Won’t listen or can’t hear?

Relative Matters were recently requested to review the care of an elderly lady in a nursing home. A care review involves a complete review of every aspect of a person’s life to ensure both their financial, physical, psychological wellbeing and religious/spiritual needs are met safely.

Care Reviews

It is often a complex piece of work because it involves reading the care plan through thoroughly, talking to care staff and other involved people such as families or external health professionals, talking to the person whom the care review is about and observing the environment. This then enables Relative Matters to make appropriate recommendations which can include things such as the purchase of more clothing, education and advice to care home staff on how best to interact or engage with the person, particularly if they have a cognitive impairment or dementia or provision of aids such as ipads to facilitate supported communication with loved ones if they live far away or other aids to enhance their ability to engage.

In this particular instance, the lady in question was withdrawn, and in discussion with care staff, Relative Matters were advised that because of her poor hearing she was choosing to disengage. There was some concern about the decline in her mood as a result. Comments such as;

“We know she can hear things but she’s choosing not to be involved”.

“You can’t engage her if she doesn’t want to be engaged”.

“She’s choosing to give up”.

Whilst for some people this may be the case, in this specific case, things just did not add up – her friend who visited frequently kept reporting she can talk and be involved if given one to one time, and her Solicitor who commissioned Relative Matters was saying the same. The inference was that the home had given up on her and that she had been labelled as someone who had withdrawn.

Our intervention

Relative Matters made enquires with the service that completed the hearing test, and were advised that the lady had been issued with new hearing aids, but that she had severe to profound hearing loss and standard hearing aids (although they were high powered ones) would only minimally help due to the specific type of hearing loss that the lady was experiencing. So, it was clear she wasn’t choosing to disengage, she just couldn’t hear!!

Relative Matters never give up on a person; the first tack in addressing this issue for the lady was to rephrase what care staff was saying in an attempt to re-educate them that the person is still inside the lady. In many discussions with various care staff members, when Relative Matters were told “she chooses not to respond to you” this was rephrased as “she has severe to profound hearing loss so it is likely she is really struggling to hear what has been said. We will keep trying to give her every opportunity to engage with us”.

Breaking down pre-conceived labels or thought patterns about people is so important. If you can change an established thinking pattern, just by rephrasing a negative statement into a positive one, this can have astounding positive effects.

On further investigation, advice was sought from the local Action for Deafness service about whether there was any device that may assist so that all opportunities had been explored and exhausted. It was identified that a personal listener device may work for the lady. Relative Matters swiftly acted to escort the lady for assessment and amazingly, one of the personal listener devices worked first time.

Fitting a personal listening device

When asked by the assessor at normal speaking pitch if she could hear, the lady said; “No I can’t hear!” Which of course she could as she heard the question at normal speaking pitch, but that her wry humour which Relative Matters had been told she possessed was coming to light immediately! The magical part is that the lady smirked and even managed a chuckle! Sharing a joke was priceless after being unable to fully engage with her in ‘normal’ conversation up until this point.

Facilitating engagement

The device has transformed the lady’s ability to engage. To capitalise on this, Relative Matters provided some education with care staff to ensure they fully understood the importance of the lady having it with her and on at all times. Within 24 hours, Relative Matters received an email from the care home Manager stating she had come downstairs, engaged in a game of dominos, had been invited to a poetry session but was most insistent she had no interest in going!

This demonstrates how this lady was given a wonderful opportunity to re-engage, have choice in what she engages in, and be able to communicate again.

Our Occupational Therapy consultant and dementia specialist, Liz Tremlett, undertook this piece of work and wrote this blog post.

Relative Matters Ltd

Relative Matters is an independent consultancy for older adults made up of a small, dedicated team of health and social care professionals, all of whom are fully insured, registered with the Health Care Professions Council (HCPC), and public disclosure certified. Working together they offer an unprecedented knowledge-base of the local care market and ensure care is highly personalised.

Keeping older people warm in winter

wintermittensmugWith autumn here and winter creeping ever so closer, there is certainly a nip in the air. With this weather comes certain obstacles, especially for elderly people. As a younger person, there are plenty of things you can do to make these chilly seasons a lot more enjoyable for them.

Avoiding Slips and Falls

The first thing you can do to help your elderly friend or relative is to find a good, sturdy walking stick or mobility aid. This will not only reduce the strain on the legs and the knees, but it will also provide that extra bit of stability for a whole host of outdoor activities.

