Tuesday, October 02, 2007

Debi and her Dad. Part 1

I've decided to use my blog to document the ups and downs of caring for my much-loved 92 year old father who lives alone on the other side of London.

I know our experiences are far from unique, so I'm hoping these posts will resonate with other people in a similar position.

This 1st post in the series was written on the tube on the way back from seeing him yesterday.

On my way up to dad's 2nd floor flat, I drop in to wish DZ's daughter a Long Life. DZ died yesterday and her funeral's today, leaving dad the only nonagenarian left in the block.

Let myself into dad's flat. He's not there! I do the usual holding-breath-while-opening-doors routine, but, no, he really isn't there. Further investigation reveals he's gone out wearing a light summer jacket (it's cold and pissing down outside), no hat or brolly and without any of his selection of walking sticks or zimmer frames.

Phone his GP. They haven't seen him either. Grab an umbrella and prepare to search the streets for him, hoping against hope that he hasn't fallen again.

As I pass the library, I peep in and think I see him in the window. But it's not him after all. Decide I might as well check properly inside. Bingo! He's there, reading a newspaper. Huddled under the brolly, we head home for lunch.
'I'm a bit doddery,' he says in wonder.
'That's why you should take your stick when you go out,' I say. 'I've left one of my 'daft-old-bugger' notes next to your keys to remind you ...'

These daft-old-bugger notes generally work well. They remind him of crucial things (eg 'Don't wear these shoes, they hurt your feet, you daft old bugger') and make him laugh.

After lunch, I fill his pill box. He's forgotten to take his morning meds as usual (in spite of the 'Don't forget to take your pills, you daft old bugger' note stuck on his cereal bowl). Decide to call every morning to remind him if I'm not going to see him that day.

His medication has been changed following a discussion I had last week with his consultant. I've questioned the meds before with his crap GP to no avail but the consultant thinks I might have hit the nail on the head with my suggestion that dad's dizzy spells might be caused by one of the items.

The dressings G & I put on his head and elbow following his last fall haven't been changed. I tried to do it myself last week but bottled out and organised a visit from a district nurse. They confirmed they would come but clearly the visit never materialised. Will have to phone them later and find out what's happening.

Also see from notes that V, his lovely carer who pops in every evening to prepare a meal and ensure he's taken his next batch of pills, has been replaced by someone I don't know. Dad's acute short term memory loss means he didn't know about the change and no one's contacted me to let me know. I'm concerned as V and I have a really good relationship and she knows exactly what dad needs. Will have to phone agency later and find out what's happening.

Leave later than intended which means I'll now be late for picking up LG from school as it takes over 1.5 hours to get home.

I am continuously enraged by dad's GP's practice. They do the absolute minimum, have been known to lie to me, are outrageously inefficient and - more importantly - treat dad in a way that is at best uncaring and at worst downright negligent. I would complain except I'm really scared that they'd take it out on dad when I'm not there. I have a strong suspicion that there have been times they've sent him away without seeing him but I can't prove anything and of course he doesn't remember.

He's so vulnerable. It appalls me when I think about people who don't have family and friends looking out for them. This is no way to treat the elders of our community.

Luckily there are also some wonderful and caring people out there, working at the sharp end of the NHS and sharing these frustrations from the other end of the stethoscope.

This is an extract from, a new book, In Stitches, by Nick Edwards, who is a doctor in an A&E dept:

A sign the world has gone mad?

What has had happened to my patients today? They seemed to be getting lost when I sent them for X-ray. I'd given the same directions as normal, there had been no secret muggers hiding in the hospital corridors and as far as I know, no problems with space - time dimensions in our particular corner of the universe.

I went to X-ray to investigate. I found it quickly because I knew the way. However, I looked for the signs for X-ray and they were gone. The nice, old-fashioned and slightly worn signs had gone; they had been replaced by a sign saying 'Department of Diagnostic Imaging'. What the hell? I know what it means but only just and only because I have been inundated by politically correct 'shit-speak' for a number of years. What a pointless waste of money; to satisfy some manager, they replaced a perfectly good sign with one that means bugger all to 90% of people. Why don't they change the toilet sign to 'Department of Faecal and Urinary Excrement' or the cafe to 'Calorific Enhancement Area'. Who makes these decisions? Who is employed to do such pointless stuff? Why? Why?? Why???

