By Chris Crowstaff, founder of Safe World for Women.
4th August 2015.
My recent blogs started out being about Mum who has been diaignosed with Alzhemer's Disease. But actually this one is at least as much about my father-in-law who has vascular dementia.
We dread to think what would have happened to my mum and my husband's dad if they were completely alone, as so many older people are.
Even just over the last two weeks there have been events which have highlighted this.
First of all a comparatively minor drama: my mum's phone stopped working. We contacted British Telecom (BT) via their website; they checked the line and said there was a fault and it would be fixed in three days. So of course I then phoned them to explain that the telephone is Mum's lifeline and that she has Alzheimer's. BT were very good indeed. They put Mum as high priority, the next day they re-wired the local exchange for her and also they phoned me to check if Mum is OK with her phone now. The woman who phoned me was genuinely very caring. I explained that Mum's line was working again but was a bit fuzzy so the nice woman said they were applying for planning permission to dig up the pavement outside Mum's house and repair the wires, which they did within a few days.
Mum of course appreciated the attention. She continues as usual, occasionally having a confused day when she asks our son where my dad is (he passed away in 2008). But always her cheerful self. Our son, who lives with her, has become expert at replying. Appropriately either tactfully refuting what she says or, in this instance, simply saying that he didn't know. Which was the best response as she soon forgot her question.
Dad's hospital visit
So then to drama with Dad (AKA Grandad - my father-in-law).
Mum comes here at the weekends to give our son some respite. Sometimes he comes here with her, to spend his free time here. So Friday evening we went to fetch Mum and our son. We stopped for 'fish and chips' on the way back.
We went to see Andrew's dad (age 93) as usual, when we got back, as he lives right next-door to us. Dad was sitting in his armchair as usual. However, another armchair was tipped over. Dad said that he'd fallen over. It was obvious that a bone was sticking out on his shoulder so we dialled the National Health Service helpline and the paramedics were duly called. Dad was taken to hospital by ambulance and we followed in our car. When we arrived, we were welcomed by a friendly woman. She said there would be a 2 to 3 hour wait. We, also being friendly, said 'OK'. In hindsight we could have been more assertive.
We were directed to a waiting room which we found to be cold and full of young people with injuries from partying. So we said Dad couldn't wait there. They allowed him (and us) to wait in a corridor in the Accident and Emergency (A & E) department which was warmer. However, Dad was sitting in a chair and this was the middle of the night. He was very tired and has venous excema - our local doctor had told us he needs to put his legs up to avoid worse problems. We had told that to the friendly woman but I didn't see her making any note of that.
About half an hour or more later, Dad was taken for an X-ray.
Hoiwever. thereafter, Dad was back again sitting in a chair, in the middle of the night, for at least a couple of hours.
After Dad had been sitting in a chair for over two hours, we asked for a bed for him - though felt rather guilty that we were being disruptive. We were told he might be able to have at trolley to lie on if one became available.
Eventually a trolley did become available. However, we were told we had to get Dad onto it ourselves. By now we started to become assertive, despite our tiredness, and said we needed help. Help reluctantly arrived. However, the 'help' also asked us if we would be able to get Dad off the trolley again - the implication being that, if we couldn't do so, then he shouldn't go onto it.
Anyway, with help, we got Dad onto the trolley and at last he went straight to sleep.
An hour or so later, he was woken by a woman doctor asking him questions which he was unable to answer due to his dementia. Someone down the corridor mentioned that his family (Andrew and I) would need to be involved. We were a few feet away and not sure why the doctor hadn't been told he had dementia and that she needed to talk to us! At 3.30am, Dad was understandably confused and exhausted.
The doctor basically just told us that we'd need to go into a consuting room with Dad, where a consultant would explain the results of the X-rays. We naively assumed that was imminent.
So Andrew checked with Dad whether he needed the toilet (he has prostate cancer and sometimes needs to dash to the toilet). Dad said he did need the toilet, so we traipsed back down the corridor to tell the receptionist (the rather unhelpful woman who had said we need to get Dad onto the trolley ourselves). She produced a bottle for Dad to use but again Andrew was left to manage the process.
Another half hour or so later, we were called in to see the consultant, at about 4 am. It seemed the consultant was to manipulate Dad's shoulder back into place.
A passing male nurse made obnoxiously snide comments (under his breath) about how much Dad would dislike this and how, even though Dad wasn't in pain at the moment, 'he soon will be'.
In fact. the lovely Doctor Shah and the lovely nurse were so good with Dad, and distracting him from the process going on, that Dad felt no pain at all.
After some time, we were told that Dad hadn't actually dislocated or fractured his shoulder, which was a huge relief.
However, we were told that he had stretched a tendon and he'd need to have his arm in a sling for four weeks. Basically he'd only have one hand for a month. That was alarming news as it meant that his care levels would have to be seriously increased and we weren't sure we could do all that ourselves. So we asked if he could be transfered to our local 'cottage hospital', which has a very good level of care for people who are recuperating.
Dad was admitted to a ward in the main hospital to be monitored. We went home for a few hours of sleep.
On our return, we found that even the hospital staff were unable to persuade Dad to keep his arm in the sling, so we started to wonder if there was any point in him being in hospital. They said his heart was being monitored for 24 hours, in case his fall was connected with heart problems. We felt sure it was more to do with Dad's usual bravado and trying to do more than he was capable of but also thought it good his heart was being monitored.
