Caring for the Elderly: Part 10
My Mother, who has had limited mobility for a decade, fell and broke her arm just before Christmas. She subsequently spent nine weeks at a specialist rehabilitation unit at our local hospital. During that time she had surgery on her arm to repair the fracture and extensive physiotherapy to try and increase her mobility. She was discharged at the beginning of February with a support package in place to facilitate her return home. Sadly, despite physiotherapy, she is immobile as the day she was admitted. Until she sees the Consultant at the Fracture Clinic and is told if her arm can bear weight, she is not allowed to do anything for herself. Hence she is currently having four home visits a day from two carers and is confined to her bedroom. The carers help her get washed, dressed and use the commode in her room. Naturally, the current situation and the inability to do anything for herself, along with the uncertainty of her long term recovery and future, is causing a great deal of anxiety not only for my Mother but the rest of the family as well. At present we have a 3 week wait before she gets to see the consultant.
My Mother’s return home has inevitably caused some logistical problems. The first is managing the multiple visits by carers to the premises. My disabled Father has his own carers who tend to his needs twice a day, along with two visits from the District Nurse. My Mother now has four visits of her own. These comings and goings have been scheduled as to not conflict with my Sisters routine. She lives with my parents and has a fulltime job. Then there is the actual management of the carers themselves. Anyone who has had experience with such services will know it is somewhat of a lottery. Some are superb, some are adequate and others are barely competent and have to be micromanaged. So far the care company has broadly supplied staff who are very professional. Mainly, those coming to the house are experienced and adaptable. However, a few less experienced carers have come at the weekend and not shut doors or locked the premises properly, which is cause for concern. For the present, myself and my Sister are trying to accommodate this new daily regime during its initial stages. Sadly, I cannot be on site indefinitely and I need to have full confidence that all care duties are undertaken properly along with ensuring the house is secure.
The second issue is that although carers can assist my Mother with washing, dressing and toilet breaks, they cannot provide her with any long term companionship. In between visits, she is alone in her room without company of any immediate form of entertainment or interaction. I am concerned that there will be both physical and mental health consequences as a result of this. The local Community Physiotherapy Team has supplied an Orthopedic chair but my Mother struggles to sit up in it. After a week she is already developing lower back pain due to her posture. This could potentially worsen over the next three weeks if not addressed. Recent changes in my Mother’s medication, made while she was in hospital have also caused some problems. She is currently having difficulty swallowing which is worrying. And then there is the psychological aspect to my Mother’s condition. She spends large amounts of time, alone with only her own thoughts for company. She is bored, agitated and generally sad. Lack of mobility leads to continence issues which are distressing for a lady of her age. Having to be dependent on others to assist in washing, dressing and going to the toilet is not something that everyone is immediately comfortable with. Loss of dignity is a major contribution to her overall unhappiness.
So far we have spent a week as a family trying to find a routine that works. It has been a very fluid situation so far. There was an initial requirement for numerous practical items which we did not have. So we had to buy a hospital table, water jugs, lightweight cutlery and utensils, wet wipes, and sanitary disposal bags. My Mother’s bedroom had to be rearranged to accommodate a hospital bed, commode and Orthopedic chair. A lot of her personal items had to be cleared away to free up space for healthcare products and medication. As so many people are now coming and going from my Mother’s room, there needs to be space and clear access. I also had to remove the carpet and have easy to clean linoleum put down instead. When dealing with commodes, there is always scope for accidents and keeping the carpet simply wasn’t practical or hygienic. I managed to get my local GP to visit recently and she is concerned that being sedentary for 9 hours a day may cause additional health issues for my Mother. She also notes that simply waiting 3 weeks for an appointment while confined to a single room is not beneficial for her mental well being. Hence, I have asked Social Services to look into the possibility of short term respite care in an more suitable environment. If for whatever reason this cannot be provided, then we may bypass the Local Authority and simply self fund it. It will cost about £2,500 for 14 days.
At present everything hinges upon the Fracture Clinic appointment and whether the Consultant thinks my Mother’s left arm can now bear weight. If they say it can, then physiotherapy will resume and we can determine whether my Mother can increase her mobility. Naturally we want this to happen but we have to be realistic about the bigger picture. Irrespective of my Mother’s fall and subsequent broken arm, she has Chronic Arthritis and her mobility has always been destined to decrease regardless of other factors. There is a good chance that her current state of health is the new baseline. If she cannot rebuild the muscle in her left arm, then she cannot use her walking frame. If she cannot use her walking frame then she cannot come down stairs to the lounge and resume her normal habits. If the status quo prevails, then she faces being confined to one room and I cannot allow that to be the extent of her remaining life. Hence there may well be some tough questions to consider come the end of March. However, for the next two months it is just a waiting game. As ever, I am considering all possibilities and exploring them should they arise. It is a rather bleak undertaking for all concerned. We are hoping for the best while simultaneously planning for the worst.
