A day in the life the ups, the downs

Having started at 7.30 a.m., I finished my morning calls slightly earlier than expected. so whilst examining my evening rota, I settled down with a cup of well earned tea .
'Good' I thought 'Not many calls tonight, so it should be a nice steady evening. Time to reward myself with a long soak in the bath along with a good book before going out again'
Ten minutes into my wallow, I can hear my phone ringing. I drag myself downstairs dripping wet to find a voice mail asking if I could take on some more calls tonight. Bang goes my bath, as I now need to get dressed and set off an hour earlier than expected. Like NOW!
Strangely enough  though, things were going really smoothly, I even had time to stop off at home half way round for a cup of tea .
I'm in a really mellow mood as I go from house to house, still gaining time as I go. I decide to spend a bit more time with a couple of my ladies; one asking me to sing to her and another sitting on the side of her bed showing me old photos and letters from her family. There was one letter from her father to her mother describing, in true Enid Blyton style, the joy of looking after his new born child. The child being the 90 year old lady sitting beside me on the bed. I leave the second lady content that I have had a worthwhile day and what is more, I am still on track to finish at 9.30pm


I have two calls to go when I enter Phyllis' house to find her in bed. She has dementia and like most dementia patients has good and bad days. She is also profoundly deaf which can also make life very difficult at times.


The fact she has made her own way to bed means it is a good day, or is it? , She has managed to use the commode, this means that her pad is no longer on when she has gone to bed, so the bed is wet. She is still wearing her clothes so they are also wet.
This was going to take longer than the half an hour I had planned. I sighed inwardly as I set about my task and whilst emptying the commode I catch sight of a pile of faeces on the bedside cabinet that she has removed from her pad. I quickly put them in the commode before cleaning it out, rolled her back and forth to change the bed sheets, cleaned her bottom up; washed her hands; put a clean pad on along with fresh pyjamas; all done with the aid of sign language. I finally tidied up the lounge, put her soiled clothes in the wash before going back into the bedroom to say goodnight. As I lent forward to kiss her forehead she jumped because she had not seen or heard me return. We both laughed before she tenderly grabbed my face with both hands, lent forward and kissed me gently on the lips. She has never done this before. Perhaps it was an apology for the mess, but it felt more than that. It was a beautiful moment I would cherish for a long time and made my day. Bless you Phyllis
I have to admit though, I did have one overwhelming thought at the time she was holding my face. 'Thank God I'd washed her hands!'

The daily routine

During my short time as a care worker I have discovered that routine is probably one of the most important things for my ladies and gents. They like to know who is coming and at what time, then more importantly, what we are doing in what order when we arrive. If I have a new carer going in to see one of my people I will always make a point of running through the order that I do things; Not only does this help the person we are caring for but also helps us as carers complete the call within the time allowed. People with dementia obviously need this routine more than anyone else but It was not until recently that I realised how much the things we say can also become part of that routine.






I have been looking after Brian for about six weeks now and quickly got him into a routine. As he sits on the chair of the stair lift I say (as I do with a lot of people) 'first floor ladies lingerie,' to which he will always chuckle and reminisce about the TV programme 'Are you being served'. Then when we get to the shower I  regale him with a verse of singing in the rain. which he dutifully joins in with; He has a little green pouch with his money in, so a burst of The Robin Hood theme has to be sung as I put it on the bedside cabinet for him, and so on.






The other night I went in and Brian had got very distressed about a family matter and his wife was almost at the end of her tether trying to calm him down. As with a lot of dementia patients he had become fixated on the problem and would not let it go despite several reassurances. It is in these circumstances that staying calm when all round you are not is the best policy. A change of subject was needed but I was not sure how, so I decided to just start getting him ready for bed, I coaxed Brian out of his chair and helped him as he unsteadily made his way to the chair lift. He was extremely confused and barely seemed to know what was going on.


As he sat in the chair of the stair lift I chipped in with my usual line 'First floor; Ladies lingerie'


Almost immediately, I could see the tension leaving his face as he looked up and chuckled 'Oh! It's you.' He then leant forward and gave me a hug.






It was one of those special moments that makes being a care worker worth while.