So we told Dad he would be there for another night and we'd come back the next day, which obviously he was a little diappointed about.
The middle of the next morning, we were rather surprised to be told that, because it was Sunday, no results would be available till the next day.
So we waited quite a long time in the coirridor to see the doctor.
Finally, we saw the lovely gentleman who told us there was no serious injury to Dad's shoulder, his heart was fine and we could take him home now. Indescribable relief!
Dad's house had seemed very strange without him. For me and, I'm sure, even more so for Andrew.
Of course, when someone's away, it makes you think what it would be like if they never came back. All the more so when the person is 93 years old and you hear so many (very valid) scare stories about vulnerable older people picking up germs in hospital. Adults who've lost both parents, even late in life, often describe themselves as feeling orphaned. Andrew's adopted, so he was in effect orphaned as a baby. Not surprisingly, Andrew was awake at night when Dad was away, worrying about feeling orphaned all over again.
So Dad's home-coming was a huge cause for celebration!
Therefore, we wanted to give Dad his freedom again. So we let him go check his post (even though it was Sunday and there was no post). After checking his post, Dad - being Dad - then sneaked off to collect his newspaper (which is a bit more of a trek). Again, being Sunday, there was no newspaper but that obviously didn't stop him.
After a short while, we heard Dad yelling 'Help!'.
We dashed down the garden path to find Dad lying flat on his back, with his trousers ripped. Luckily no blood from his head. We helped him back to the garden table and bandaged his arm and leg.
The following day, we took Dad to the local doctor's surgery to have his new wounds professionally bandaged by a nurse.
Next we took him out for lunch, for a treat.
On the way there, he slept and then woke to tell us that the kittens were looking worried. We don't have any kittens - and certainly not in the car. We thought it must be a vivid dream and he'd soon forget it. But all the journey, he insisted that there were cats in the car - which was a little alarming as he doesn't usually have delusions.
Anyway, he enjoyed his lunch and then did seem to forget about the cats.
But it's always hard when Dad, or Mum, have delusions (more often Mum) because of course we need to make a quick decision how to respond. And to get a balance between going along with the delusion and bringing them back to reality. And because the rest of the time they are very lucid it is still always a shock for us.
A change of scene and some food usually helps, as in this case.
This morning, Dad has even forgotten his hospital journey and doesn't know why he has bandages on his arm and leg. Which actually is a blessing. And it's certainly a blessing to see him back sitting happily at his breakfast table and then going into his sitting room to read his newspaper.
An uninvited 'tradesman'
When we returned home, I found there were several urgent phone messages from our son, saying to phone him. For some reason, my cheap mobile phone had not beeped to inform me there were any messages. In future I'll make a point of checking it.
Our son had been with my mum all weekend, while the drama was going on. Our son was understandably tired. Mum is inclined to wake him early (at the crack of dawn). So, today, he'd gone back to sleep.
He awoke to find a stranger in Mum's sitting-room, having tea with her. He found that the stranger had been working in Mum's garden for an hour or so.
Intelligently, he told the stranger to stop work until he'd spoken to me on the phone. The stranger told our son that Mum had instructed him to do quite a lot of work which would amount to £350 which would need to be paid in cash.
However, he obligingly went away for lunch.
By the time I phoned our son, at 3 pm, the stranger returned so I was able to speak to him by phone. I asked him how he'd made contact with my mum. He said he had been doing work locally and Mum had walked around to ask him to do some work for her. Since Mum hasn't left her house for at least six months, I found that hard to believe. I asked him when that was and he said he coudn't remember. So by now I was already a bit stressed(!) and had little patience, so I told him that his dementia was worse than Mum's. He then said he thought it was probably Saturday. Now, Mum had been with us from Friday to Sunday evening so it was impossible that Mum had talked to him on Saturday.
It seemed obvous therefore that he'd actually either knocked on Mum's door and asked her for work, or just gone ahead with it. Neither was legal.
I asked him if he'd seen the notice on Mum's door. He said he hadn't. It's impossible not to see it. The notice is also on her window. It was put there by the police (on my request, after a previous recent 'cold-caller').
I asked this guy's name and he seemed evasive but did manage to come up up with a name, business name, and phone number, when pushed to do so.
Now of course I understand that people are desperate for work and money. If this guy had given me a sob-story I might have felt like dealing with him more compassionately. But he blatantly lied to me.
However desperate someone is, preying on vulnerable older people is not the way to go! So I told him he is not going to be paid and that he will be reported. He apologised and said that he'd told my mum she wouldn't necessarily have to pay. So I said, 'You've done this for free then?' - and he said 'It seems like it yes.'. I certainly felt a pang of sympathy. But, none-the-less, I did report him to our local police and fraud squad. Because who knows how many elder people he was preying on, who did not have family. And I was also concerned he might return to Mum.
Hence the theme of this blog is what happens to vulnerable elder people with dementia who do have not family...?
And we're in the 'developed' world. In the UK, where we have our precious National Health Service.
I'd very much like to konw what happens to vulnerable elder people with dementia in the developing world...
Certainly in some parts of the world they are all too often dealt with as being 'bewitched' and therefore ostracised...