Home Care – Positives & Negatives

It’s good to be back, finding time to update my blog again.  I still can’t believe I’ve only found the time to write one blog post in 11 months, I guess it shows just how busy life has been with caring for my Dad. . 

In my last post I discussed the positive’s of my ‘Carer Assessment’ and the steps I’d taken to put a ‘Care Package’ in place for my Dad.  However, it was not easy sailing, it took a long time to get the right amount of support for my dad without taking away some of his independence.  It was also quite difficult for me to rely on others to help care for my Dad, I had just spent over 2yrs taking responsibility for all aspects of his care, medication, hospital appointments etc. . This was a learning curve in ‘Trust’ and ‘Sharing’ in others i.e Experienced Carers (or so I thought)

The Care Plan – Initial Meeting with Care Providor 

After an initial meeting with the ‘Care Providor’ a ‘Care Plan’ was created and signed off, this listed the care my dad would receive, which including help with personal care, washing & dressing, medication & nutrition.  It was noted during the meeting that Dad had almost stopped making himself anything to eat, other than tea & toast and that I had taken on all of the meal preparation over the last few months ( a requirement that would be now be met by the Carers)

Care Package:

September 2017 – The care package was (as always) discussed with my Dad, he agreed with the plan, which was put into action the following week.  I agreed to take a step back during this time to see how the care package was progressing, I would still be there in between the carer visits to check on my Dad, and I would carry on doing all of his cleaning, washing, shopping & taking care of his garden.  I would also be making sure everything agreed was taking place, and documented in the care plan file.  The care plan file listed dads needs, and each visit was documented with the time the carer arrived, what had taken place, and the time they had left.  This provided me with the information I needed to make sure the appropriate care was being given, and I could also see what dad had been eating & drinking (or what he had refused to eat on some visits)

My decision to put the care package in place for my dad, came following a fall and a hospital stay where I witnessed a real change in my dad, he became very confused and disorientated and this caused me some concern.  I also felt it was something I had to consider after my carer assessment, due to the increased pressure I felt I was under caring for my dad on my own.

Positives:

There was a lot of positives to report, although it was difficult knowing other people were letting themselves into my dads house (a key safe was installed which contained a key for the Carers) I had to put my trust in them.  I was assured that professional experienced Carers would be involved in my dads care, they would be understanding of his needs and be competent in caring for the elderly. (I had requested that dads Carers were more mature as I didn’t think young Carers would be accepted by my dad especially around his personal care, washing & dressing, the social worker and the care manager had both agreed to this request) Dad is a very proud man and he wouldn’t take kindly to a young carer helping him wash or dress, he would feel as if they had better things to do and I knew this would be a problem (dad has a granddaughter in her 30s and he certainly wouldnt allow her to help him wash/dress) I wanted to make sure dads dignity would be considered at all times.

The first few visits went well, Carers were arriving on time and following the care plan, dad was happy with the care he was getting and the help with meal preparation and medication. Dad seemed happy and I found my visits more relaxed as I could be the ‘daughter’ again.  I could read the care file to check on dads food intake and the times of arrival.  I found the kitchen to be tidy, dishes washed, dad looking clean and tidy, so all good to start with.

There had been a number of different Carers at first, even though we discussed continuity of care with the care services, but I let this go at first as I wanted to see how everything would become established over the next few weeks.

Eventually it seemed that continuity had been established and Dad had been assigned three lovely mature Carers, who I met in the early days of his care package, and I was very happy with them.  They soon got used to my dads needs, they gained his trust and mine and they stayed in touch with me, which was really good of them.  Dad soon began to look forward to each one of them calling, he built up a great rapport with them as they took time to sit and chat with him, getting to know him and his life experiences.  I even started to call in when they were there some days and it was lovely to see dads sense of humour returning, they brought out his cheeky side again.

The months that followed brought a little sense of relief to me, the care package was going well, dad seemed to enjoy the Carers coming in, he soon started to offer them cups of tea when they arrived, even though they insisted that’s what they were her to do for him! That was dads politeness coming through and that had to be good.

It wasn’t long before they got used to my dad, they soon realised he would have days when he would say he wasnt hungry, or that he’d already ate something, but they knew this wasn’t right and they would liaise with me, they would also start to encourage dad with a choice of breakfast, lunch or dinner, or just make him something nice and invite him to the table, where he would eat his meals, they would sit with him and have a cup of tea with him.

Some mornings dad would already be up and about before the carer arrived and although that was good for his own independence, it was worrying as dad was very vulnerable in the morning due to his balance and lack of coordination. Some days he would wash and shave, but most days he needed help or prompting with this.