It also occurred to me, that my little one liners and songs are what identifies me to a lot of people with dementia,  His short term memory did not pick up on my face but my daily routine performance.

Animal Antics

Many of my ladies and gents have pets to keep them company. I have often found these four legged friends to be a useful tool when visiting someone for the first time, start talking about their beloved animals and you are the best care worker in the world.

In fact some animals rely on my calls as much as the people I am caring for, because it is also their opportunity for a toilet break and food.








I have two ladies with cats; The first lady often greets me with 'Where's my cats? I haven't seen my animals for three days. I bet that Cow next door has taken them in.' She will then lean out of the window and start shouting at the unfortunate lady to let her cats out of her house. I might add at this point that she only has one cat and the neighbour does not take it in, and this regular event takes place at about 7AM most mornings until the feline responsible for all this commotion returns,usually before I have to move on to my next call. I have to admit I am always glad if the cat has already returned before I arrive because it makes my life so much easier; if the cat is home I have a calm reasonable lady to deal with, whereas she will be very agitated and won't do anything until the little moggy has returned.
On Wednesdays  I arrive later for one reason or another and on one such occasion,  I could hear the lady shouting out of the window before I entered the house.
'I have lost my cat, someone has stolen him, I haven't seen him for three days, I bet it's her next door.'
 I spent the best part of the call calming her down by saying that he always comes home, I saw him yesterday and it's a nice day so perhaps he has decided to spend time in the sunshine. All to no avail. I have to admit to being concerned myself at this time of day and even took to shouting out of the window myself in a vain attempt to lure him home. Because the lady was so agitated and I had other calls to make, I rang the office to explain the situation before leaving some 40 minutes later. It was on the way out that I happened to glance into the bedroom and saw the cat innocently curled up on her bed oblivious to the consternation it had caused.

Another lady's cat always comes over for a stroke as I enter, but scuttles off the moment I start work because it knows that I am about to get the hoover out. It always seems to forgive me afterwards and  comes back purring as I sit down to fill in my care notes. All very nice but I wish that it did not sit on the page I am writing on.

And finally there is one lady that I visit with two beautiful collies called Ghost and Whiskey. When I arrive they go berserk which proves very difficult when trying to get in the door. Ghost, a stunning silver grey wolf like creature, immediately grabs his ball and barges Whiskey out of the way. Whiskey, the old boy of the two, then barks relentlessly in frustration, as if he wished he had thought about getting the ball first.

There is not much for me to do at this particular call apart from checking the lady is OK and has taken her meds, so I often stay for a chat a and more often than not play with the dogs especially when the conversation dries up a bit. I have even taken to training them to take turns with the ball and have to admit this is a bit of a treat for me as I used to have a dog and since she passed away, we have decided not to have another one due to health reasons.

After I had been visiting for a few months the lady concerned answered the door with a smile and said 

'I think my dogs think that you come to see them and not me.'

'Why is that?' I asked
'Well ten minutes before you arrive they have both started to sit by the front door waiting for you'

Mistaken Identity

Phylis lives all by herself rattling round in a huge house in the middle of nowhere. Because she has dementia, she gets very confused about what time of day it is and what we are coming in to do. I know that she particularly looks forward to my visits so I always try to stay patient with her as she repeats herself relentlessly throughout the call.  It's quite sad that all she really looks forward to in life is our four visits a day. As I leave she always wants to know how long she has to wait for the next carer to call and who it might be?

I had not seen her for about a week and was asked to go out to her at the last minute today because someone phoned in sick. As I enter the I hear her call from her sitting room.






'Hello, Who is it?
'It's Only Ian, Phylis'
'Oh Hello Ian. What have you come to do?'
'Well shall we go to the bathroom and get you washed, dressed and changed into some clean clothes'
'I hope you are a bit more 'with it' than last night'
'What do you mean?'
'Well you didn't seem to know what you were doing last night'
'I wasn't here Phylis'
'Yes you were, it took four attempts to get my pad on and you didn't even remember where the key was to lock up!'
'Definitely not me, I wasn't even working'
'I am sure he said his name was Ian'

'Then the penny dropped that we have another new carer called Ian working for us'

'Oh you mean Big Ian' I explained
'Why do you call him Big Ian?' she asked
'Because he is six foot five and I am five foot four'
'Oh that explains it, he does look like you though!