I needed a caffeinated beverage in a disposable single-use container - management-speak for shit NHS/Happy Shopper instant coffee. I went to sit in the 'Relaxation, Rest and Reflection Room', previously known as staff room. There, the nurses were moaning that tonight one of their colleagues had called in sick and to save money their shift would not be covered by a bank nurse. In A&E, staff shortages can seriously undermine the safety of patient care.

I am sure this genius plan was decided by some personnel manager who I doubt has ever seen a patient, cannula or trolley, and therefore is obviously an expert at making nursing planning decisions. We have a hospital that can fund unnecessary new signs, but not replace nurses when they off sick. So, tonight who is going to go looking for the patients when they got lost on route to the Department of Diagnostic Imaging?


Jane Henry said...

Oh Debi. Many sympathies. Have been through similar with my fil, but luckily we're on hand and he wasn't as old. We also have a fantastic GP which makes a big difference. But I came across indifferent/patronising social workers who weren't prepared to see beyond their nose to realise that my poor mil was in no fit state to care for him.

Now mil is on her own and 83, but in very sound mind, if not the best of health.

Twice in the last year I've had a knock on the door from the hairdresser saying, I've rung and she's not there. It makes your heart go down to your boots doesn't it?

I feel sure that one day I will walk into a major catastrophe.

chin up.

love Jxxx

Debi said...

Thanks, J. My chin is well up as I love my dad so much so there's no hint of resentment at him needing me - just anxiety and sadness.

I think if you have elderly parent(s) you learn to live with a constant lowish state of anxiety and then every so often it gets cranked up to the max.

Unknown said...

I think most of us can relate to this, Debi, on one level or another. When my dad was on an oncology ward we had to clean the filthy room ourselves and provide extra blankets for him because they had run out. The NHS is/has fallen by the wayside and is no longer something that we should be proud of for the most part. What exactly are we paying for?

Anonymous said...

What shines through is the love and respect you have for your father, family and friends it's like a beacon. Your father sounds a wonderful man with a totally free spirit.

The lack of concern, help, care for vunerable people in general is bad. With varying agencies struggling and passing the buck, with the main problem being NHS/care systems can't be run as profit and loss. Ok, if they were run more efficiently yes there could be a lot more done. I've read some extracts from Nick Edwards book and he is spot on. Am clerk in the NHS and we're told to look out how to make savings, which we do our upmost to do. All of us put in unpaid overtime every week to ensure results get to the appropriate place, which we accept as providing a service. But it knocks you back when managers, adminstrators, numer crunchers tell us we're not doing it right and find board rooms and managers offices get top of the range carpets, etc. Sorry to wonder off the point here, but there is a lot of good, kind people in the service hampered. The old saying about 'Lions led by donkeys' is a bit of an insult to donkeys, at least they are gentle, hardworking creatures with nice strokable ears. Apologies for rambling.

Unknown said...

Your dad certainly does sound like a free spirit Debi. I also feel for you and your trials of trying to get him proper care. It seems the NHS nowadays is a real lottery, but I like to think, want to think, that there are good people working in it. It just seems that all to often as Nick Edwards describes they are just frustrated by the paper pushers and politicos who do not seem to have the vision to turn it around.

Debi said...

To discuss the state of the NHS here is certainly not off the point. Dad would be delighted he's not the only focus of this post.

I think there's 2 points:
one is about the general breakdown of communities - in other cultures, elders are respected for their wisdom and experience. Here they're frequently just considered a nuisance.

2nd point is indeed about the NHS. Every time something frustrating happens round dad's care, I recognise it's almost always the result of under-resourcing (the district nurses got back to me today and said they had no record of needing to visit dad - in spite of 3 phone calls to arrange it - one of which they made to me) or pure stupidity (Kath's carpets example).

Unknown said...

Oh Debi, my heart goes out to you. This is hard stuff - for you and for your dad. Battling the system can be soul destroying, caring for a loved one who is in no position to care for themselves can be draining. But you sound like you do it with such good grace and humour too. You are both blessed to have each other.
I can't comment on the state of the NHS but to say that it sounds desperately scary.
And yes, your observation about our and society's failure to care for our elders (and their collective widsom) is more than well made. It deserves a post of its own.

Unknown said...

oops, wisdom, sorry, not widsom...