The importance of being persistent

Sally Alder

I became aware of this lady in February when I took over another scheme. I noticed that she made strange comments during a tea and cake activity and that other residents seemed to be helping her out. I also noticed that she wandered around the scheme a lot without a purpose.

I managed to get hold of her son and he explained that he also had concerns but that there was differences of opinion between himself and his sister about how to move forward. I explained that I could ring the social services and we agreed that I would visit this lady to get her permission to do this.

At this visit this lady was slightly unkempt, was delusional, reporting that she was looking after limbless babies in her bungalow. She also was unable to explain how to cook the ready meals in the freezer and reported she could not use the shower. She agreed for me to contact the social services to see if I could get her some extra support.

I contacted the social services who agreed to look into the case, raising my concerns for her personal safety re getting lost/ becoming ill with cooking food inappropriately, and her inability to look after herself.

Residents on the scheme also started coming to me with stories of this lady knocking on their doors early in the mornings, concerns over her wandering around the scheme and saying strange things.

When I did not hear anything from the social services I chased them up and the case had been put as not urgent just pending because the daughter had said there was no urgency. I challenged this as the residents were taking time to come and see me every time I was on the scheme to express their concerns and what was I doing about things and also workmen reported her leaving her bungalow unlocked. I stressed it was an urgent case.

Once again I did not hear back so I telephoned them again. They reported her case was still pending and had not been moved to urgent. I explained my concerns again. It was agreed that I would try to contact the family, and the GP to see if this lady had had a memory test and I was to re-contact them with any further concerns.

The next day when I visited the scheme the police arrived reporting that they had been contacted by a resident that there were burglars in her garden. It was this lady who was imagining that they were there. I visited with the police and this lady was reassured. I spent some time with her and her conversation was confused, she was unable to make herself a drink, had minimal food in. I left her with a neighbour and went to make some more calls!

The memory assessment team told me this lady had had a diagnosis of dementia and Alzheimer’s in 2012 and that she was already under the mental health team. I telephoned the mental health team who reported they were aware and were trying to get together with the family soon. I expressed my and the other residents concerns that things were not moving quickly enough. It was agreed that I would contact the social services again and the GP.

I updated the care alarm and left messages for the family. I spoke to the GP who advised me that the daughter was seeing another GP who knew this lady well to discuss the issues. I telephoned the social worker to update her and she agreed to pass the information on to try to make the case an urgent one.

Since then I know the social worker has been to visit this lady with her daughter present to discuss her care needs and they are also going to liaise with the mental health team. I too have managed to meet with the daughter which has been helpful as I have been able to discuss with her the other residents as well as my own concerns about her mother's behaviour and her ability to care for herself and keep herself safe.

I also found out from the daughter that her mother loved to socialise so I agreed to take her to the local memory club held x1 each month to see if she would enjoy that and she did- hence my post!

I have written this in sequence (1 month )so that you can see how tenacious you have to be to try to move things forward. It has been my first instance of someone who is quite far down the line with this condition who only had one visit from a local company and one from her daughter each week which was clearly not enough. It also shows that even though I pressed the case with the social services it was put on pending x2 because the daughter said it was not urgent -yet she did not see her mother every day like the fellow residents did who were very concerned.

Speaking last week with the daughter I can see that she is concerned that her mother be given the chance to stay at the scheme rather than be put in a home. Both myself and the social worker explained that options of care coming into the home would be tried first as this lady is very popular on the scheme and has quite a lot of support and friendship there- hence a neighbour offering to take her to the Memory club next time. It reveals how unaware families are of where to access help (- the GP had just advised them to look for a home!) which would explain her reluctance to let the social workers get involved.

The social worker told me that dementia cases always took a long time to get going when I expressed my frustration. It strikes me as sad that someone who was diagnosed over 2 years ago has been left with so little monitoring and little family support.

As I write this I have still not been updated as to what the outcome was from the social worker assessment so still have that to chase up!