It wasn’t long before dad had days when he would insist that he could stay in bed, and the carer would call me to let me know, on these occasions I would go and encourage him to get up, help him wash and dress and prepare breakfast.  However, due to the patience of the carers, they soon started to encourage dad to get out of bed while they were there.  They had a lovely way of talking to him, they would also remind him that it was safer for them to help him (I could see that dads independent streak could come out still, and you had to respect that)

By the end of 2017 I noticed that Dads short-term memory had started to decline more, he couldn’t remember if anyone had been some days, and he would sometimes say that he had cooked, or washed up as nobody had been near.  This, I knew was not true, but I never contradicted dad, what was the point of that?  I would just read the care file to make sure. . .

Negatives:

I don’t really want to focus on the negatives of the care package because I was always able to rectify any issues by speaking with the care services.  However, there were times when I did despair and wondered how anyone going into a vulnerable elderly persons home and leaving, knowing they had not given the care required, could be ignored.  My dad was lucky, he had a voice in me, I was also well informed of the services and the expectations of good and bad care! I had worked in the NHS for 28yrs and was familiar with the good and sometimes poor care! My dad was vulnerable and under no circumstances would my he become a victim of bad care, not on my watch.

Although we had established a continuity of care with the two to three Carers, there were times they had days off, holidays, sick leave etc. . and other Carers had taken on dads calls.  This is when numerous instances of concern crept in, most of the time it I felt it was due to the lack of experience and knowledge of the elderly and their needs as well as the general complacency of young Carers.  I am, by no means making any statement that ‘young Carers’ are not carrying out their expected care duties with compassion, as I have come across a number of young Carers who do a great job under immense pressure.  However, a certain person who was assigned to my dad on a few occasions left me with quite a few reasons to be concerned, all of which was reported to the care agency.  Here are just some of the issues addressed during this time:

  • Late morning arrivals – Dad already up, dressed, trying to make his breakfast
  • Lunch/Dinner – Meals not made as dad had said he’d already eaten
  • Meals left out – Not observed eating so left to go cold (not eaten)
  • Missed calls – Dad had been forgotten on some occasions.
  • Meds forgotten to be administered
  • Dad left in stained clothing (food spills)
  • Times not being adhered too (quick in & out calls and not the half hour as agreed)

All of the above happened over a number of months, and each time I raised concerns with the care service, they always apologised and agreed they would speak with the carer, unfortunately it still happened.

I was surprised to be told that the care service had a shortage of Carers in my dads area, and that other Carers had to cover from a different area, hence the late calls some days, but this was not good practice surely, and was not discussed in any meeting with the care services prior to the care plan and times of visits being agreed!

Having had several meetings with dad’s social worker and the care services, it was always agreed that dads care plan could be met.  After all this was a paid service, it wasn’t free, the cost was coming out of my dads pocket, and we should not have had any part of his care compromised due to staff shortages.

These services are bid for, they have to show they can provide the service prior to any funding being commissioned.  Therefore, to be told by the care providor that shortages led to my dads care issues seemed very inappropriate.

I was eventually left with no option but to request this person be removed from attending my dads home.

Eventually things got better, dad gained the support and care he required, as agreed in his care plan.  The two Carers he was lucky to have, provided the best care and support throughout each day, they thought so much about my dad and treated him with respect at all times.  They took the time to talk with him, laugh with him and most of all became friends with him and myself. They met my son & daughter and my grandchildren, they talked about their families too, it was really nice to get to know these two lovely ladies who cared about my dad, and were generally concerned if he wasn’t his usual self.

I made sure I praised their commitment, support and respect, all of which I passed onto the care service and social worker during review meetings.

Things were going well and I started to feel less guilty about considering the care package. . . Both, Dad and I had made two lovely friends, and over the next few months everything was going well and we were soon into the spring of 2018.

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Embrace The Knowledge Of Our Aging Relatives

If only everyone took the time to listen:

Browsing through Twitter this evening, I came across a tweet posted by @IAmJohnSparks

I couldn’t resist sharing, as it made me think of all the times I have regarded my dad as the most influential person in my life, the one who I go to foe advice, the source of knowledge that was second to none in my eyes.

Please read the tweet, take it in, think about the words, and if possible respond to let me know who, in your eyes is that person and what is it that you have learned from them.

I can recall a conversation I had with my son’s teacher at one of his parents evenings, we were discussing the usual, work, attitude, progress etc. . Then, the teacher asked me about my dad, which I thought was a bit of a strange question, considering I hadn’t even mentioned him.  However, it was then that I found out that anything that was discussed in certain lessons such as ‘History’ Geography’ that my son had doubts about, or found hard to believe, apparently he would inform the teacher that he would go and ask his granddad!

This, I believe happened a number of times with different teachers, and my son would go back to those teachers to let them know they were right, as his granddad had verified the information.  I found this to be really funny at the time, but I also felt proud that my son had such a respect for his granddad and the knowledge he held.

He still seeks him  out now for clarification on certain things.

I would love to hear some feedback, and maybe we could build on this to promote the knowledge and learning we should be gaining from our elderly relatives and the aging population.