Tag: ageing in place

Care-Worker Tips: For When your Client Doesn’t Answer the Door

SIGNS THAT SOMETHING COULD BE AMISS:

1.  Blinds down in the middle of the day.

2.  A barking and very annoyed-sounding dog.

3.  Client’s car (if they still drive) is in the driveway / is not in the driveway

4. An over-flowing letterbox.

These would be the winning top four indicators that tell me, as a visiting Carer on the job, that there may be something awry when I arrive for a shift at the home of an older person.  Inevitably, one or all of these ‘clues’ will mean my Client has either gone out, is in bed, or possibly laying injured on the floor hoping that someone, OH PLEASE GOD… will find them.

Perhaps from a medical emergency, or more commonly – they’ve had a nasty FALL. 

A jam-packed letterbox I am immediately suspicious of.  Especially if there is distinct and varying shades of weathered-ness on the junk-mail spilling out of it.  Goodness knows how many days it’s been piling up for (or why the postie insists on stuffing more in???). 

In my experience, this says ‘nobody is looking out for me; I am all alone’ and it’s never a good sign.

That, or my Client has been whisked away by an enthusiastic son or daughter for family jollies at the beach house and, what with the excitement of it all… nobody thought to call and cancel mum’s scheduled shifts.  A more common occurrence over the festive season or public holidays, this one.

Similarly, an unrestrained Maltipoo with a demented look in it’s eye, doing cartwheels across the furniture and yapping its head off as you buzz the doorbell, can be of great concern too.  If ‘mum’ was OK and had been poised waiting for her Home Carer’s visit as normal, she would’ve already bellowed “OH SHUT UP, MOLLY!” and had him tethered to the leg of the kitchen table by now. 

Observing blinds that are down or curtains tightly drawn still in ‘night time’ mode when it’s well past lunchtime-o’clock, doesn’t send me much of a positive vibe either.  A creature of habit Mr Bill Cornfoot, he should be sitting in his lounge room armchair munching a cheese sandwich, half watching TV, half doing the crossword at this time of day.

Why isn’t he calling out for me to come straight in like he usually does? 

And why is his door LOCKED???

Ah, yes… waiting for a Senior to arrive at their front door can be a worrisome few moments for a travelling Care-worker.  And tempting though it is to roll your eyes and say “Oh god, where’s he gone this time?”  You know in reality, that there is every conceivable possibility that something untoward may have happened to your beloved Client.

The more likely scenario though, is that they have merely forgotten what day it is and have instead gone out.  Doctor’s appointments, to the shops for groceries, getting their hair done, a day at the races, or been taken by friends to play the pokies at the RSL… we hear it all.

And that’s fine.  As long as we KNOW.

I have several repeat offender Clients in this category who despite having had their Home Help service scheduled at the EXACT same time, on the EXACT same day, every week for the last two years, they continue their pattern of being frequently absent on service day.

Arrrggggh the frustration!  So then we play the waiting game…

Because bound by a Duty of Care policy, as a paid Carer I am obliged to take appropriate and timely action when a Client fails to present at the door to ensure they are found safe ‘n’ sound and free from harm.

The key word here being:  FOUND.

.

THE ART OF DOOR-KNOCKING

But before launching the official Sea-to-Air search & rescue mission, it’s important to give your aged Client a fair amount of time to respond to your initial knock.  Followed by a calculated and respectful waiting period (depending on their general state of health and / or their mobility speed), before you go leaning on doorbells or knocking more loudly-er for the second, third or one hundredth time.

Some people can become exceptionally aggravated if they feel pressured into hurrying unnecessarily – so use your discretion. One buzz only, then wait… count to to 20 or whatever it takes before you start ding-donging away furiously.

Remember the reason you are there.  And that it’s not about YOU getting to your lunch break on time – keep your composure and STAY COOL!

(Futile when they aren’t home of course, but as a process of elimination it has to be done).

And while some Clients with gazelle-like reflexes are capable of appearing within seconds (they’ve been glued to the window since breakfast in anticipation of your arrival) other movement-compromised Seniors can take many minutes to complete the long, pain-staking trip up the hallway to their front door. 

Handy if you know this because you visit them regularly, but hard to juggle waiting time-frames if you’re meeting a brand new Client for the very FIRST time.  You don’t want to appear rude or impatient by knocking or ringing continuously, yet you also hope your Client has heard the doorbell and is at least on their way. 

More often than not though, you’ll find the more slower-paced folk will either call out that they are coming, or for you to “Come in, dear” which solves the problem, saves you time and puts everyone’s minds at ease immediately. 

Lovely.

.

KEY SAFES

Some of my more frail Clients, however, can be SO delicate or unwell (you actually wonder how they manage living alone) that their families conveniently arrange for a key-safe to be affixed outside the front door somewhere, perhaps attached to a step railing or post.

This brilliant contraption requires a secret code number to open it before: Hey Presto!  It pops open to reveal a key hiding snug inside for you, as their Carer, to let yourself in.

Word from the wise here:  Make sure you knock first before you stride on in.  And also call out to announce your arrival.  You don’t want your unsuspecting client, in mid-doze, dying of fright as you suddenly appear with your bucket and mop from behind the sofa!

