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.

double vision

Whilst visiting Louisa the other day she handed me a letter and asked if I could read it to her.


'It's about my eyes' she said. 'I am having my an operation on them, so hopefully I will be able to read it myself soon.'


I opened the envelope and started to read the information out loud. It was standard stuff about what to do on the day of the operation; Time and date; What to bring; where to park;  post op treatment etc.
I had read two pages and just turned over the third page to read when I stopped in my tracks.


'Have you had any trouble with double vision Louisa? I enquired
'No?'
'Are you sure?'
'Yes I'm having a cataract removed in my left eye'
'And that hasn't caused any double vision?'
'No. Why?
'Well they've sent you two identical letters in the same envelope.'

Outrageous treatment of Carers

Just recently there has been a lot in the news about poor care. Whilst I abhor what has gone on, I am equally disgusted with the way some carers are treated by their companies. I recently spoke to two different carers who work for two different companies and was astonished to find that they are not paid for any time that they take to travel between calls. They are expected to either cut short one call to reach the next or use their own time if they take too long at the call. This effectively means that vulnerable people are being rushed by a carer who is constantly looking to leave after 6 minutes because that constitutes 15 minutes care; This in itself must create stress to the service users and the carer resulting in fraught situations where someone is taking longer than expected;  worst case scenario this could lead to abuse. The alternative is that the more conscientious carers work for five hours and get paid for four. At rate of £7.20 an hour that sounds like it takes it below the minimum wage. Is it any wonder we are hearing stories of poor care when the carers are treated in such a way.


On a note about zero hours contracts being outlawed the companies are getting round it by offering a 7 hour contract over a week.

hallucinations

I was visiting Jean, my lonely lady who lives alone in a remote village. If you remember she is the one who always looks for any excuse to keep you longer than necessary and spends her day watching the clock for when the next carer arrives. In recent months I have been doing her late call and have spent a bit of time each evening talking about her past. She has some lovely stories about her escapades during the war.




Tonight I noticed a piece of cotton wool taped to her arm and asked what it was
'I have had a blood test because the doctor thought I had a urine infection but wants to check out some other avenues' she replied candidly
'So it's not a urine infection then' I enquired.
'No, bloody doctors blame everything on urine infections' she retorted
'Well it can be quite nasty,'I explained 'I've had lots of ladies and gents who have had them and they can cause hallucinations.'
'What do you mean?'
'Well, most of them believe they can see people in the corners of the room and they start talking to them'
'I talk to my departed husband every morning; I tell him he has to go before you lot arrive'
'That's different, lots of people do that. In these cases they hear them talking and even hold conversations. They really believe the person is in the room.'
'Oh really! Just from something as simple as a urine infection?'
'Yes!'
'Incredible! she chuckled 'How do I go about getting one of these urine infections? I could do with some company'

Not every one is the same

It struck me today how much I have to change my behaviour according to the different situations and people I am visiting. You can't teach this skill as it is something you either do naturally or have to learn as you gain experience.

One of my ladies for example, loves to listen to me singing when I do my chores (must be tone deaf) but occasionally when she has had a bad night she wants silence. I have learnt over time to assess her mood before I make too much noise.There are some ladies and Gents who like a laugh and joke and others who just want you to go in, do your job and disappear; Some want to know all the gossip and others barely say a word; Some of my ladies like a cuddle when they are feeling a bit low; Nearly all appreciate a kiss on the forehead to say goodnight, whereas there are a few who definitely 'DON'T!'

Subject matter has to be considered too, I avoid politics and religion at all costs. You have to tune into people's sense of humour as well, I remember one occasion when I got it totally wrong;  I am always looking for little bits of humour or news to share as I do my visits, so when I saw a clip on 'You Tube' with two men doing a clever routine in the nude with a small towel to cover their decency, I thought I had found  a little gem. I went from call to call demonstrating the scene using tea towels, keeping my clothes on of course. Everyone found it hilarious, especially as I was deliberately being rubbish at it and kept dropping the towel on the floor.

'I think you had better keep you clothes on for now Dear!'
'Perhaps a bit more practise is in order'
'I don't think it's ready for the stage yet Luv'

 As I left each house I could hear chuckles and guffaws echoing in my ears and I was feeling pleased with my day's work. Apart from one gentleman who stopped me in mid flow and told me that it was ridiculously crude and not funny at all. What's more he barely spoke to me properly for two days despite my apologies. I stick to talking about  the routes I take on my bike rides now.

