Archive for June, 2012

Carers Matter so Carers Need a Break

 I know from personal experience that although caring for a loved one can be rewarding it can also be time consuming, frustrating, overwhelming and exhausting. One thing is sure however, if you are providing “regular and substantial care” for a relative you are entitled to a break or respite from caring, even if support is also provided by Social Services.

Respite care means temporary relief and usually consists of extra services provided for a limited period of time to allow you to take a break from your caring responsibilities. It may be provided for your elderly relative or for you. It may be for as little as an hour, a night, a day or a week or two, depending on you and your relative’s circumstances.

Respite care can be provided on a regular basis or at a time of crisis, for example if you had to go into hospital. It can be provided in your relative’s home, for example by having a temporary carer from an agency (who can live in if required) while you are away, or your relative may move temporarily into a care home or hospital environment.

For people, who fund their own services, or like my parents, had a Personal Budget from Social Services, there are other options. For example, staying together is a small hotel with a care worker from an agency visiting to provide personal care and help with dressing, or finding a luxury care home that offers respite breaks for ex servicemen and their partners. These are merely examples. The key is to find out what is really important to your loved one and plan around that.

Whether Social Services, the NHS or your relative are responsible for funding respite care, if you are providing regular care and support to your relative, it is important that you look after yourself by ensuring that you have regular breaks from caring.

Here is an example of how I arranged for one carer to have regular breaks from caring.

Joan was exhausted having been caring for her husband John, who had a major stroke several years ago, for a number of years. She told me that she was finding it difficult to cope, as her husband’s concentration and short term memory had deteriorated and his care needs had increased.

As the couple had savings and investments they were not entitled to funding from Social Services. After talking to them both to find out which support would best meet their needs. I arranged a daily visit from an agency care worker to help with John’s personal care and for the time to be increased to sit with John twice a week while Joan went shopping or to see a friend or have her hair done. I also found a care home that had a good day-centre attached which John agreed to go to once a week. He had always been sociable and enjoyed going to the centre and joining some of the activities. Joan also found the Manager very supportive and knowledgeable about how to manage her husband when he became frustrated.

I also arranged for John to spend a week in the care home while Joan went on a cruise with her friend. John had made friends with another resident who also enjoyed watching sport on TV and if you were passing by his room you could hear their excited cheers. Following the success of his first stay at the care home I encouraged Joan to arrange regular stays for John.

It is really important that we look after our own health in order to be able to continue caring. It’s the same principle as the demonstration on an aircraft before take off, when we are told to put our own oxygen mask on first before we put on our child’s. So go girl and book that break!

Caring for Elderly Parents from a Distance

Caring for your mother or father can be stressful enough but imagine how you would cope if they live over an hours drive away or maybe you already have to travel a long distance to see your elderly parents. Only last weekend a woman who was very worried about her elderly father asked me for help. He has a short term memory problem, seriously and possibly end stage heart failure and lives in an inappropriate and far too big house with an upstairs bathroom over 150 miles away from her. She is his nearest relative.

From personal experience I know that caring, no matter where you live can be long lasting and ever expanding. What may begin as an occasional social phone call to share family news, can eventually turn into regular phone calls about health symptoms, arranging for groceries to be delivered and managing household bills. What starts, as a monthly trip to “check on Mum’ can become a bigger project to move her to a care home nearer to where you live.

Sometimes your Mum or Dad may ask for help, at the start of an illness for example. However when you live far away, some detective work may be necessary to uncover the signs that they may need more help.

So what can we do when faced with the worry and responsibility of an ageing loved one who needs care and support and lives a long drive away?

It can be difficult to know when your mother or father needs help from phone calls, as older people are fiercely independent and often over estimate their abilities. If you are personally unable to visit to do the detective work you could contact people who see Mum or Dad regularly – local relatives, friends, neighbours or a doctor for example – and ask them to drop you an email if they are concerned.

When you spend a longer visit, you can look for possible problem areas. It can be easier for your loved one to disguise problems during a short phone call than during a longer personal visit. You can make the most of your visit if you plan beforehand and develop a list of potential problem areas you want to check on while you are there. As well as safety issues, try and determine your relative’s mood and general health. If your Mum or Dad are depressed, they may brighten up during a phone call, but find their cheerful mood difficult to keep up during a longer visit.

If you are unable to visit your parent as regularly as you would like, you could try Skype, a free piece of computer software that enables people to see and speak to each other wherever they are in the world for free. You may need to enlist a local helper to support Mum or Dad to use the computer but this can be a great solution to bringing long distance families together.