An hour later I happened to be speaking to BIG Ian to clarify a few things about some calls he was making that evening. I asked him how he got on with Phylis and he started laughing, it turned out that he had tried to put a new pad on with out taking the old one off and got in a right old pickle. I told him not to worry I have done similar things myself because you lose track with her continual bombardment of questions. He finished the story off by proudly repeating her passing words

'Thank you Ian you always make me laugh and I will always think of you as my friend'

I didn't have the heart to tell him that she thought she was talking to me.

When Carers can be a hindrance

Dennis is a quiet, almost reclusive chap who lives on his own and suffers with dementia. Of late he has gotten worse due to circumstances that have upset his daily routine. Invariably I walk in to find him just sitting there staring at the walls in silence, waiting for the warden or me to make our daily calls. Conversation can be quite hard, he often gives one word answers, not because he is being rude but because he can't think of any way to elaborate. As a consequence, I know that a lot of carers go in, do their tasks and leave.





Just recently I asked him why he does not go out more, and was surprised to hear that he was in fact sitting in waiting for the warden and me to arrive.

'It's rude to go out when you know someone is coming to visit'

So in fact along with his meals on wheels, our visits had become his life. He was even sitting in waiting for the 'check' call over the tannoy system

This was obviously unacceptable, so I suggested to Dennis that he at least go to  'The Coffee Morning'* on Wednesdays and I will make my visit later on that day.

The following Wednesday I arrived just after he had got home and the difference in him was remarkable; He was smiling, talkative and more alive than I have ever known since visiting him.

It's an interesting thought that Carers are supposed to improve quality of life, but in this case we had become a hindrance.

Since that day I have spoken to the family and suggested  '**Singing for the brain', which he now attends on Thursdays.


* Quote from a lady 'why do they call them coffee mornings, when we all drink tea?'
** http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=760

Precious Times

As I go round to see my ladies and gents it strikes me that the older we get the more value our time on earth.

 I was touched by a comment from a 95 year old gent today, who dutifully got up to go to the front door of his care home to see his daughter off. This involved a walk down three corridors and trip in the lift.

As he struggled to get out of his chair his daughter protested ‘You stay in your chair Dad, I'll be alright,  I'm sure the Carer has some things to do and probably wants to get on.’

‘No I have a mind of my own and I am going to come downstairs and see you off’ came the firm reply

　
I patiently waited the ten minutes for him to get back up to the room and as he sat down he apologised for making me wait before saying : -

‘I always like to walk down to the front door to say goodbye to my daughters. I may never see them again!’

New Technology

Interestingly, we often go on about how the youth of today don't know about things like vinyl records etc.

I went to see an elderly chap today who was excitedly telling me that he went to buy the new Bond movie 'Skyfall' for his son, and was astonished that he could only buy it in a disc format (not tape).

I had to bite my tongue when he said 'Do you know they can get a whole film onto one disc nowadays? It's amazing!' and then after a few seconds he asked 'Will it play on my Cd player?'

'I'm afraid not'

 'Oh well never mind I am sure my son will be able to play it, he has all these new fangled gadgets'

Ok Partner

As I was about to leave a chap with dementia, his wife says can you get him to drink his Movicol; he takes so long to drink it, it wears me out having to keep prompting him. So I poured his drink along with a glass of water for myself and sat opposite him at the table.

'Ok' I say in my best Texan accent ' Ok Partner, the first one to down the drink gets the girl'
He won! His wife stood there gob smacked.

Not quite sure what happened after I left.   

The power of suggestion

I am often called out to go outside of my area. It was on one such occasion I went to see Babs. When I arrived, she had swapped the keys round in her key safe. After spending five minutes trying to get the keys in the lock, I twigged that I possibly had the keys for the back door. So off I scramble through the garden which was in pitch darkness and into the house which was also in darkness. I always carry a torch with me and felt quite the intruder as I flashed my torch round trying to find a light switch, half expecting the police to knock on the door at any moment.






