Tag: dementia

Teepa Snow: the GEMS model

Peter revisited this model. Teepa Snow’s fascinating video introduction to the model is here.

To quote the web site: “The only constant with dementia, or brains in general, is that they are ever-changing. All humans experience brain change every day. This GEMS Model, developed by Teepa Snow and based on the Allen Cognitive Scale, recognizes the shifts in our skills and abilities in any given moment. With dementia, while the progression, pattern, and changes may look very different for each type of dementia, the movement through the GEMS is somewhat predictable. Your understanding of the remaining abilities at each step of this journey can make a world of difference.” – “Just like gems, each person is precious, valuable, and unique, and given the right setting and care, can shine.” – Teepa Snow

Covid vaccine

We were told that vaccinations were progressing well. One issue raised was about where someone has had an allergic reaction to vaccinations in the past. The questions asked before someone has the covid jab include ones about reactions and anaphylactic shock. The guidance is very clear that anyone who is vulnerable should raise the potential issue and only be vaccinated in a hospital.

Some vaccination centres are ahead of others. Guys hospital, for example, is able to vaccinate carers (the call handlers vet those claiming to be carers). Having had rather a lot of visits to Guys recently, I recommend their efficient and very clean centres.

Guys is where I had my jab. For me it was quick, painless and came with a cup of coffee and a biscuit. Thank you NHS.

Scam phone calls

Sadly a carer reported her mum had been receiving lots of scam calls on her land-line. The callers claimed to be from a variety of organisations, including HMRC and BT. They asked for personal details. Stopping these calls is very difficult, as the callers use a variety of numbers and block tracing. The police were involved in this case. They advised the mum to hang up if she didn’t know the caller – she replied “but that would be very rude”.

The group suggested her mum get a mobile phone. This had been tried and she had mislaid three of them!

Easy use Telephones

The group liked the idea of phones with big keys, showing photos of the people who had been pre-programmed into the phone,

Here is an example [we have not tested this model – it is included just for information].

Keep warm

Another story was about a mum turning the heating down, she didn’t want a big bill. There had been several discussions about the need to keep warm, particularly as the mum doesn’t move about very much. This hadn’t been as successful as hoped for. The mum, somewhat frustrated with the radiator controls, had smashed them with a broom handle.

Janet suggested putting notes around the house reminding mum, and any visitors, not to turn the heating off.

The mum and daughter came to our Friendship group the following day. Janet asked the mum, in passing, if she was warm enough. She said “yes” and that she would never turn the heating off and be cold…

Melting away

Being isolated in a care home is having negative effects on those staying there. A carer said her mum’s home had not had any covid cases and they wanted to keep it that way. This was good news from a physical health perspective, but was having a big impact on mental health. The carer felt her mum was melting away. The lack of in-person contact is leading to difficulties in communicating by phone, as mum is unsure about who she is talking to and is easily distracted.

Emotional rollercoaster

A carer, who has been at home with his wife for many months, said that she doesn’t recognise him and her emotions were in turmoil. She had lost her language. He tries a variety of methods to distract and calm her, sometimes succeeding. Like other group members the strain is clear when he speaks, but he puts a brave face on and is as positive as possible.

Dementia and learning difficulties

People often don’t just have one issue to deal with. In this case, the challenges of being in a care home continue to cause the person, her carer, and the home problems and stress. Here is another home that has no cases of covid and is very protective of its people – especially as it is in an area of very high infection rates. The person wants to see her carer, wants to go home and can not understand what is happening to her. Her frustration means she is considered a “disruptive” person.

Carer mental well-being

How would you cope if you were looking after three old ladies each with different ailments and a son? What if, in addition, your husband and father had died in the recent past. And then covid and lockdown arrives? How much counselling and support would be needed?

Charcoal

Some people with dementia develop their own ideas on health remedies, often based on memories from the past. A carer mentioned again that his sister had decided that charcoal would help fend off covid. The group seem to think it odd that anyone would want to take charcoal. A quick look at Amazon shows that charcoal is a popular remedy (but not for covid), see here.

On a positive note, the sister has a covid jab booked.

Let’s see some real people!

Our final story was from a carer who’s dad was doing well. He often spoke to family and friends on the telephone. This went well, but then he was keen to go and meet them. He had difficulty in understanding why he couldn’t.

Postscript

We were ready to say goodbye, when the subject of disappearing pens came up. Two carers said that pens had found their ways into mysterious areas of trousers or leggings. How they got there and how to get them out had been proving a challenge.

Next meeting the 8th March.

Coping strategies for feelings of being overwhelmed

Peter spoke about the issue that affects many of us at the moment. A summary of the talk is here and a one page help-sheet here.

Dementia research

Janet talked through the possibly avoidable factors contributing to developing dementia.

Vaccinations

A very popular topic. Several members of the group had taken their loved one for their first jab. Local surgeries and the Princess Royal hospital had provided a very safe and efficient service. Picking a quiet time was recommended.