Many people believe it is only the height of the user that determines the walking stick height. But in reality, people come in all sorts of shapes, sizes and proportions. The secret to measuring your walking stick is by following this method:

walkingstickmeasure
Walking Stick Measure

Once you have helped them choose the perfect walking stick, make sure you accompany them on a couple of walks as they get used to the conditions. If you notice they are struggling, perhaps invest in a sturdy ferrule to put at the bottom of the stick.

If they have a garden or driveway, make sure it is gritted each week, as the bags can be too heavy for an elderly person to lift. You could also buy them a handrail if they have slippy steps at the front door.

The Right Clothes

Having the correct indoor and outdoor clothing is essential. Make sure they are a wearing at least a couple of layers as this is more effective than just one thick layer. Thick shoes for outside and nice warm slippers for indoors will keep their toes from freezing. Thick socks, gloves, a hat, and a scarf will ensure their face avoids a chill, as well as protection from illnesses.

Indoors

Try and keep the temperature inside their home above 18 degrees, as being alone in a cold house can cause many problems, including hypothermia. Help out your elderly friend or relative by providing them with a talking thermometer. This will help them keep on top of the temperature in their home when you are not around.

Also, try and organise it so their heating is serviced each year by a professional. This will make sure everything is safe and cost effective to keep their home warm throughout the cold months.

Perhaps treat them to a lovely home cooked meal like a hot bowl of soup or some shepherd’s pie. This will give you peace of mind that you are doing all you can to ensure they are eating enough.

If you need more information on looking after elderly people in cold weather, check out the NHS guide on winter health.

This guest post was provided by Rachel Campbell, a Digital PR Executive for Ability Superstore (https://www.abilitysuperstore.com/)

How to Manage Incontinence When Travelling

Incontinence affects some older people (although it is not an inevitable part of ageing) If someone you know is challenged by continence, try these tips from Harman Direct will be helpful.

Toilet, Wc, Loo, Public Toilet, Cute, Funny, Woman, Man Managing it at the best of times can be tough but when you want to take a trip, go on holiday, attend a family event and so on, all of a sudden it can seem like too big a hurdle to jump.

The good news us that with a range of incontinence products at your fingertips and some of these top tips, you can manage incontinence when travelling, whether this is a shopping trip or a week long holiday in tropical climates…Male & female toilet signs

#1 The right incontinence products for the trip you have planned

If you are incontinent or are caring for someone that is, having the right incontinence products is simply a must. It makes the journey and experience far more pleasurable, but you will also be more confident too.

In most part, finding the right product for you is a trial and error basis. Many people feel happy with a pad, fixed inside their normal, everyday underwear. Other people, however, prefer an incontinent pant as they feel it is more secure, giving them confidence. Or, you may use the pant when sleeping as you feel more protected.

If you know you have a journey coming up, why not spend some time trying out various products to see how they feel, as well as their fit and how confident you feel using and wearing them? The key to confident travel is successfully and confidently managing your incontinence at home.

#2 Be well prepared

On one hand, being prepared could be squashing enough pads into your suitcase and hand luggage for the entire trip or for those with greater need, it may mean having more products to travel with.

Dependent on where you travelling to, you may feel confident that when you reach your destination that you can find and buy incontinence pads or pants that will suit you. However, in foreign climes, the availability of incontinence products may be less and thus, finding it difficult to buy incontinence products may mean you don’t enjoy the holiday or travel experience as much as you should.

The same is also true of additional products you may use such as personal wipes or intimate cleansing wash.

#3 Be aware of bathroom locations

This doesn’t mean poring over a map, noting every location of every public toilet on your journey but it doesn’t harm to know where restrooms and bathrooms are likely to be located.

  • Motorway service stations will frequently have a restroom
  • Garages will also sometimes have toilets but not all
  • Cafes, bars, restaurants and pubs will frequently have bathrooms too
  • Public toilets can be sparse in some cities, towns and villages in the UK and on the continent too
  • Train and bus stations will often have plenty of toilets, as do airports and other transport hubs

Having a sense of where you will find a bathroom can alleviate your embarrassment and help make the journey less stressful and uncomfortable.

#4 Stick with your routine

Travelling or a holiday is a chance to take in new places, kick back and enjoy yourself but this does not mean falling into ways that can increase your incontinence.