Oh, and make sure you PUT THE KEY BACK in the safe for other Carers who might need to get in after you’ve been and gone.  The havoc you can create if you forget this can be totally disruptive and cause all sorts of headaches.

.

STALK YOUR CLIENT

Once you’ve done the acceptable amount of knocking and ringing, and you still haven’t had a response, there are windows you can peer through, and gently tap upon, as well. 

Move stealthily around the outer rim of the house, calling out their name and rat-a-tat-tatting as you go, just on the off-chance that your Client is in another room, in the shower, or maybe just finishing up important business in the bathroom… no presh!

Or perhaps they haven’t got their hearing aids in?

Or they’re yakking on the phone?

Or they’re having a bit of a zzzz after a poor night’s sleep?

Keep knocking and also check out in the back yard and garage areas too, if you can access them.  I once had a Client whose life revolved completely around her magnificent garden so I knew I’d always find her out back in her wide-brimmed hat digging away in the veggie patch… head down, bum up!

Sometimes too, at this nomadic point, you’ll find a neighbour can often lean over the fence and offer you THEIR five bobs worth on where they think your Client is (or isn’t). 

“Oh I saw the ambulance there early this morning.  Mary’s daughter said she may’ve had a heart attack so I think they’ve taken her in for some tests.”

Although not to be taken as gospel, you at least know that something serious has happened which explains why your dear Client is not going to be home no matter how furiously you knock. At this point, you’d report in to the office and let them take them wheel.

.

HELP!  I’VE FALLEN OVER!

The other less desirable scenario, is discovering your Client on the ground from having an incident such as a Fall.  As unpleasant as this thought is, it is very much a reality considering the age and the state of health of the older adults you are dealing with. 

I once found dear Mr Jeffery Bonecracker out by his clothesline one afternoon after he’d tripped over the peg basket and gone for a tumble.  Although he swore he was fine and ‘please don’t make a fuss, Dollie’, turns out he had a shattered hip, a dislocated shoulder and required two months in hospital (throw in a further six weeks in Rehab).

FUSS?!  Very glad I chose to ignore Jeff’s plea and immediately called emergency services for a whole ambulance-load of fuss! 

Note:  Never hesitate in calling for an ambulance if you feel it’s warranted.  Better safe than sorry – you don’t want the alternative on your conscience.

.

PASS THE BUCK

So once you’ve explored all the accessible surroundings of your Client’s property (and checked under the clothesline) and you STILL haven’t made contact, it’s time to officially launch into plan B: Ring your office.  

Here is the typical procedure a Care Co-Ordinator or Administrator might follow when they receive a report from a Support Worker out in the field with a Client who has not responded:

Often, in all the fervour of a better offer, some Clients just downright forget to notify their care provider that they won’t be home today and to please cancel service.  Annoying, but understandable and as we all know in life – stuff happens.

STEP 3: Call the Police:

Finally, the last ditch effort in pin-pointing the whereabouts of your missing Senior is to bring in The Law.  Meaning yes, the Police are informed and a Welfare Check is systematically conducted by them at your Client’s home to ascertain if they are in there or not.  If that means breaking down the door then SO BE IT!

I remember one day not being able to locate my client Mrs Doreen Appelblatt… to pick her up and take her for her regular weekly one hour of shopping.  I’d felt quite concerned at the time when she didn’t answer her door as she had complained only the week before of experiencing dizzy spells and ‘feeling a bit off’ recently. 

The office too, had exhausted all avenues of contact but had managed to locate Doreen’s daughter Ellie who had also become quite anxious.  So much so, that she had jumped in the car and driven the hour long trip to Doreen’s house to see for herself where mum was.

“I rang and reminded her last night that Dollie was coming today to take her shopping – she should be home!”  

Oh god, what if she was on the floor, had slipped in the shower, passed-out and unconscious in the bathroom?  Perhaps she’d banged her head on the dresser and was slowly bleeding to death after crawling on hand ‘n’ knee trying to haul herself to the phone? 

As peppy and alert as Doreen usually seemed, she was 88 years old and had had medical mishaps in the past. Perhaps her number was up and she now lay slumped in a chair from suffering a life-threatening INTRA-CEREBRAL BRAIN ANEURYSM???

(Honestly, the things that fly through your mind!)

But then… as we waited nervously in a clump on the porch for the Police to arrive, Ellie and neighbour Jim (who’d kindly sent out a search party of his own via his Canary Club peeps) watched as a taxi roared round the corner and pulled into Doreen’s driveway.  

In disbelief we looked on, as four high-spirited ladies wearing matching blouses piled out of the car, all yakking at once and juggling handbags with platefuls of cookies and sponge cake.

“Pop the hood, if you would kind Sir!” sang Doreen, oblivious to everything except extracting an enormous gold trophy from the boot of the cab.

I remember daughter Ellie looking relieved, as were we all… but at the same time she was fuming that her absent-minded mother had missed yet another valuable council-provided service, wasted everyone’s time and caused a whole lot of bother.  Not to mention having the nice police officers in on the act, too!

Apparently winning the tuesday morning Senior Ladies’ ten-pin bowling ’round-robin’ just wasn’t going to cut it this time.

“Oh, MUMMMM!!!”

HAPPY CARING!