June 22, 2012

An unfortunate conjunction of events took place a few days ago. At two o’clock on Thursday afternoon I arrived at the care home to find Mabel dressed to go out but with her eyes glazed. She did not respond in any way to my voice. I discovered that neither of her hearing aids was working. With the batteries replaced, she could hear again, so we went out in the car with Ian. But whenever we tried to speak to Mum all she would say is “shut up”.

With Mum returned to the lounge of the home I kept my four o’clock appointment with a senior for Mabel’s six-month review. We sat in Mum’s room where her HASP file is kept. As the carer moved back and forth in the file, passing it over to me when appropriate, I was given to understand that Mabel had gained weight in the last six months. Good. I was told that there was the beginning of bedsores, but that members of staff were dealing with this by turning Mabel twice every night. Good. In addition, Mabel was now signed up for the most suitable type of pad for daytime wear as well as an absorbent pad for night-time. Noted. We discussed the current use of the hoist. After 45 minutes of question and answer I was happy to sign off the paperwork, happy too that though suffering from full-blown dementia, Mabel is being well cared for.

On the way out, I looked in on Mum again. She was smiling and trying to speak. In other words, as she got used to the hearing aids again, she was plugging back into the world as well as can be expected.

When I got back home I wrote an email to the manager about the hearing aid situation. I’d been assured by a carer that the hearing aids had been working when Mabel had been dressed in the morning, but, all the same, Mum had clearly been sitting in silence for a long time. The lack of stimulation had had a decidedly stultifying effect, just as a fortnight before the extra stimulation from having Ian around for an hour twice a day had had an enlivening effect. Having got that off my chest, I took the opportunity to pass on Ian’s complaint about there being too much Scottish music in the lounge. And I added a paragraph about my perennial concern about staff numbers.

A day or so later I got a reply from the manager. She told me that she had instigated a system whereby a sheet would be signed twice a day to indicate that Mabel’s hearing aids had been tested and were working. However, reading between the lines, I felt that the manager was not too pleased, either with me or with something else.

I thought about this for a while and came to the conclusion that my own email hadn’t struck the right balance. So I wrote again, stressing how pleased I was in general terms about the work that the care home is doing on my mother’s behalf. This time I ended by saying that a carer had taken it upon himself to show me the hoist in operation, and that I was very grateful to him for having taken this initiative. I refrained from mentioning that as the demonstration took place in the lounge, and Mabel was shifted from wheelchair to comfy seat, Andy Stewart was singing yet again, courtesy of the usual CD, about a soldier, a Scottish soldier.

It’s Saturday lunchtime. I’m feeding Mum, but she’s eating through almost-closed eyes and the whole meal is a bit of a struggle, each mouthful needing to be negotiated between moribund Mum and me. It could certainly be soul-destroying to be doing this work day after day. Indeed, I’ve learned that one of the carers, a pleasant and hard-working individual, has been signed off work for several weeks with depression. That only increases the pressure on everybody else of course, especially the senior who has to draw up the duty rotas. Dear me - the work force is underpaid and the manager is finding it increasingly difficult to recruit motivated, responsible staff. I should be trying to find ways of making her life easier, not sending critical emails.

So I’ll be more careful how I word my communications in future. No offloading of my own angst (not that I’m in the habit of doing this). I don’t want the institution collapsing into a slough of despond. I’m sure that this could happen though. I’ve heard about care homes that are in a terrible state of demotivation. That would certainly not be in Mabel’s best interests.

A much loved resident who has been here for several years passed away this week. The man who I never saw eating but who always gave me a thumbs-up sign when he saw me with Mabel. Will his death be the straw that breaks the care home’s back? Surely not. The manager is made of sterner - as well as kinder - stuff. And with the support of the key staff that surrounds her, the care home will pull through.



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