Being a carer is not easy for anyone and both you and the person you are caring for will have to make adjustments and sacrifices. When you don’t live where the care is needed, it can be especially difficult to feel that you are doing enough and that what you are doing is important. Believe me, it usually is and you don’t have to do it all on your own. To find out what help is available  you may find the following links helpful. I wish you the very best of luck with caring across the miles.

The Carers Trust http://www.carers.org/

Carers UK www.carersuk.org or Carers Line 08088 08 777

 

 

Unwrapping Elder Abuse

 

Can you imagine what is must feel like to find that an elderly person you care about has been mistreated in some way. Maybe that they have been hit, handled roughly,  left in a soiled pad, talked over, ignored, shouted at, ridiculed, left in a room smelling of urine or locked in their room?

Hardly a week goes by when my consultants and I don’t come across an older person’s human or civil rights being violated in some way. Only this week when I was visiting a man in a nursing home he wanted to use the toilet urgently. His request was ignored and instead a trained nurse reassured him that he wasn’t to worry because he was wearing a pad. If this was how staff behaved in front of me I wondered what else might be going on behind closed doors. In another I found a lady who had previously been alert to be passive, unfocused and incoherent when I visited her. When I asked what happened, I was told there had been ‘an incident’ and in order to manage her aggressive behaviour, her medication had been changed.

Abuse does not occur exclusively in a care or nursing home and can occur anywhere, such as in a person’s own home, or in hospital and is not always intentional. You may be surprised to learn that one UK study found that over 300,000 people aged over 66 years living in their own home, reported experiencing mistreatment by a family member, close friend, care worker or neighbour in the previous year.

Basically there are five types of abuse that I want to make you aware of: emotional, financial, physical, institutional and neglect. However, in practice one type of abuse rarely occurs in isolation and situations often involve two or more types of abuse. For example financial abuse may also involve emotional abuse if someone is being threatened as well as complying with inappropriate demands for money.

I must also urge caution, as there can be reasons other than abuse for many of the signs listed below, so be careful not to jump to conclusions.

Here are some of the possible signs that someone is being abused and mistreated.

Emotional abuse

  • Changes in mood and behaviour that are out of character
  • Loss of appetite
  • Changes in sleep pattern
  • Fear and anxiety
  • Depression

Financial abuse

  • Unexplained loss of money
  • Unusual activity in their bank account
  • Deterioration in standard of living for example not being able to pay for things they could previously afford.
  • Person unable to access their own money to check their account
  • Sudden change or creation of a will to benefit someone significantly
  • Cheques being cashed without the person’s consent
  • Personal belongings missing, such as jewellery.

Physical abuse

  • Cuts, scratches and bite marks
  • Finger marks
  • Burns and scalds
  • Unexplained bruises (especially if there is a lot of bruising of different ages illustrated by varying levels of discolouration
  • Loss of weight, loss of hair and change of appetite

Institutional abuse

  • Inappropriate approaches to continence issues such as toileting at prescribed times as opposed to when a person wishes to use the toilet
  • Lack of privacy for example leaving the door open when someone is taken to the toilet
  • Dehumanising language that does not treat a person with dignity and respect
  • Abuse of medication
  • Failure to promote or support an individual’s religious or cultural needs
  • No access to personal possessions
  • Failure to knock on a person’s door before entering for example their bedroom or bathroom

Neglect

  • Urine smell in a person’s environment
  • Pressure sores
  • Lack of stimulation or prolonged isolation
  • Person has unkept appearance or is dressed inappropriately
  • Signs of malnourishment or dehydration
  • Not being helped to the toilet when assistance is requested.
  • Under or over medication.

What to do if you suspect that your relative is being abused

If you become suspicious that your relative is being abused because you have observed changes in their behaviour or living patterns it is important that you do not ignore it.

I would be honest and talk to them about what you suspect in a calm and sensitive way and help them realise that there are people who can help them. Your relative may take a while before they agree to you taking the matter forward on their behalf. If they lack mental capacity to make the decision, you can make it for them by acting in their best interest.

You need to refer the situation, which is known as an, ‘Adult Safeguarding Alert’, to their local Social Services Department and they will arrange to have the matter investigated.

If your relative has been subjected to abuse and feels they require independent support to help them through the process and to ensure their wishes are heard, you can contact a local voluntary service such as Age UK or the Alzheimers Society who may provide, or put you in touch, with an independent advocacy service.

We all have the right to feel and be safe, regardless of our age or circumstances, so you may be surprised to know that reported incidents of abuse towards older people are increasing. It is therefore important that we are vigilant to ensure our relatives and their property and belongings are safe and they are treated with the dignity and respect they have a right to and deserve.