Category: Diary Blog

How Secure Are Our Loved Ones?

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After talking with staff at an aged care facility I was shocked to hear that is commonplace for shady individuals to be stealing possessions off the elderly. I am told that some carers and other staff can be involved, but also outsiders that just enter the buildings and case out rooms. I have also heard ‘couples’ masquerade as family members.

I was staggered to hear these situations are occurring but then recently spoke with a person who has a friend with alcohol related dementia (Korsakoff Dementia) who has no money, and has been placed in an aged care facility. This man has had his own clothes stolen and has been left with practically nothing.

Have others experienced issues of theft and dishonesty? If so are there any tips or things that can be done to safeguard people with dementia in aged care homes and hospitals? Our elderly are extremely vulnerable to scammers and thieves and we must safeguard them where possible.

 

 

An Insightful Lesson From A Beautiful Lady

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Yesterday I sat with one of the most amazing ladies I have ever met. ‘Humble Hannah’ is 94 years old and an absolute treasure of a person. She always thanks me for talking with her and and tells me what a pleasure it is to have such an interesting conversation together. Hannah is so lady-like and nice that I would do absolutely anything for her.

But yesterday she gave me a lesson in humanity presented in a 3 minute flawless monologue with perfectly chosen words. Her message was about the elderly, and the way they should be cared for. This is pretty much how it transpired:

Hannah: I think the elderly of today need to be taught a skill. I know many of us may not be around for much longer but we need to stay refreshed and keep learning new things. The people (carers) here are lovely and try hard, but much of the time I am a little bit bored.I remember a time when I went up to an aboriginal community near the top of Australia and taught some women the skill of spinning and weaving. It took them a few days to master the skill, but when they did they were ever so pleased and the look on the ladies’ faces was priceless and they were so proud of their accomplishments.

Brett: That sounds like a fantastic idea Hannah, what sort of skills would you like to learn?

Hannah: I would like to attempt some pottery making with clay and one of those spinning wheels. I would also like to do some cake decorating or maybe some cooking. It would probably be something basic but it would be nutritious and I could feed the other wonderful people I would consider close friends here. Maybe we could listen to some nice music as well, I remember when the machine came out with the big horn on it which astounded everybody at the time. (gramophone)

I was in awe of what I had just heard and wished I had recorded it. Some big lessons on what the elderly are really thinking as they collectively sit in their armchairs watching Andre Rieu belt out another tune on the tv for the millionth time…..

I then sat with Dad on another couch but kept one eye on Hannah’s table to watch the interactions. ‘Jack the Dentist’ was reading the newspaper but had fallen asleep, and it was priceless watching Hannah (who was sitting next to him) as she carefully lifted up a curled corner of the newspaper trying to sneakily read an article without disturbing Jack. I could see her mind ticking over and she knew she could take his paper and he would probably not remember he was reading it if he awoke, but she chose to just keep re-reading that corner and leave his paper in place for him. Not many people would have done that and I was once again impressed. I walked over and said “It’s ok Hannah, you can take his paper, Jack won’t mind”.

Funnily enough – Jack then woke up with a start and did in fact mind and instantly leered at the paper Hannah was now reading. I could see a ‘resident rumble’ about to start as Jack was about to snatch his paper back.So I ran to Dad’s room and rushed back to give Jack a brand new, freshly un-opened newspaper (as Dad cannot read anymore) which he duly appreciated. The problem was solved, the resident’s were happy and Hannah gets my vote for ” Resident of the Week”.

Hot Stuff in The Nursing Home

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I was in the nursing home yesterday morning chatting with some residents when 80 yo “Moody Judy” came up to the table we were sitting at. I never know what Judy will say when I greet her with my usual “Good morning Judy …How are you today?”….I then hold my breath….and wait for the reaction, which is always clear cut and direct but could be either “absolutely wonderful kind sir” or “What’s so bloody good about it?” ( then she storms off).

Well today was different, I gave her my usual greeting and she had me wondering when she said nothing, but reached out for my arm,rubbed it, felt how warm I was, smiled and said “ooohhh….aren’t you hot stuff this morning?”

I cheekily responded with “It’s a little bit early for that kind of banter Judy…don’t you think?” (thinking she won’t get the joke). Quick as a wink she retorted with “Typical man, always taking every conversation straight into the gutter!, some things never change…..but you are lucky I like you”.

I have been warned….🙂

This Notice Helped Save Dad Being Sent To A Mental Health Facility

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This was a note I placed on Dad’s hospital room door, & at the top of his medical notes.

