I went to see Edna today and had a quick word with Alma before I went to the flat. She actually had a shower yesterday! And I think she let the girls dress her this morning. So something I said may have registered with her. But she was still wearing the same clothes today she had on Tuesday - so I still think there are issues with how well she can care for herself.
She seemed unsettled today and clearly is worried about the way things are going at the moment. She was saying she would let things go on as they are 'for a couple of days' I found myself wondering when the review of her care package would take place. I checked how long she has been home and to my surprise discovered it is 2 weeks and 2 days - so there is another 2 weeks almost before the 28 day review . It seems as if she has been home for MUCH longer than that.
As I write this we are on the verge of a swine flu pandemic. I spent the morning reading up on it for professional reasons - but Edna is so clearly in one of the very vulnerable groups , I found myself asking Alma if they had a pandemic plan - which they do.
If the pandemic happens and gets into Fosters Edna would be so SO vulnerable because of her COPD. I cant do anything about it - but I do feel I need to do what I can to ensure she is protected. Obviously if I come down with flu, I wont go and see her - but she has so many carers going in the chances of her being exposed are high. And if the pandemic hits hard, will carers and meals on wheels be available?
Yet another thing for me to worry about.
Thursday, 30 April 2009
Tuesday, 28 April 2009
Mrs Hyde back again?
I went to see Edna today partly to give her the receipt to prove I had paid her telephone bill and partly just to see her.
The first thing that happened was Alma asked me please to try and persuade her NOT to get dressed before the girls go in in the morning becasue they are worried about her personal hygiene and whether she is washing. I did my best. I didnt say Alma has asked me to talk to her but I managed to work the converstaion round to a discussion of what the girls did in the morning and suggested that for the rest of this week at least she should let them wash and dress her and see if she felt better during the day. My logic for this is that stuggling to get dressed makes her feel porly. All I can do is see what happens. According to Edna she is due to have a shower tomorrow anyway. This was news to Alma I might add.
The rest of the visit was vaguely disturbing. She apparently doesnt remember that she changed her will after Alan died and that I am now keeping it for her. She was also talking about a bank account that no-one knew about except her. When I reminded her I knew all about both Lloyds and Natwest she was clearly surprised and seemed concerned that I was saying I knew about her 2 Lloyds accounts. When I reminded her that she had signed the forms to enable me to manage her accounts, again she clearly did not remember it.
This is very worrying not because it is further evidence of her problem, but because it makes me feel very vulnerable to accusations of manipulation and trying to defraud her. Luckily during the course of our chat she did make it clear she was happy I was trying to help her. 'I know your OK - its everyone else I'm worried about'
At one point she didnt beleive she was 87 and clearly had no idea what day of the week it was.
I also got the feeling that some of the stuff she was telling about what she had and eaten recently wasnt accurate - but I have no easy way to check that.
She had another rant about being treated like a child. She knew (or seemed to know) that the consultant would be going to see her to review how she was getting on with the Exelon in capsule form. She asked me who had told me - and I said the district nurses. She then had a bit of arant about how they should have told her. I did try to get her to see that they may have told her but she forgot, but she wasnt prepared to accept that.
Mrs Hyde seemed to be just below the surface ready to emerge if given the slightest chance. It was a worrying visit. I left feeling ready to burst into tears. But having managed to get myself energised and positive after a few very bad days, I am not going to let this get me down. I need to acknowledge the emotion, and learn what I need to learn from it.
That is really what I do in the blog. By writing things down I get insights that are sometimes very surprising but often very helpful.
The first thing that happened was Alma asked me please to try and persuade her NOT to get dressed before the girls go in in the morning becasue they are worried about her personal hygiene and whether she is washing. I did my best. I didnt say Alma has asked me to talk to her but I managed to work the converstaion round to a discussion of what the girls did in the morning and suggested that for the rest of this week at least she should let them wash and dress her and see if she felt better during the day. My logic for this is that stuggling to get dressed makes her feel porly. All I can do is see what happens. According to Edna she is due to have a shower tomorrow anyway. This was news to Alma I might add.
