If you’re ever worried about someone you know – maybe a friend or relative – because they seem unwell or distressed, what can you do to help … especially if you don’t normally look after their healthcare? This question has been brought on by my own experiences in the last 48 hours, liaising about two much-loved elderly friends who clearly needed help, but whose families either felt out of their depth or weren’t in a position to establish what help could be offered. If we can support people to prevent the situation worsening, we can help keep them out of hospital, which – no matter how good our hospital teams are – is better for everyone.
On one case, a lady felt so distressed by recent memory tests that she declared that she wouldn’t attend further appointments. It’s easy to understand how such tests could be distressing; if you can’t answer the questions, you could might well feel under pressure and as if you’ve somehow failed. When I used to take my own mum to such tests, I highlighted to her afterwards the things she’d been able to do without difficulty and we made the whole thing into a fun trip out – but what if you haven’t someone to go with and you come home dispirited?
People tend to think they can’t talk to doctors and healthcare teams about someone they care for, or simply care about – but they can! The healthcare staff can’t reveal anything about the patient – but you can tell them anything you think they should know! By ringing the appropriate team and letting them know how the lady felt, then suggesting how they might make future visits more positive for her, I was able to arrange that an alert was placed on the system so that whoever her appointment was with would be aware they needed to use extra sensitivity – and when the lady came out of yesterday’s appointment, she said it had gone well and everyone had been very pleasant. Such a simple solution!
In the other case, a lady’s behaviour had become unusual for her in various ways, including being very sleepy, but the incident which prompted her daughter’s call to me was that she’d got up and dressed at 1.30am for a lunchtime appointment and seemed generally muddled. She’d fallen a couple of weeks before and seemed disorientated, but nobody had taken a urine sample. Now then, I’m certainly not a medic, but I’m an experienced former carer, and like many carers I learned along the way that it’s always worth getting a urine sample tested if someone’s behaviour changes in a way that you can’t explain, including if they seem unusually muddled. A test was duly done and yes, the poor lady had a bad infection and was given antibiotics. By the way, you may hear such infections referred to as “U.T.I.s”; that stands for urinary tract infections – so it’s what many people simply call a water infection.
So, the message this month is twofold:
- if someone’s behaviour changes and they’re extra-muddled (and possibly agitated or extra-sleepy or withdrawn), it’s worth arranging for a urine sample to be tested
- and although the Hippocratic oath prevents healthcare teams talking about a patient to someone who hasn’t been authorised to receive that information, it most certainly doesn’t prevent you from offering helpful information to healthcare teams
Yes, we’re working towards making hospital dementia care the best it can be, but in many situations we can keep people out of hospital by taking simple steps to avoid problems escalating. If you care about someone, please realise how valuable your concern is and never think it’s simply not your place to offer input. The person you help might never know to thank you for it, but you’ll know you’ve done the best you can to support them.