Covid

Two members had contracted the virus. One had thought it was just a cold but, at Janet’s prompting, they had gone for a test – and came back positive. The other’s husband had gone into hospital, caught it, come out and given it to her. Both were able to pop along to the group for a short while – another success for Zooming. We wish thenm a speedy recovery.

Missing? Presumed dead?

Two very unfortunate stories.

One person had been in and out of hospital. On trying to trace them in hospital, their wife had to wait 48 hours before she was able to make contact. Other patients in the ward were eventually able to make calls to the carer – the hospital staff less successful.

Another carer was confused when she tried to get her mum’s prescription. Mum had been recently discharged from hospital. The hospital didn’t tell her GP that she had been discharged, they said she was dead! The pharmacist was, understandably, reluctant to issue a prescription for a dead person. The carer said “But I only spoke to her 10 minutes ago – she is at home!”. In the end, it was agreed she was alive [and came to our Friendship Group on the 12th January].

Visiting Care homes

More changes have come about with the latest lockdown. One carer is concerned that her relative is feeling isolated and depressed. Their home is understaffed (due to the virus) and is not providing the stimulation, activities, and other support that is needed. There has been a promise of an assessment visit from the mental health team.

Another carer was told she can visit her mum, by standing on a wooden plinth outside and speaking through a window. The home had arranged a special room for visitors, but this was not going to be used for the foreseeable future. Update: the day after this meeting the carer contacted the home, was assertive in setting out the reasons why the special room should be used – and the care home manager agreed. Success! Update2: the following day the home owner stated the home would not allow visitors to use the special room.

Location, location, location

We were told a Friendship Group regular was now reluctant to eat – in the kitchen. But, she would eat – in a favourite chair. Feeling safe, comfortable and relaxed made all the difference.

90 minute turn-around

Christmas had gone really well for a carer and her mum. In the evening the carer returned to her home, then 90 minutes later she had a call from her mum’s neighbour. Mum had come round asking questions in a confused state. The carer went back and found her mum’s mental state had radically changed. Just a temporary blip. Since then, mum has continued to be rather good at cooking vegetables, but forgets the meat and potatoes.

It was good to see the group members and hear how they were managing, even it these difficult times.

Next meeting the 8th February.

Janet’s report from the Greenwich Dementia Action Group (DAG)

The group had a very interesting insight into what the council have been doing to support and protect those in care homes. This information was correct at the time of the meeting, but subject to change afterwards.

• Homes had allocated “staff wellbeing rooms” to allow staff (who are on 12 hour shifts) to have a space to take a beak from the stress of their work.
• The council had made a commitment that no-one with a positive covid test would be discharged from hospital into a care home. Those waiting discharge would have a test 24 hours before leaving the hospital. If they were positive, then they would be placed in the Eltham Community Hospital, or remain in hospital, until they were clear.
• Decisions on having visitors in care homes must be agreed by the local Director of Public Health, after appropriate safeguards have been put in place.
• Visitors to care homes will need to be tested 24 hours before their visit. On arrival, they will need to change their clothes and wear a mask. They will be allowed to hug their relative, but not kiss them.
• “Lateral-flow” 30 minus tests will be rolled-out, following a pilot. This test is very staff-time-intensive.
• Visits will take place in bedrooms or visitor areas.
• The vaccine is being rolled-out to residents and staff from 3 local hospitals: Kings, Guys and the Princess Royal. At the time of the meeting the vaccine was being distributed in packs of 975, which could not be split and needed to be used within 3 days.
• Once vaccinated the usual hands/face/space rules still apply.
• Testing for the virus will be once each week. If there is an outbreak, then an action meeting will be held within 24 hours.
• Care home inspections have ben suspended for the time being.
• Staff should not now work across multiple sites or multiple locations within one home.

Visiting care homes (carers’ experiences)

The arrangements are changing regularly, as the government policy twists, u-turns, and is re-interpreted.

One carer told us she had been told the Christmas arrangements at her mum’s care home would involve: A quick virus test (the 20 minute Lateral Flow Test), clean cloths, masks etc, chaperoning by staff = a 15 minute visit.

Another carer said her relative’s home would be ready for visits soon, using a perspex screen to divide the room. She couldn’t get an appointment until 28th December.

Reducing medication

A long standing member of our Friendship Group had benefitted from having her medication reduced, following a cautious plan. Her paranoia had resurfaced, but was forgotten after 30 seconds – an interesting trade-off.

A degree of stress

An unexpected discussion had come about for a carer when his sister became distressed about not getting a first class degree – 30 years ago. Other concerns were around mobile phones, flu jabs, virus jabs, and taking carbon as a supplement, to name a few.

Eating and drinking

A husband forgets to drink, which causes medical issues. A mum has decided she will only eat chops, which has not caused any problems. Carers need to go with the flow.

Covid vaccinations

We have one mum lined up for a vaccination on 11 January at Guy’s hospital and another at the Pru. It looks like the NHS is rapidly contacting people in the top category of those in need. Both of the mums’ carers were in a rather positive mood.

We hope the New Year brings more good news. We are back on 11th January 2021.