When Dad was highly agitated in hospital our family was very worried about triggering any behaviours.

As we are family, we intimately knew all the indicators that told us Dad was starting to escalate. This is really hard to pass onto others, but so worth it.

We were extremely fine tuned to his body language and would know by the pressure in his hands as to how dad was feeling. Everybody is different so this trait is probably unique to dad.

The reason why I am sharing this note is because it is super important to let hospital/aged care staff know how to handle the person with dementia the best they can. It is safer for them and better for the person with dementia.

By simply shaking Dad’s hand you can tell ‘where he is at’ and react accordingly.

Just imagine what would happen if a new nurse came on shift and had no idea that if you try and remove dad’s shirt when he is agitated you may get whacked.? This would mean security would be called and heavy restraint.Plus the potential for injury to the nurse.

You will also notice I tried to explain the best way to give dad medication. Obviously people with dementia often do not want to take meds and can be a volatile ‘flash point’.

I was not trying to tell the fabulous nurses how to do their job, but with dementia it is best to share as many ‘little tips’ as you can as it can make everyone’s day so much better.

Music To Their Ears

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Had a fabulous chat with two older ladies in the nursing home today. The conversation started with one lady telling me how she would love to go back to Hindmarsh Island where she was captivated by the mystery of the place and was wanting to go swimming near the rocks. She then told me about the music of the era and how it had no beat, was quiet but beautiful. She was totally in the moment and I could see her reminiscing as she spoke.

As another lady sat down we continued with the music theme. She described how she lived in the country and enjoyed the dances where the women would sit around the edge of the hall hoping to be asked for a dance by a young man. She described how her girlfriends would get excited and pull faces behind the men and mouth the words “He’s gonna pick you!”. ( she went thru the whole story so many times…lol) She also mentioned how the announcer would call out “Gentlemen take your partners fore….”. After the dance the boys would then walk her and her girlfriends home for hot chocolate and supper with her parents.

Good times!

Time To Change The Beat?….

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I received a good suggestion today from a senior aged care executive in regard to the role of police attending call-outs by residents. There are many occasions when people with dementia engage police patrols to attend their aged care facility in relation to “stolen items”.

The police are often called to find these stolen items only to discover they are in fact ‘misplaced items’ that have been put in a different drawer by mistake.The patrols are obliged to attend these incidents which are often a waste of time and police resources.

The suggestion was to have dedicated police that could handle this type of situation on the lower end of the urgency scale.

Perhaps older police members that have dementia/aged care training? The call out could be handled by a single member (as opposed to a pair) and perhaps be an excellent role for someone nearing retirement age.

I thought this was a positive and proactive idea that may be suitable for our ageing population.

Dementia is Different….Modern Hospital Care Needs to Adapt

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Dementia is Different to any other medical condition. Dementia is incurable, progressive and requires a unique brand of care. I have a passion for providing a different model of care within our hospitals and am looking to change the way people with dementia are treated in Australia.

Dementia has many symptoms,side effects and unique considerations and everyone has a different journey. With an ageing population we need to change the way hospitals provide their care and ,modify the environment to be dementia friendly. A person is diagnosed every 6 minutes in Australia and hospitals need to change their methods now to accommodate this growing problem.

In a perfect world this is how I would set up a hospital to admit people with dementia:

  • Dementia patients would not have to enter through the ED (Emergency Department)- They would have a different pathway into the hospital with a quiet environment, dementia trained nurses, minimal stimulus and have more of a nursing home feel.
  • Dementia patients would be greeted and comforted in a gentle way and attempts made to pacify and calm the person before any bloods or x-rays are taken. These tasks would be attempted after the person is either calm or de-escalated.
  • The entry to hospital would be near the ED so the restraint team (security) can be utilised if required as a last option, not a first option. The security team would also be dementia trained and they would use a less is more approach both in member numbers and also physicality. Code blacks would be a last resort.
  • The environment would not resemble a hospital ED but moreso a warm nursing home feel with dimmed lights, calm music and muted ambience. Medical equipment would be disguised or hidden and recliner chairs provided if the patient resisted the bed.
  • Emphasis on ‘calming before treating’ would be the focus.
  • If the person was admitted to a ward it would be a geriatric ward that is purpose built and once again resemble a nursing home feel. There would be minimal people in hallways and larger nurses stations. The bed buzzer/alarms would be muted near rooms, but audible in nurses station. A light would flash outside the room and over the bed.
  • People with dementia would be in single sex rooms or small wards(with other people  based on similar stages of dementia severity).  Bathrooms would be dementia friendly with rails in showers, safety arms on toilets,heated bathrooms,exhaust fans, shelves for towels and toiletries, a shower head that can be used on or off the wall. Hygiene and cleanliness a priority. Hand gel would be accessible. Soft music would be piped into the bathrooms and frosted shower screens (or curtain) a must.
  • Patient gowns would be dignified and keep people’s cheeks in check:)
  • Patients with cognitive impairment would be identified by the new symbol outside their doors, near their beds and also on their medical file. Maybe a severity rating could also be adopted to allow for appropriate care?
  • The nursing staff would be hand selected for people with dementia and they all would have a patient and caring manner.  The catering staff would be trained to not remove food trays until the nurse has ensured the patient has had time and the support to eat their meal.
  • The food tray would be ‘dementia friendly’.The menu would have appropriate food choices with pictures for easy recognition so they could be pointed out by the patient.The patient would have the option to just order a ‘dementia friendly meal’ by the hospital or have a family member select the options for them (depending on how progressed the dementia is). – or select themselves.
  • The food tray and plates/bowls would be colour appropriate to avoid confusion, with minimal lids on desserts such as yoghurt and fruit. Spoons,bowl guards and plenty of napkins and a cold flannel would all be provided.
  • Only one plate or bowl would be served at a time to avoid confusion and the nurse would be actively involved in the meal process if required.Independence would be encouraged.
  •  Warmed blankets would be applied after night showers to ensure patients get off to sleep better.A built in music system could be accessed near each bed to help with sleep – a single push button to access ‘sleep music’. Staff will ensure wards and rooms are kept quiet after 6pm and before 7am.
  • Lights would be eased on and off via an automatic dimming system to allow people to not be startled and shocked. This would reduce anxiety and keep people calm. If people need to sleep in longer this would be catered for when appropriate.
  • Younger onset people with dementia would have their own ward space/section with age appropriate environments eg music, activities and surroundings.They would be treated just as equally as older people with dementia.
  • Code blacks would diminish, less resources would be used, and money saved by the hospital.The initial financial outlay would be counteracted by better patient behaviour on wards, and less ‘behaviour triggered’ resources required (eg security, nurse specials, etc).
  • A dementia specialist could be rostered on the ward to deal with behaviours of concern and take diversionary action. One trained dementia staff member could save 6 guards being called multiple times.
  • Our most vulnerable members of our community have earnt the right to respect & dignity at all times.

Maybe I am dreaming or maybe some of these ideas could just work?

Worth a try…..You know why?

DEMENTIA IS DIFFERENT.

 

 

The Cognitive Impairment Identifier Symbol (CII)

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The symbol above is one to look out for when a person with dementia is in hospital.The symbol will be placed near the patient’s bed and will be used to indicate that the patient has cognitive impairment. This will ensure that the person with dementia will be treated appropriately.

The current problem in hospitals is that staff are often unaware of any impairment or are not trained in how to work with people who have a cognitive impairment. Hospital staff will be trained in how to care for people with dementia and will include the following:

  • Introduce yourself
  • make sure you have eye contact at all times
  • remain calm and talk in a matter of fact way
  • involve carers (family)
  • keep sentences short & simple
  • focus on one instruction at a time
  • give time for responses
  • repeat yourself…don’t assume you have been understood
  • do not give too many choices

The idea is to promote a better awareness of dementia, reduce stigma and provide a better level of care to the person with dementia.

This is a great step forward!

* this campaign was originally initiated by the Ballarat Health Service and has been producing positive results.It is now being implemented into the CALHN (Central Adelaide Health Network) which includes the RAH (Royal Adelaide Hospital) and TQEH (The Queen Elizabeth Hospital)

What Would You Do If You Were Diagnosed With Dementia?

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When dad was diagnosed I had no idea what dementia even was. Now that I know what it looks like I would certainly do things differently. Family and caregivers are impacted massively, so this list is to help make their life easier also.