I eventually found Babs lying in bed upstairs and quite downhearted saying she had nothing to live for and so on.

‘Have you eaten’ I asked

‘No and I don’t really fancy anything thank you’

As I went back down the stairs I noticed a container at the foot of the stairs and whilst thanking my lucky stars I hadn’t trod on it on the way up, I realised that it was her 'meals on wheels' dinner from lunchtime, untouched. So I made a sandwich with a cup of tea and left it by her bedside just in case she was peckish later.

The next day I happened to be asked to go and see Babs again. This time the front door key was in the key safe and I found Babs downstairs watching television. Whilst I was pleased to see her up and about, I noticed with regret that another meal was sitting at the foot of the stairs and my sandwich from the night before was in the bin.

‘What would you like to eat’ I said,

Again I got a negative reply but this time I wanted to watch her eat, so I made a sandwich with a cup of tea and put it on her lap.

‘I don’t want anything to eat’ came the immediate response.

‘I know’ I replied, as I pulled up a chair in front of her and asked ‘How did you meet your husband?’

From that point on there was no stopping her as she talked about her family and past life whilst I sat and listened. Admittedly the conversation did go round in circles a bit, but every now and then I would let my eyes drift briefly towards the plate and she would take a bite from the sandwich; by the time I left thirty minutes later the plate was empty. The power of suggestion is a wonderful thing.


 

 

Singing for the brain

Whenever Artie goes out (My chap with dementia), I always make a point of asking if he enjoyed himself on the folowing day and  will always get a blank look or a comment such as 'Did I?' Yesterday, because he enjoys singing so much, I suggested that his wife took him to the Alzheimers society's 'Singing for the brain' group. Today I asked his wife if they enjoyed it and he immediately chirped up. 'Oh yes it was very good.'

Unlocking dementia with a song

Artiie suffers with terrible dementia but even though he cannot remember things that were said five minutes earlier, you can tell that he was true gentleman in every sense of the word. After I have finished getting him washed and dressed, he always shakes my hand and thanks me, even offering money on occasions, which I obviously decline. As I have became a familiar face he greets me with a smile and asks what we were going to do now. To which I say ‘Let's go upstairs to change out of your pyjamas’. and every day he looks down and chuckles ‘Oh I didn’t even know I still had them on’.

To overcome my nervousness of washing and dressing my people I always talk or sing. One day I was chatting and as a throw away comment said ‘I bet you were a bit of a rascal with the ladies.’
He looked at me for a few seconds whilst he tried to cast his mind back and then with a little twinkle in his eye said ‘ Yes, I suspect you’re right’.

It was whilst rehearsing to do an Old Time Music Hall show, I took it upon myself to practise my songs on Artie and as usual he smiled blankly down at me until one day I sang ‘Here we are again, happy as can be’ His face lit up and in he came with ‘All good friends and jolly good company’ By the time I went to walk out of the door, we had his wife joining in downstairs and it was a very happy household that I left behind me on that day. La di da di da La di da di di.

Since that day our repertoire has increased and the one we enjoy most is ‘Lets all go down the Strand’ to which Artie replies ‘Ave a banana’ The interesting thing is that I taught him that line, because he sang everything else but had to ask me what I was singing at that point. Within a couple of days he would add it in without prompting.

Artie always seems to enjoy the singing and at one point looked me in the eye and said ‘I don’t know who you are or why you come here, but I do enjoy your company? You're such a jolly chap and you always make me smile’

Since my experience with Artie I try to sing to all my dementia patients; it seems to me, that music unlocks a part of the memory that cannot normally be reached. I have since found out about the Alzheimers group 'Singing for the Brains' http://alzheimers.org.uk/site/scripts/documents_info.php?documentID=760 which Artie now attends.

A few months later, I was working with another carer, who occasionally looks after Artie when I can't make it.
Whilst we were getting one of 'The Old Dears' ready for bed, I started singing to her, at which point the Carer turned round and said 'Oh So that's what Artie was singing when I was dressing him the other day'
It's nice to think that Artie remembers my songs whilst I am away, even if he doesn't know my name.