On the other side of the coin there is Sandra, a lady brought up in the East End of London who loves a bit of smutty humour. I clearly have to be careful what I say as I have a professional image to uphold but the other day she was looking at her bird feeders and I told her a story about the ones in my garden.....

I had bought some suet balls and a feeder for the feeding station and watched with anticipation for any sign of activity. After about two weeks I had given up hope and mentioned this to my wife, who said we have to be patient as the birds need to get used to them being there. The knowledgeable remark of an avid 'Springwatch' viewer
Another week went by and whilst at work I received a text from my wife which read like this: -
'Great tits on your fat balls' to which I replied  'Yes darling, but are there any birds on our feeders yet?'

 When I hit the punch line Sandra laughed like a drain for about five minutes.

Gallows humour

Edith is an independent lady who refuses to acknowledge the fact that she is getting on a bit. She is over 90 but still likes to get out and about despite her family telling her to take it easy and let them drive her about.

Yesterday as I entered her apartment found her sitting in her armchair with a huge black eye. 

'Goodness Edith, what have you done to yourself'

'I fell over outside Tesco' she replied casually.
'Tesco?' I said with a certain amount of shock. 'But that's on the other side of town!

'I know, I fell off of the bus' 

'What were you doing going to Tesco's when there is a shop round the corner?'

'Well my kettle broke, so I was taking it back'

'You should have waited until your daughter could take you'

'I know, I was a bit silly really; ended up at A&E for three hours and I have bruised all my ribs too'

'Yes it was more than a bit silly and I bet you didn't have your walking stick with you either'

'Nope and you know what was even sillier' she smirked 'it wasn't until later on that I realized that I had bought the kettle from Sainsbury's'

the water jug

Meals on wheels is a life line for a large number of elderly people. They provide a hot meal every day served on a plate from a friendly smiling face. The food is wholesome and provides a balanced diet for many who can't be bothered to cook and start to neglect their health. Like care workers, they are also another contact with the outside world for what would otherwise be a lonely existence. They also provide an information service to the elderly with various leaflets about health issues and awareness of cold calling fraudsters.





Earlier this year they gave all their customers a fleece blanket along with some instant hot drinks to help keep warm through the winter months.  I had to smile as I entered  each house and saw the now familiar black and white fleece folded on the side or laying on a lap.

'I see you have had a present from Meals on wheels' I would say to them
'Oh yes, isn't it lovely' and 'What a great idea' and 'It's keeping me nice and warm' came the regular replies.

No doubt pleased with the popularity of this gesture Meals on wheels tried again this week, giving a free water jug along with a letter explaining the importance of keeping hydrated. As a carer I thought this was a great idea as I calculated that 90 percent of my ladies and gents have had a urine infection at some time since I started and one gentleman has died.

Needless to say, I used the jug as a talking point, but unfortunately I was not greeted with the same positive responses as the blanket.

'Bloody thing taking up space'
'I can't drink all that in a day'
'I have spent all my life drinking tea, why should I start changing now?'
''I suppose it's some busy body up at the council trying to tell us what we should and shouldn't do again'
'You can tell those do gooders to stick their jug where the sun don't shine'

Coming from ladies and gentleman as old as a hundred who am I to argue; I obviously tried, but in most cases my protestations fell on deaf ears

I was beginning to get a bit wary about commenting on these unwanted gifts and receiving barrages of abuse;
There was one lady, however, that I was convinced would be pleased about her new jug. Despite having a lot of money, she would always make do with a coke bottle as her water receptacle, with myself and another carer always on the look out for a new one as a replacement when the old one got stale and began to smell.
'Why do I need to waste money on a proper jug when an old coke bottle will do' she would say
So as I entered her house I was pleased to see the new jug sitting on the side but dismayed to see it empty. Perhaps it had only just arrived I thought, so unperturbed and convinced she would be pleased with her new acquisition, I enquired if she liked it.

'Bloody thing, what a waste of time!' she replied
I was quite taken back by this retort and immediately started on my healthy living response.....
'But you need to drink plenty of water to stop urine infections'
'I know that!' she said
'And you of all people should know that'
'I know!'
'You had urine infection only last month'
'I know!
'And you could do with a new jug as those old coke bottles are unhygenic'
'I know!'
'So why are you not using it'
'Bloody thing leaks, it has a pin hole in the bottom, I fell asleep and woke up with water everywhere'