This is my starting list:

• Tell everyone ASAP
• Get my financial affairs in order (will, advance care directive, power of attorney, guardianship)
• Organise all my bank accounts, service providers (gas, electricity etc) paperwork into clearly marked separate folders. (so a close family member could easily take over if required)
• Arrange my home to be changed to a ‘dementia friendly’ one. Eg rails in shower, label water taps “hot and cold”, etc…etc…
• Talk with my family heaps – offload my words of wisdom and stories to my wife and kids
• Make an impact on everyone I come in contact with – be super positive and tell them about dementia and how I am dealing with it. (no more stigma!)
• Talk with family and friends and have strategies on how to treat me along the journey and advise them of all the things that would upset me in advance.
• Write “My Life Story” document as a starting point for people to assist me. This document would change constantly and need to be reviewed monthly.
• I would write a massive list of everything I like and don’t like. It would be extremely detailed and include my fave colour (black), fave food(bbq chicken), fave smell(vanilla), how I like my coffee, etc..etc…(It would be in categories allowing for family to follow easily)
• De-clutter my home – free myself of things I no longer use.
• Write a personal diary to capture my thoughts and frustrations. (or blog)
• Hit the ‘bucket list’ real hard – eg go on holiday to fave destination, go parachuting etc…I would do this in reverse order with the most physically and mentally challenging things first.
• I would use video all the time. I would capture my favourite things and have them for the future when I can sit back and re-watch my memories.
• Visit the very best aged care facilities in advance and select the top 3 that I like based on my needs. Eg activities, environment, location to family.
• Sell my car and use the money to pay for new transport methods. Eg taxi’s and buses. (pay friends petrol money)
• I would make myself a personalised card that I could hand to people if I struggled with communication etc so they could assist me. It would have my emergency contact numbers on them.
• I would buy a dementia medical bracelet to alert people of my condition. Invest in a personal alert system and or KISA phone.
• I would try not to feel sorry for myself, but impart my knowledge and do talks in schools and community groups for as long as I am capable.
• I would surround myself with my favourite things and people.

This is my own personal list, and is very individual, and I am missing heaps of things, but I thought it may spark a conversation that would encourage many of you to add things that are important to YOU and we can all learn from these (and I may pinch a few of your ideas as well).

Approximately 1 in every 3 people will get dementia in the later years…a dementia plan is definitely worth thinking about!

A Story of Empowerment…. “Sorry, I Have To Go To Art Class”

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(*The powerful & moving letter below has been posted on behalf of fellow ‘Dignity in Care Australia’ member Jen Pilling):

This story looks at care from a different perspective. As a manager from an Aged Care Residential Facility where the approach is centred on lifestyle, engagement and socialisation, I would like to share some thoughts and experiences in the hope that we, through continuous improvement and the connecting and sharing of stories, can build better cultures to address these issues and improve our care with dignity.

This was a letter that I received from a relative who had transferred his mother to our facility from another residential facility under recommendation. The letter was sent approximately 24 hours after his mother was admitted to our facility:

“I cannot thank you enough – I have spent the last 2.5 years worrying about my gorgeous mother and my life was revolved around trying to spend time with her or to take her home for a visit. My worry came because I would often arrive at her previous facility to witness her having a panic attack or curled up in her bed in a catatonic state.

Mum’s facility considered us the whinging family. Her special diet requirements were ignored which compounded her health issues.

She was not showered every day and suffered UTIs and she was conditioned not to ring her bell for assistance as staff did not come to her aid anyhow. She was left in her room with nothing but TV. In her quest for social interaction she would knock on the neighbour’s door and ask for a cup of tea or if they wanted to join her (as she would have done at home). This meant she was seen as obnoxious by the staff that said she was “disruptive to others” or “trying to escape” – so they confined her more. They didn’t understand her so they controlled her to fit their pattern or workload and anything that didn’t fit their mould was frowned upon and reported to family members as if she was a naughty child.

On Friday I came into your facility to find mum on her way to an art class. She had a smile on her face bigger than I had seen in years. She gave me a hug and told me she didn’t have time to see me as she was busy…”sorry son I have an art class”.

Being made redundant like that made me so happy. My visits are now a bonus in her life instead of a necessity. Staff were telling me how well mum was doing instead of how obnoxious she was.

I felt like in 24 hours the mother I had known had returned. Her body language was relaxed and her face emanates who she really is – someone who loves people and loves a chat. Her body was no longer tense and frightened. Now we know she is in safe hands. Thank you for returning dignity to her life and treating her with respect”.

*It was heart warming for us to receive this letter of course and its benefits were far reaching. It was used to empower our staff as reinforcement to continue to look beyond behaviours and replace this with the delight of discovering the real person.

It empowered the family to “let go” and have a life outside being prime carers, it of course empowered the resident to “give permission” to the family to “let go” and empowered her to have no fear being exactly who she was.