HOW DID THIS HAPPEN?
You are enjoying life, your parent / parents are also enjoying life to the full, your children are growing up and planning their own futures…. And then you get the call. Your mother or father has fallen and fractured her hip and are admitted to hospital. They will need care when they are discharged and suddenly your world is turned upside down. You are suddenly faced with organising your own family, having to go to work, negotiating time off work for hospital visits and trying to get some form of care in place when they are finally at home .You will have to organise transport, getting them home safely, food shopping, collection of prescriptions amongst many other things. Where do you start?
The other scenario may be that you are noticing your parents becoming increasingly forgetful, and a neighbour has called you to say that there is a smell of gas in the home, or they are concerned because your parent has forgotten her keys for the second time and is locked out. This is just a sample of distressing scenarios that can happen. What you once thought was absent mindedness due to the aging process has become a more worrying situation. Again, where do you start? The health and social care systems can be a navigational maze with complicated vocabulary and a plethora of form filling. Suddenly you may be asking yourself how did this happen? Life become becomes chaotic as hospitals and doctors’ appointments have to be arranged and, care put in place. Perhaps there is social services involvement, assessments to attend and so much more to think about and organise.
Having been a Clinical Nurse Specialist in discharging hospital patients for over fourteen years and the Director of Operations in a domiciliary care company, has given me the experience of supporting patients clients and families that face these situations.
Indeed, you may be living on your own and not sure where to start planning your own future healthcare. Often families and individuals face crises when it happens, causing confusion, distress and feelings of helplessness for all concerned. Be Prepared. It is far easier to have knowledge and sources at hand for that inevitable emergency If your loved one has suffered an accident or an admission to hospital it is a very upsetting time for all. There are key people who can give you advice and support and who will help answer your questions. Try to have conversations with them all at the earliest opportunity.
If your loved one has suffered an accident or an admission to hospital it is a very upsetting time for all. There are key people who can give you advice and support and who will help answer your questions, and again, have conversations with them all at the earliest opportunity.
- The ward sister/Manager will be able to listen to your concerns. Explain openly, the circumstances that you or your loved ones are facing. Examples of this will be how often you can visit them at home and how often you can help. The nursing staff will have asked and assessed the home environment. The Ward sister may organise a Multidisciplinary Team Meeting, whereby nursing staff, doctors, physiotherapists and, occupational therapists will attend and discuss your parent’s healthcare. Full assessments will be undertaken on mobility, functionality, continence, Falls risks, nutrition and hydration, and tissue viability and adapted equipment such as crutches and an electric bed, hoists and any other equipment that may be required and this will be provided and delivered free of charge by the NHS. It is their professional assessments and judgments that will decide what is required and will be installed into your parents’ home. Again, it may be helpful to think of planning and layout of the room that your parents will be staying in. An occupational therapist may undertake a home visit to help you with this. The patient may also be referred to social services for an assessment, in order that a care package can be organised. Adult Services social workers often have a speciality in older adults and are employed by the Local Authority. However, this will be organised for you by the hospital teams. A discharge letter will be sent to your parents GP explaining diagnosis, treatment, reason for admission and medication. So even though hospital teams work extremely hard to give your parents an optimised and organised discharge, you may work full time or live far away. There is also the situation whereby your once, slightly forgetful parent has been diagnosed with dementia, which entails more concern and worry. Whilst one strives to attain independence, autonomy and choice for a parent there is always the worry that they are alone at home and will they be able to cope? and you cannot be there twenty-four hours a day. Or, maybe, you may worry that your parent is lonely and doesn’t go out as much as they used to, especially if your parent has recently lost a partner and your parent is at risk of becoming isolated. It is to be remembered that social services can only provide a certain amount of care packages, and it is advisable to research private domiciliary care companies before a crisis point occurs. Have conversations with the managers to see what kind of care they provide, what training their carers and support workers undertake, and what the costs are. Try several different agencies and see which ones make you feel confident. Personal recommendation is always a good start, however, look at the company's reviews on websites and a look at the CQC rating. Carers and support workers provide the following:
- Personal care
- Accompany on outings such as to the library
- Accompany on Dr’s appointments
- Meal preparation
- Medication administration and prompting
- Monitoring of health and well being
- Companionship
- Facilitation and enablement of your parents stay at home
- 24-hour care
- Live in care
If on the other hand, it is no longer viable for your parent to live alone at home and a more intensive nursing regime is required, take time to look at the local nursing homes, or ones that may be near to where you live, so that visiting becomes easier. Talk to the managers and see what facilities they offer. Check the reviews, and again their CQC reports. Many of these nursing centres or care homes offer respite packages if you need a break or a holiday and offer long term and short-term care. Rehabilitation centres are useful for post-operative rehabilitation in order to regain strength and mobility prior to going home. Rehabilitation centres also offer short term respite packages.
Caring for elderly parents initiates a rollercoaster of emotions’ and these may include guilt, frustration, anger, feelings of helplessness and loneliness. All of these emotions are to be expected as you may find that your life has changed dramatically, and you may also feel that your life is no longer your own, but taken over by the physical, emotional and medical needs of your parents. You may feel guilty because you cannot provide the care that as a daughter/ son you should be giving. You may feel that you're being judged by others, that responsibility for your parents’ rests solely on your shoulders. Most of these emotions can be extremely painful as you see your parents becoming vulnerable and fragile. These emotions may incur a feeling of loss as you witness your parent not being able to cope with life and are not the vibrant parent who always looked after you.
By having a contingency plan and a strategy at hand, helps prevent crisis planning when illness or accidents occur. You will have been proactive in alleviating some of your concerns and anxieties. Have conversations with your parent/ parents on what their future wishes regarding their future healthcare may be. Find out what support services are available such a specialist nurses for example Admiral Nurses who specialise in dementia, what resources Age UK offer, The Parkinson’s specialist team, to name a few Seek a solicitor’s advice if you feel that your parent’s mental capacity is deteriorating.
All this adds up to having informed choices, in order to have possible outcomes for the health and wellbeing for the person who is dear to you. Join a local Carer Forum, whereby you can exchange views with other carers and enable you to realise you are not alone. They also provide support and advice. . It is also important that you take care of your own health and wellbeing. We all want the very best for our parents, and we want them to have full and enjoyable lives, whereby they are nurtured and cared for. By having a contingency plan at the ready may help reduce the feelings of panic and helplessness. Most of us have a mother or a father who will age and they deserve what help we can offer them.
SABINA KELLY RN Ba (Hons) B.Sc. (Hons) sabinakellylondon@yahoo.com