The rest of the visit was vaguely disturbing. She apparently doesnt remember that she changed her will after Alan died and that I am now keeping it for her. She was also talking about a bank account that no-one knew about except her. When I reminded her I knew all about both Lloyds and Natwest she was clearly surprised and seemed concerned that I was saying I knew about her 2 Lloyds accounts. When I reminded her that she had signed the forms to enable me to manage her accounts, again she clearly did not remember it.
This is very worrying not because it is further evidence of her problem, but because it makes me feel very vulnerable to accusations of manipulation and trying to defraud her. Luckily during the course of our chat she did make it clear she was happy I was trying to help her. 'I know your OK - its everyone else I'm worried about'
At one point she didnt beleive she was 87 and clearly had no idea what day of the week it was.
I also got the feeling that some of the stuff she was telling about what she had and eaten recently wasnt accurate - but I have no easy way to check that.
She had another rant about being treated like a child. She knew (or seemed to know) that the consultant would be going to see her to review how she was getting on with the Exelon in capsule form. She asked me who had told me - and I said the district nurses. She then had a bit of arant about how they should have told her. I did try to get her to see that they may have told her but she forgot, but she wasnt prepared to accept that.
Mrs Hyde seemed to be just below the surface ready to emerge if given the slightest chance. It was a worrying visit. I left feeling ready to burst into tears. But having managed to get myself energised and positive after a few very bad days, I am not going to let this get me down. I need to acknowledge the emotion, and learn what I need to learn from it.
That is really what I do in the blog. By writing things down I get insights that are sometimes very surprising but often very helpful.
Sunday, 26 April 2009
A prayer answered?
On Wednesday I was asking for help to hear and understand Edna's concerns. I am wondering if i have been shown a way to do that better - in a very unusual way. Last night at ghost hunt, I encountered an amazing medium. It is always possible to write off the TV mediums as fakes because the whole thing could have been staged and all the 'clients' could have been plants. Last night I saw the medium do a reading that I know wasn't a fake , and then very unnervingly she was able to tell me things about me and my situation that were uncannily accurate. While my state of mind could have been deduced from conversation and body language, the fact that I once owned an alsation who used to offer her left paw to shake could not have been. And it was information no-one else there knew about me. So she has a real ability.
Prior to this display of psychic ability, we had been discussing whether people could train their psychic powers. She says yes they can . We also discussed whether the way I seem to be a very good agony aunt is a demonstration of some psychic ability. She thinks it is. Now if I could improve that empathy and turn it to Edna's situation I rerally would hear and understand much better.
I am not going to write off ANYTHING however unusual that I think could help me in this situation. I know at least one ordained minister who would not write off mediumship and psychic powers as the work of the devil - so I am going to assume this may be an answer to my prayer on Wednesday (lets be honest my constant prayer since the diagnosis , in one form or another)
So I will try to book a training session with Carolyn and see what happens.
Prior to this display of psychic ability, we had been discussing whether people could train their psychic powers. She says yes they can . We also discussed whether the way I seem to be a very good agony aunt is a demonstration of some psychic ability. She thinks it is. Now if I could improve that empathy and turn it to Edna's situation I rerally would hear and understand much better.
I am not going to write off ANYTHING however unusual that I think could help me in this situation. I know at least one ordained minister who would not write off mediumship and psychic powers as the work of the devil - so I am going to assume this may be an answer to my prayer on Wednesday (lets be honest my constant prayer since the diagnosis , in one form or another)
So I will try to book a training session with Carolyn and see what happens.
Thursday, 23 April 2009
Shopping trip
It happened!! It nearly DIDNT happen and she needed some persuasion, but I got her to Sainsbury and she was able to pick her own shopping.
We had one or two 'discussions'. She bought more tomatoes than I thought she needed and she insisted she does herself grilled tomatoes. Hmmm. She also bought some cooked chicken legs and again insisted they were part of her regular shopping. Again hmmmmm. And she got a dozen eggs insisiting she really liked them and often had 2 eggs a day. Even bigger hmmmmm as I know she has only got through 4 eggs in 9 days.
