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