For example, you may know that drinking too much coffee or drinking excess alcohol can have a huge impact on your incontinence. You may also know that eating spicy food causes your bladder to become irritated and over active. When this is the case, suddenly indulging in these kinds of food and drink can instantly impact on your incontinence, making is more difficult to manage.

To enjoy your travels, stick to your routine when it comes to food and drink to keep your incontinence manageable.

#5 Invest a few pounds in a disabled toilet key

In the UK, there are many public disabled toilets that can be used IF you have a key to unlock them.

These public toilets are clean and bigger than the average cubicle, meaning you have more space to change your pad or pants in relatively comfort and with an increased level of privacy, something that many people with incontinence prize.

To buy a key that works in most disabled toilets costs only a few pounds. By having this key with you, if necessary, you can gain access quickly to a clean toilet. For those people who are carers, these toilets are invaluable as they are conveniently located and perfect for helping their client or spouse etc.

Managing incontinence takes some thought and preparation but you can manage it and have a great time!

 

Providing a range of incontinence pads, pants and products, HARTMANN Direct understands the need for quality products for those managing incontinence on a daily basis. With the right combination of product and exercise, incontinence is far more manageable.

 

Planning End of Life Care

As its Dying Matters Awareness Week I would like to talk to you about the importance of getting your elderly loved ones to make plans for their end of life care. I have seen what happens when people don’t plan for having an accident, a stroke or an illness such as dementia, which leaves them unable to make decisions such as whether they want life prolonging treatment and how and where they would like to be treated.

This issue is very important to me and although I will be unable to control what happens to me if I find myself in this situation, I want to choose how I live the end of my life and how my funeral is conducted. I have therefore taken out a Lasting Power of Attorney for both my property and affairs and my health and well-being. I am also  one of the 3 in 10 people who have made a will. Why on earth would I want to leave my hard earned dosh to the Government?

Holy spirit dove flies in blue sky, bright light shines from heaven, christian symbol, holy bible story

I would much rather address these matters while I am relatively young and have no intention of dying, although  like everyone else I have no control over that whatsoever. If I leave it too late and am no longer able to make my own decisions, I will not be able to make these plans myself.  Now I can relax, forget about the Lasting Powers of Attorney which will only be able to be used if I am unfortunate enough to loose my marbles so there is no danger of my sons (who are my attorneys)  selling  my home and emigrating with my loot.

Although it is possible to download the LPA forms and will template  from the Internet  and do it yourself I chose not to do this as unintentional mistakes can be made by not considering all eventualities. If you have made your own will and LPAs this only comes to light when it is too late to do anything about it. So find yourself a good solicitor. You will be glad you did.

Here is an example of a situation  I remember from my days of working on night duty at the local hospital. that illustrates my point nicely. I have made up their names for anonymity. To be honest I can’t remember them anyway!

Example of  how failing to plan can cause conflict in a family

Steve lived near his father and they had an especially close relationship. When his father had a stroke Steve was asked whether or not he wanted his father to be resuscitated if his condition deteriorated. Steve told me that his father valued his quality of life and felt that if it was seriously compromised, he would not want his life to be prolonged. However, his brother disagreed and as you can imagine, the situation could have caused a serious conflict within the family. Luckily his father’s condition improved and a decision did not have to be made.

Another example is a personal one. When my father became terminally ill, I knew exactly what his wishes were and had power of attorney to back up decisions I made on his behalf. He died peacefully at home listening to his favourite music, being assured it was OK to let go and reassured that my brother, sister and I would look after our Mother. I cannot stress enough the comfort it gave me to know I was carrying out his wishes just as he would have wanted.

A letter of wishes

I have one last thing to do to ensure my choices are taken into account, I am writing a letter of wishes to be go with my papers, so that my sons know exactly what I want to happen if I have an accident become seriously ill or lose the ability to make decisions for any other reason. Also where and how I want to live if I am unable to make my own choices, how I would like my body disposed of at the end of my life and what I want to happen afterwards.

We are all going to die

As a society we tend to avoid talking about these matters. However, death is a part of life and if they are faced, discussed and planned for we can forget about them, know our wishes will be heeded and acted upon and that we have saved the person or people we have left behind the responsibility of guessing our choices. Don’t leave it too late

Millions leave it too late to discuss end of life wishes. Don’t let an older person you care about be one of them.! The following website offers lots of good information to help you. Dying Matters.Org