Susan rang me one Monday morning and sounded upset. She had just returned from seeing her GP about the affect her 85-year-old mother, who is suffering from dementia, was having on her. She told me that her GP suggested she contact Relative Matters, the care consultancy I set up a few months ago, to see if we could help. Susan told me that she was exhausted. Her mother had rung her at least 20 times over the weekend for reassurance and the doctor had told her that it was time her mother moved into a care home.
Ann, Susan’s mother, had lived alone since her husband died just over a year ago, in the bungalow he had designed for them both. It has a large garden and being at the top of a hill, stunning views of the sea. In addition to not wanting to move into a care home per se, Ann’s bungalow was symbolic of her husband and their life together and reinforced her deep desire to remain living there for as long as possible. Susan was resigned about Ann needing to move into a care home eventually, but stated tearfully, “if you can only help her enjoy her garden for one more summer, I will know that I have done my best for Mum.”
Susan explained that she had arranged for agency carers to provide care and support to her mother daily and for Meals on Wheels to be delivered to ensure she had at least one decent meal every day. However, she told me her mother didn’t like the meals much, so at the weekend when she was not working, Susan often took a home cooked meal round to her. These arrangements had been in place for over a year, during which time she and her husband had not been able to have a break.
I arranged to meet Susan and her mother to understand their needs and the situation better. I also met with them on another occasion to discuss Ann’s options and choices and make a plan. It was clear their overall aim was for Ann to remain living in her own home for as long as possible. So we got planning and here is what we came up with.
We changed Ann’s care provider to one that specialises in dementia. I reinforced her need for continuity with the new agency and negotiated a preferential rate that saved Ann £100 a week.
We included the following social activities: attending a Healthy Living Centre two days a week, shopping for food and retail therapy, visiting a garden centre for morning coffee/afternoon tea, re-joining the horticultural society Ann used to belong to, and support her to grow vegetables and cook them for her main meal. Ann used to love gardening and cooking and had not undertaken these activities for over a year.
We maintained mental and sensory stimulation by carers discussing news items from the newspaper Ann had once enjoyed and using reminiscence puzzles, a sensory DVD, putting photographs into a life journal.
We used technology to maintain Ann’s independence and to reassure Susan that her mother would be safe when she and her Carers were not around. Here is what we eventually decided on:
- Provision of a 24-hour personal response service to go with her community care alarm, whereby a trained member of staff would respond personally to emergency calls. They would quickly assess the situation and ensure the appropriate assistance is provided. This gave Susan confidence that emergencies could be dealt with quickly when she was at work.
- A service that would call Ann twice a day, seven days a week to check she was OK.
- An iPod to download opera and relaxation music.
- A bedside lamp that senses movement and will come on during the night if Ann gets up.
- A Property Exit Sensor to provide a warning by alerting the Care Centre if Ann left the bungalow and didn’t return within a predetermined time.
- When batteries begin to get low in the equipment , a silent call will be made to the Care Centre and someone will come out to replace them for Ann.
The care plan was put in place over two months ago, since when Ann has only telephoned Susan twice and they both appear much happier. Ann’s medication for anxiety has been discontinued and she has begun to put on much needed weight. Susan and her husband enjoyed a long weekend in Paris and are planning a cruise later in the year. Me? I am thrilled to have been able to make the world a better place for older people, one at a time. Or in this case, two at a time.