The father of a close friend of mine has a dementia diagnosis and now lives in a residential (not nursing) care home. He had to be admitted to hospital just before Christmas with acute kidney injury and by early January had made good progress in respect of the original ailment; the registrar met with my friend and suggested that her father was now ready for discharge. My friend, however, pointed out that her father was now considerably more confused than he had been upon admission; the conversation was taking place on a Friday and she expressed her great concern about discharge whilst her father appeared to have an unresolved delirium. It was agreed at that meeting that further tests would be undertaken and her father would remain in hospital at least over the weekend.
Whilst she was driving home, her father was in fact discharged back to the care home. The care home team had not been contacted and had not therefore assessed the gentleman’s readiness for discharge; had they done so, they could not have allowed his return because his needs were now nursing needs. They did their best to care for him over the weekend, but on the Monday the GP was consulted and he stated that the gentleman definitely needed to be in hospital; due to the pressure within A & E, it was eight hours before an ambulance arrived to collect him and 20 hours later that he was admitted onto a ward. It was discovered that impaction accompanied by dehydration was causing the additional confusion my friend had been so concerned about on the Friday. The GP stated very firmly in his letter to the hospital that the gentleman should not have been discharged.
Had my friend’s insight as a carer been respected and acted upon, a 94-year-old man would have been spared four very stressful days of upheaval whilst suffering from unresolved delirium, the ambulance service would have had one patient fewer, A & E wouldn’t have had to re-assess and re-admit the gentleman and the care home staff wouldn’t have had a weekend of trying to care for a gentleman whose needs they weren’t currently able to meet.
A neighbour had for some time been concerned about a friend whose short-term memory was becoming less and less reliable. They eventually agreed that she should accompany the friend to her GP for memory assessment. As the lady’s daughter lives a distance away, my neighbour liaised with her and the daughter was grateful for the support my neighbour was offering.
On the day of the appointment, the lady kept forgetting what they were going to the GP for and repeatedly asked whether it was about her flu jab; my neighbour reminded her each time that they were going about her memory. Upon entering the consulting room, the lady was asked what she’d come for and suggested it was for her flu jab; my neighbour again reminded her it was about her memory and explained to the GP that the lady’s short-term memory had progressively worsened very noticeably in recent months. The GP did an assessment in which the lady struggled with anything relating to short-term memory.
The GP concluded that the lady was suffering from anxiety and should come back again if the problem got worse. The lady then asked about her flu jab; it transpired she’d had it a fortnight previously.
(This story, of course, doesn’t simply relate to respecting the insight of carers; there’s a whole additional story there about awareness of the value of full assessment leading to a possible dementia diagnosis – but I’ll leave that for another time).
A relative of mine whose mother has a dementia diagnosis is in the process of trying to move her from one end of the country to the other so that he can take better care of her; he is her only child and currently coordinates her care long-distance. He has tried very hard to liaise with all agencies currently involved and had very recently met again with most of them in person, so was surprised to be informed by one link that in three days’ time there was to be a meeting of all agencies (medical care, social services, homecare services) involved with his mother’s care, but that he had not been invited to participate. He made contact with the coordinator of that meeting and requested that they contact him at the appointed time so that he could be involved in the meeting by phone, then he made all necessary arrangements at work to ensure he was available for that meeting. He then sat waiting, but the call never came.
This man is desperately trying to care for his mother and ensure her safety and well-being until she can be found a suitable place near his home; he is supportive, intelligent and communicative. How can he possibly be omitted from a multi-disciplinary meeting about her care?