In the car on the way home she was talking about her friend Doris and siad she had heard she had died. This is a discussion we first had years ago. I commented that I was glad she had remembered that and told her about all the times in hopsital she was convinced Doris was there with her. Is this a sign that her cognition is improving as a result of treatment?
Getting her back into her flat proved challenging and at one point she nearly fell. When we got back into her flat thewre was no sign of her meal. I laft a message for the warden and the home care team to find out if it had come and been stored somewhere. It is possible that knowing she was coming out she cancelled the meal - but forget she cancelled it. She kept saying that next time we went out she would cancel so we could have lunch out.
I have the horrible feeling the net result of whaetever has gone wrong will be that she doesnt have a proper meal today. I'm betting that if the home care team offewr to make her something she will declare she can manage to get herself something to eat.
No doubt I will find out tommorrow.
On the whole a succesful day - and I know Edna enjoyed it.
We had one or two 'discussions'. She bought more tomatoes than I thought she needed and she insisted she does herself grilled tomatoes. Hmmm. She also bought some cooked chicken legs and again insisted they were part of her regular shopping. Again hmmmmm. And she got a dozen eggs insisiting she really liked them and often had 2 eggs a day. Even bigger hmmmmm as I know she has only got through 4 eggs in 9 days.
In the car on the way home she was talking about her friend Doris and siad she had heard she had died. This is a discussion we first had years ago. I commented that I was glad she had remembered that and told her about all the times in hopsital she was convinced Doris was there with her. Is this a sign that her cognition is improving as a result of treatment?
Getting her back into her flat proved challenging and at one point she nearly fell. When we got back into her flat thewre was no sign of her meal. I laft a message for the warden and the home care team to find out if it had come and been stored somewhere. It is possible that knowing she was coming out she cancelled the meal - but forget she cancelled it. She kept saying that next time we went out she would cancel so we could have lunch out.
I have the horrible feeling the net result of whaetever has gone wrong will be that she doesnt have a proper meal today. I'm betting that if the home care team offewr to make her something she will declare she can manage to get herself something to eat.
No doubt I will find out tommorrow.
On the whole a succesful day - and I know Edna enjoyed it.
A timely refelction
I subscribe to health fitness and weight loss site that sends out various newsletters every day. One is called 'Healthy reflections. I often put these in my other blog about managing changes in my life - the mian chnage I am trying to manage being getting rid of my excess fat!
However this one seems very apt for this blog.
One common trait to nearly every good leader is the art of listening. Many times, the best leaders can be among the quietest in the room. They know their time is well spent in hearing new perspectives, ideas, and thoughts. It's how they grow personally and build visions. The wisest leaders know that hearing themselves talk is no way to build trust and goodwill. You can do the same thing. When a friend needs to talk, resist the urge to give advice right away and just listen. Ask questions, and really try to understand the answer. When a customer calls, don't say a word about your product until you fully know their needs. When your spouse is hurting, it's not the time to prove that you were right. Over time, you can develop that leader-like sense of when to open your mouth and when to keep it clamped firmly shut.
In a way I am trying to 'lead' a diverse gorup of Edna and her carers down a path that works for all of them - the goal being Edna's continued health. I know I tend to jump to conclusions sometimes. I do need to listen to what everyone - especially Edna is saying to make sure I have the full picture. I ama good listener - its one reason why I have ended up being an agony auntto so many people over the years . It is something I pride myself on. I need to use those skills now with Edna
Today the plan is thast I am taking Edna out to do her shopping for the first time in a long time. I wonder if she will go or find an excuse to duck out of it? If she does I need to hear the message behind her words and actions.
May God grant me the grace to hear properly, the discernment to understand properly and the patience to cope.
However this one seems very apt for this blog.
One common trait to nearly every good leader is the art of listening. Many times, the best leaders can be among the quietest in the room. They know their time is well spent in hearing new perspectives, ideas, and thoughts. It's how they grow personally and build visions. The wisest leaders know that hearing themselves talk is no way to build trust and goodwill. You can do the same thing. When a friend needs to talk, resist the urge to give advice right away and just listen. Ask questions, and really try to understand the answer. When a customer calls, don't say a word about your product until you fully know their needs. When your spouse is hurting, it's not the time to prove that you were right. Over time, you can develop that leader-like sense of when to open your mouth and when to keep it clamped firmly shut.
