Coming Home

One of my colleagues is not well at the moment and is unlikely to be back at work in a rush. So as is the norm, her work needed to be reallocated.

That’s how I found myself with a file for Mrs K. A woman who has a diagnosis of Alzheimer’s type dementia. Through a series of ways and means (she likes going on to the seaside), she found herself in a hospital a few hundred miles out of London.

Much liasing with hospital wards and hospital social workers ensued and although I even suggested going to visit Mrs K the very suggestion was slightly ridiculed. I have to say though, just as I don’t like to place people in residential care homes that I haven’t seen, I also don’t like managing care for someone that I have never met.

Anyhow, when someone is in hospital they are well-placed for lots of reports to be written and for decisions to be made on those accounts.

The decision-making process was befuzzled by a couple of factors. Prior to Mrs K’s admission to hospital, she had not been in receipt of any care services.  She was visited regularly by a care coordinator for the purpose really of trying to coax her into receipt of home care – but she had, to date, refused.

The reports from the hospital indicated, however,  that she required dementia nursing care.

That’s quite a jump in a couple of weeks – by any standards – considering the hospital admission was for a chest infection.

After a period of delayed discharge payments when both boroughs were having some kind of argument about whose responsibility paying for an IMCA would be (personally, I dispute that she is unbefriended in any case – as there is a partner – but that’s a different argument for a different day (and perhaps an indication of institutional homophobia as her partner is female)) , we made a temporary interim care placement to a nursing home in London with a view of planning care from there. At least she is now somewhere that her family find it more easy to visit and, well, yes, I do too.

National Gallery, London

Having now visited her a couple of times and spoken to the residential home as well as her friends and partner, I am assured that we should, at least, try to move her home with a care package. After all, she states explicitly that that is what she wants and there is a good historical knowledge that she has always been incredibly attached to her home. She has a cat and a canary waiting for her too. Moving to residential care from an acute hospital admission is always heart-wrenching although sometimes unavoidable but there is a grief process for a familiar place and setting that is often disregarded when such moves are made.

Now though, I have a race against time though having been allocated what I consider to be not-enough-time to arrange a safe move home. Not least because (as I discovered on visiting yesterday) the home needs a rather thorough deep clean before we’d be able to put a service in.

But as always with these time-limited issues (and this is something I have grown better at with experience), I phrased a humble email to the respective manager explaining risk and safe return home and how much preferable to our ethos (and to the council’s bank balance) a return home would be as opposed to a permanent nursing placement (which I suspect was expected).

I most humbly stated I was doing all that I possibly could to speed up and facilitate a move (which is true – I’m just away on training for three days). I expect to follow up with another humble and apologetic email next week updating what I have achieved in the additional time and why I need an extra extension.

I have to say though, these kinds of situations – moving someone home against the expectations – give me a considerable amount of satisfaction.

5 thoughts on “Coming Home

  1. I went to a conference on the 20th and they had a psychiatrist talking about delerium in the acute care setting, why it happens and how those factors make an already fragile brain (ie someone with pre-existing dementia) even worse. It was very interesting and just goes to show that, at least in the US, going to the hospital is very bad for you! At any rate, I’m glad you were able to get her home!

  2. Thanks guys. I have to say this with my fingers crossed because she isn’t home yet although I’m pretty confident at this point 🙂

  3. Being in an unfamiliar setting can really disorientate. I went on holiday with my mum, who had mild dementia at that point; she fell asleep on a sun lounger on the beach and when she woke up she had no idea where she was and got very distressed. To make matters worse, a thunderstorm started. I don’t know how we ever got her back to the hotel..

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