have more time to spend with the residents and the residents, in turn, aren't annoyed or distressed by the old troublemakers.

However, there's a problem ahead.

The Home has decided to create a "High Dependency Dementia Unit" to cope with exactly such difficult cases. And they have decided that they want to base this Unit in Mum's household. The Relatives were "consulted" last week (I was unable to attend), but apparently the meeting went badly. The Home presented a fait accompli, telling the Relatives that the plan was going ahead - the specialist staff had already been hired. In turn, the Relatives told the Home that their elderly charges were happy and settled and were NOT to be moved. It seems that the Managers were a little stunned by the vehemence of the reaction. This might look like a stalemate, but I was told that they will simply wait for natural attrition and then move more "challenging" cases into the vacated rooms.

This means that the idyll is doomed.

Of course, this all comes down to money. There is FAR more money to be earned from the State in looking after difficult charges. I am bitterly disappointed that this organisation - a charity - is behaving in a fashion more suited to a business in seeking to maximise profit ahead of the wellbeing of its existing residents. I'm all for them starting up a new unit, but I wish they would leave their existing clients to enjoy a peaceful and relaxing end to their days. If only a "calm and pleasant" unit was prized (and priced) as highly as a "complex and unpredictable" one.

Mum could, of course, be moved to another household in the Home, but she would lose contact with the staff members on whom she currently depends, to whom she has grown close. Also, I chose Mum's room very carefully - it is at the end of the household, away from the noise of the Lounge and with a very pleasant view over the garden and a field. If Mum were to be moved to the first available room in another household, she is bound to suffer from the upheaval and she would inevitably be placed in a less advantageous room. As someone who is paying full whack for Mum's care, I feel outraged that decisions like this have been taken without my consent. It's like paying for a good hotel room and then being switched to a budget chain after a few nights.

I have made several attempts to speak to someone at the Home about this but have been fobbed off, told that someone will call me back, which doesn't happen. On Friday, I was told that the person who had been avoiding my calls was now on leave, but that the General Manager would speak to me later - he then left early. I am becoming annoyed about this. I intend to pursue this one and raise some publicity about what's happening.

Sunday 4 April 2010

school report day

I found Mum sitting at the desk in the Lounge, having just taken a call from a relative. She couldn't remember who it was that had just rung off. Her Key Worker told me that it was her Cousin.

Mum looked well, but was wheezing and very out of breath by the time we got to the armchairs. Ever since my Father died from Pneumonia, I've been alert to low lung function, so I checked with the Key Worker, who showed me records to prove that Mum had been seen by the Doctor. Apparently, all is well with her lungs, so it's a bit of a mystery why she's short of breath. Mum and I sat there smiling and holding hands, with nothing much to tell each other about our lives.

The Key Worker took the opportunity to sit with me and go through Mum's 'Life Plan', checking that I was still in agreement with various protocols in place around Mum. The only one that had changed was that the sensor under her mattress now alerts staff immediately once she rises during the night, so that they can come and help her in the bathroom. Originally, the alarm had only sounded if Mum didn't return to bed within 10 minutes, giving her time to see to herself. She is past being able to cope now, and the Key Worker was quite frank that Mum is now essentially incontinent.

It was surreal to be sitting next to a beaming Mum all the time that this was being discussed. The Mum I used to know would have angrily denied most of the stuff we were covering. Sometimes it makes me feel so guilty that I find it easier to like this version of Mum. She's much more easy-going and non-judgemental.

We discussed Mum's activities. Mum always claims that they don't do anything, but it turns out that she goes to every single event in "The Venue": sing-alongs, poetry readings, bingo, movies and dances. I was treated to some charming anecdotes about her participation. It seems that Mum is going through a bit of a jewellery-flaunting phase, and regularly returns to her room to add another rope of beads or a broach to add interest. She's still competing for the attention of any young men who come onto the household, with a view to securing a boyfriend.

The Key Worker asked me what I thought of the ever-changing decorations around the room. I told her that I felt reassured, as a relative, to know that the staff themselves were taking the trouble to make artwork for the walls - this month the walls are alive with Easter Eggs and Bunnies and there were some South Park-esque wall decorations which included real twigs and artificial birds. I told the Key Worker that seeing the effort that the Care Staff put into the decorations helps me believe that they are committed to more than their shifts. This went down well because, apparently, the Management are considering installing permanent artworks and banning the "tacky decorations". I was asked to complete a questionnaire on the issue and I was lavish with my praise of the team's efforts. I made the additional suggestion that maybe the residents themselves should be involved in making the decorations, but conceded that this would probably require more staff members to supervise the activity.

This is when I learned that the Care Team are also resisting the Management's decision to cut staffing to the level of 2 workers per household. As the Key Worker told me, this would mean that the residents would be unsupervised any time that both workers were needed to lift or bathe someone. The staff are currently documenting everything that they do in an effort to justify the presence of the third staff member. I am somewhat alarmed that the Management is trying to cut costs in this way whilst the fees I'm paying rise ever higher.

Mum's overall 'Well-being' report was very positive: she's relatively active and participative, sociable and friendly. She shows some awareness and can ask for help. I left the Home in the evening, feeling happier about the Care Staff, who seem more attentive than they were last year. I've seen a marked improvement over the past months, since the Gerry Robinson TV documentary. Simple changes, like sitting down to eat alongside the residents, can make a huge difference in normalising the experience for everyone.