In a way I am trying to 'lead' a diverse gorup of Edna and her carers down a path that works for all of them - the goal being Edna's continued health. I know I tend to jump to conclusions sometimes. I do need to listen to what everyone - especially Edna is saying to make sure I have the full picture. I ama good listener - its one reason why I have ended up being an agony auntto so many people over the years . It is something I pride myself on. I need to use those skills now with Edna
Today the plan is thast I am taking Edna out to do her shopping for the first time in a long time. I wonder if she will go or find an excuse to duck out of it? If she does I need to hear the message behind her words and actions.
May God grant me the grace to hear properly, the discernment to understand properly and the patience to cope.
Wednesday, 22 April 2009
Patient focussed care
That is the mantra of the NHS . Right now I feel it is not exactly failing Edna but not really helping her either.
Edna's GP is refusing to prescribe her Rivastigmine. So Dr Ostler (I think that is the name ) who I beleive is the psychogeriatrician who originally reccomended the Rivastigmine is going to continue to prescribe it. But finally realising that the patch isn't really suitable for a patiet NOT in reeidential care she is being changed to the oral version. This should make thingas easier since it can be included in a blister pack - except it is a twice daily dosage so it needs the home care team to prompt -and hopefully observe.
The downside is she may well have more side effects, and because it is coming by a different route it will not be in the same blister pack with her other medications. Now I can see that causing a problem since Edna doesnt really like change and I suspect will panic a bit about it. She will certainly get fed up and start complaining about why things have to change and why can't she be left to get on with things the way she used to.
The district nurse who rang me was at great pains to reassure me that they were not discharging Edna, that they would still be seeing her at least once a week for her legs - but clearly the impossibility of anyone not medically trained managing the patch on her own has changed plans.
I am also getting rather annoyed by Alma the wraden at Fosters. She clearly thinks very poorly of the NHS and the home care team. Given half a chnace she will go on about how if GP's didn't prescribe paracetamol and E45 cream they would have the money for the more expensive drugs. She also c an't see why they bring two or sometimes 3 people to visit Edna and thinks it is a waste of money. She may well be right - but when I am concerned about Edna I don;t really care about her views on things ! More worringly I don;t think she rerally beleives the diagnosis of dementia. She has never beleived half of Edna's problems were real - and she may well have a point. She is quite capable of attentuon seeking behaviour - as are all old people. But if Alma really thinks Edna could fool a psychaitrist into thinking she had dementia when she didnt then I think SHE needfs some treatment.
I am worried how this could impact on Edna. Alma can be very brusque - and sometimes I think Edna needs that . She is inclined to wallow in self pity (and right now that feels like the pot calling the kettle black) But how much of her awkwardness is genuine and how much is the dementia? Will Alma allow for that? And what could it do to Edna if she doesnt? This comes back to the point that I have no idea of how to deal with someone with dementia - and I dont suppose Alma does either. But at least I beleive the d ementia exists.
There is only 3 weeksa of the home care package left. I hope the care can be continued for a while after the 28 days. They seem to be working pretty well - and I was impressed with the way they rang me as soon as they noticed a problem with the blister pack.
Now if only I culd solve the mystery of where those 3 old blister packs came from. Alma denies all knowledge of them. When she told me her medeications were sorted out she meant new packs would arrive today. So where were those 3 old packs and who put them in the cupboard. Did Edna do it and lie to me? or did she genuinely forget? Or did the homecare team find them the night before last?
I would love to know but unless the homecare team DID find them I doubt if I ever will
Edna's GP is refusing to prescribe her Rivastigmine. So Dr Ostler (I think that is the name ) who I beleive is the psychogeriatrician who originally reccomended the Rivastigmine is going to continue to prescribe it. But finally realising that the patch isn't really suitable for a patiet NOT in reeidential care she is being changed to the oral version. This should make thingas easier since it can be included in a blister pack - except it is a twice daily dosage so it needs the home care team to prompt -and hopefully observe.
