If you intend to help an elderly relative with their care needs, you need to prepare yourself for a lot of complex assessments and form filling. No form is more important than your relative's care plan.
By the time that I got my Dad to accept that we needed to pay someone to look after him, he could no longer remember his medical history and was incapable of stating his care needs. I soon discovered that Dad could not be assessed for anything unless I was present. All Dad wanted was to be left alone in peace, which conflicted with my need to get on with my life without worrying that he was lying helpless in a bath of cold water, too confused to pull the plug and call for help.
This essential difference of viewpoint resulted in some bizarre conversations. When Social Services visited at my request to assess his care needs, Dad's objective was to demonstrate that he didn't need any help. Had I not been there, I think he might have got away with it. But I was there, cast in the uncomfortable role of bad guy, contradicting Dad's assertions that he could 'easily walk a mile' when he could barely get to the front door, betraying his trust by telling a total stranger about all the experiences that he preferred to forget about - or indeed, that he had forgotten about. Like the time when he nearly set fire to the flat by putting a towel to dry on a convector heater. I remember Dad looking at me with horror, as if to say, 'Why are you telling them about that, son, do you want them to put me away?'
Social services' assessment of Dad's care needs was a lengthy process. After the initial interview and health & safety assessment of his flat, a team of social workers visited him daily for six weeks. At the end of this period, they concluded that he would benefit from a daily one hour visit from a carer. I was given a list of recommended care agencies to contact.
The care agency had to make their own assessment of care needs and conduct a further health and safety assessment. Again, this required an initial interview followed by a period of observation.
After a few weeks of care in his own home, I threw in the towel for trying to support Dad in his semi-independent living. No care plan, short of 24 hour care, would enable him to live safely in his own home. Yes, he only needed one hour of care a day, but he regularly became so confused that it was impossible to predict when his needs would arise.
When Dad first moved into his care home, I spent several hours with the duty care manager completing his care plan - in effect a set of handover notes from me to the care team. The form was about the size of an average novel. I had to provide details about Dad's medical history, his family history, his care needs, his likes and dislikes. I can remember feeling incredibly hopeful, that here at last was the opportunity to define the care experience that I wanted my Dad to enjoy.
it sounds so simple- I wanted them to understand that the key to Dad's happiness is a regular supply of whiskey, some stimulating conversation and current affairs programmes on the TV.
Looking back, I realise that my expectations were wildly optimistic. The care plan is an incredibly important document, but the turnover of staff in the care home means that I constantly have to restate his care needs to new staff and agency staff. Someone who stands in for a few shifts will never have time to read thick documents on a dozen or more residents. Just getting the staff to give Dad a nip of whiskey now and then has been a major struggle.
Eight months on, this continues to be a source of great frustration to me. Everything that I want Dad's carers to do is written there in the plan. The hard part is getting anyone to take any notice of it. I know that I am not helped in this by Dad's tendency to refuse any activity that is offered to him because he 'doesn't feel up to it today', as well as his inability to ask for anything, even the glass of whiskey that he so eagerly accepts if offered.
Next week, I shall attend the first review meeting about Dad's care plan, which promises to be an interesting conversation.
You can read about my 'reverse parenting' challenge - trying to keep my Dad cheerful without losing my own sanity at www.declineandfalls.blog.co.uk
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