The downside is she may well have more side effects, and because it is coming by a different route it will not be in the same blister pack with her other medications. Now I can see that causing a problem since Edna doesnt really like change and I suspect will panic a bit about it. She will certainly get fed up and start complaining about why things have to change and why can't she be left to get on with things the way she used to.
The district nurse who rang me was at great pains to reassure me that they were not discharging Edna, that they would still be seeing her at least once a week for her legs - but clearly the impossibility of anyone not medically trained managing the patch on her own has changed plans.
I am also getting rather annoyed by Alma the wraden at Fosters. She clearly thinks very poorly of the NHS and the home care team. Given half a chnace she will go on about how if GP's didn't prescribe paracetamol and E45 cream they would have the money for the more expensive drugs. She also c an't see why they bring two or sometimes 3 people to visit Edna and thinks it is a waste of money. She may well be right - but when I am concerned about Edna I don;t really care about her views on things ! More worringly I don;t think she rerally beleives the diagnosis of dementia. She has never beleived half of Edna's problems were real - and she may well have a point. She is quite capable of attentuon seeking behaviour - as are all old people. But if Alma really thinks Edna could fool a psychaitrist into thinking she had dementia when she didnt then I think SHE needfs some treatment.
I am worried how this could impact on Edna. Alma can be very brusque - and sometimes I think Edna needs that . She is inclined to wallow in self pity (and right now that feels like the pot calling the kettle black) But how much of her awkwardness is genuine and how much is the dementia? Will Alma allow for that? And what could it do to Edna if she doesnt? This comes back to the point that I have no idea of how to deal with someone with dementia - and I dont suppose Alma does either. But at least I beleive the d ementia exists.
There is only 3 weeksa of the home care package left. I hope the care can be continued for a while after the 28 days. They seem to be working pretty well - and I was impressed with the way they rang me as soon as they noticed a problem with the blister pack.
Now if only I culd solve the mystery of where those 3 old blister packs came from. Alma denies all knowledge of them. When she told me her medeications were sorted out she meant new packs would arrive today. So where were those 3 old packs and who put them in the cupboard. Did Edna do it and lie to me? or did she genuinely forget? Or did the homecare team find them the night before last?
I would love to know but unless the homecare team DID find them I doubt if I ever will
Tuesday, 21 April 2009
Just when I thoght things were going ok
.......... something major goes wrong.
Yesterday I had a call from someone (district nurse?) witha query about Edna's medication saying I needed to pick it up. I didn;t get this meassge until today - so I rang the warden and she said it was all sorted out. I have never collected Edna's medication.
So I popped across to see Edna and flund 3 blister packs in her cupboard. This evening I got a call from the home care team comncerned that the packs are all dated February and don lt contain the right drugs.
Luckily the morning meds are correct so I've been able to tell them they can be given - but to omit the evening ones. I have also said that by tomorrow they will have blister packs wioth the CORRECT drugs in.
I will go over in the morning and sort it out. Somoen has got something wrong - and I intend to find out eho.
Edna will either be totally laid back and 'it doesn't matter becasue they do any good' OR she will be in a panic 'why can't it be simple like it was before'
Both attitudes are equally annoying.......................
Yesterday I had a call from someone (district nurse?) witha query about Edna's medication saying I needed to pick it up. I didn;t get this meassge until today - so I rang the warden and she said it was all sorted out. I have never collected Edna's medication.
So I popped across to see Edna and flund 3 blister packs in her cupboard. This evening I got a call from the home care team comncerned that the packs are all dated February and don lt contain the right drugs.
Luckily the morning meds are correct so I've been able to tell them they can be given - but to omit the evening ones. I have also said that by tomorrow they will have blister packs wioth the CORRECT drugs in.
I will go over in the morning and sort it out. Somoen has got something wrong - and I intend to find out eho.
Edna will either be totally laid back and 'it doesn't matter becasue they do any good' OR she will be in a panic 'why can't it be simple like it was before'
Both attitudes are equally annoying.......................
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