Posted in Alzheimer's Disease, Dementia, Working with Elderly

An Alzheimer’s Poem

Leaving our Loved Ones “Sad and Sick…and Lost”

Every time I visit 82-year old Ruth Cuddlepot I read this poem. 

She has it up on a wall of her home near the toaster, just above the kitchen bench.  I know it by heart now because it’s so hard to miss and I stand there every Wednesday reading it (at least three times over) – while I’m waiting for her crumpets to pop!  

It’s a short, but popular verse and most of us carers have encountered it on our travels in and around the Aged-Care industry. To be honest, I always feel annoyed whenever I read it because as far as describing the hopelessness and grim reality of Alzheimer’s disease – it’s pretty spot on.

It is also completely sad.

We all know this one, right? 

The story goes that back in her day, Ruth Cuddlepot had etched herself out and prospered, in an outstanding career as a principal in some posh private school for boys (at the time the youngest female to obtain such a role).  She never married, didn’t have children and had no real family to speak of.  Therefore, she had bucket-loads of money tucked away ready to spend totally on herself, whenever she might need it. 

That day came a few years back when Ruth received the official crushing diagnosis of Alzheimer’s Disease.  Being such an insightful person however, she decided early on that she would set herself up for when the time came, when she could no longer work or take care of herself.  

Indeed, there would be NO nursing home for Ms Ruth Cuddlepot! 

Instead, she arranged her affairs and teed-up the lawyers so she could be completely looked after and cared for IN HER OWN HOME. No matter what.  She knew her condition would deteriorate; that her memory would crumble, and she would eventually “lose my marbles completely!”  

Apparently, that’s how Ruth used to say it, although I didn’t know her then and have relied on verbal reports from other carers to fill me in on all the background reading. 

Needless to say, she was a very clever lady. Although, by the time I had the pleasure of caring for Ruth Cuddlepot she was no longer the organised and efficient educator I had been told she once was. 

Ruth had, instead, evolved into ‘Ruthie’.  

And thanks to the personality-morphing Alzheimer’s, Ruthie had become a frail, yet openly happy and affectionate elderly woman…. WHO LOVED TO HUG! 

Even when her speech faltered, Ruthie could at least continue to communicate with a nice big welcoming embrace whenever I arrived for my shift.  I looked forward to it in fact!  

There she would be, sitting at her favourite spot on a chair in the sun at her enormous loungeroom windows… the spot where she had the wonderful view of her garden and a watchful eye on the next visitor she could throw her arms around and give a great big squeeeeze to!  

Really if it wasn’t so heart-breaking, it would be lovely.

Ruthie in her window…
 – waiting for the next hug-ee!

Recently though, Ruthie had started calling me Wendy.  

Which is fine by me because you can imagine it happens a lot in this line of work (I’m also known as Debbie, Louise and Margie with some of my other cognitively-challenged clients). Let’s face it, remembering each carer’s name, rank and serial number is understandably not high on the priority list for some seniors – especially when they no longer know their OWN name!

I knew something had started to change in Ruthie when one day – the hugs stopped.  

And another cruel stage of the Alzheimer’s curse set in… Ruthie Cuddlepot started to become aggressive.

Without much warning her moods became erratic and it eventuated that Ruthie couldn’t STAND to be touched.  Not even a handshake or a gentle pat on the shoulder.  You just wouldn’t dare in case she would flare up and start screaming and punching the air (or anything else within proximity) in what appeared to be the ultimate frustration within Ruthie’s muddled-up brain. 

This most heartless and indiscriminate disease had finally taken hold of her … it has been just awful to watch.

Finally, after accusations that Ruthie had started slapping and pushing her carer’s, we were told there was a serious incident last week where she had to be whisked away by ambulance and sedated in hospital.  

Quite honestly, it became apparent to us all, that they didnt know WHAT to do with her!

After all Ruth’s organising, having purposely prepared herself and her future to remain forever being tended to in her own home by an army of paid care-working bees, it now seemed this was no longer a viable option.  

I wonder now looking back, how Ruthie could have possibly planned for this gloom-ridden stage of her illness?

Perhaps she’d anticipated that by this late phase: 1) she wouldn’t know where she lived, and 2) she wouldn’t care?

I hoped so for her sake.

The poem was right, and the best of Ruth had gone. 

And yes, we had failed in standing beside her.  Basically, it had become too unsafe to do so!  Poor Ruthie had become a danger not only to herself, but to everyone else as well.  And if a support worker is under any threat whilst looking after an elderly person in their home, then the people in charge needed to move to an ulterior arrangement.  

I was informed only today that the once proud and brilliant Ruth Cuddlepot had been relocated ‘indefinitely’ into a High Care facility.  

Just like the poem had foretold she was now sad and sick and lost.  Her beautiful forward-thinking mind now full-to-capacity on sensory-depriving medication to keep her comatose and manageable (for her own protection, we were told).

I have deliberated greatly about going to visit Ruthie but honestly, what would be the point? Without sounding totally selfish – I don’t think I could bear it.  

The worst part is finding out she doesn’t even have a window.

HAPPY CARING!

Cheers, Dollie

Posted in Aged Care, Dementia

Dementia Diagnosis for Aunty Win

A Letter to my Fam

Winnie – younger days
(always had great hair!)

I received this email from my cousin Rochelle recently.

Thought I’d share it here (because I can), and also to emphasise how shitty and random Dementia is. Not to mention the despair and frustration for families who are left heart-broken as they watch on hopelessly; it is totally NOT FAIR.

Aunt Winnie taught me that girls don’t have to aspire to be receptionists or “office note-takers” or run around after others… “unless you want to, then that’s fine, too.”

Instead, if you’ve got the gumption (her favourite word) – you can make a great career doing something you love, settle down and hopefully find a nice boy “wearing not-too-tight slacks” to make a good enough life together.

It has eventuated that I have done both.

Aunt ‘Winnie-the-Poo‘ – – –  YOU ROCK!

(We miss you so much).

Happy family, beachy days
(and the discovery of ginger beer!!)

To my dear family,

I’ve been back from overseas for almost 2 weeks and there have been a few changes with Mum (our Winnie), so thought I’d send a group email update so you all know where that’s at.

Unfortunately, and as predicted by most of us, her mental health has declined significantly.  

I took her to her GP and she completed a MoCA test (half hour competency testing), where the results were not flash:  ie: 10 out of 30 is bad.

Poor mum scored 2…(TWO!)  Is that even a number???

Thank the Lord she defiantly remembered where she was from, although truthfully, I think she must have fluked the second point by just sheer good luck!

We also discussed her anxiety levels and turns out, they’ve put Mum on a little ‘upper’ to assist with her mood.  Arthur is great with mum and loves her to bits which I could cry with relief about cos he’s such a caring wonderful man.  

Obviously, as a retired school teacher, he revels in the role of directing and correcting!  (Plus, the Citalopram will be doing it’s job – keeping Mum calm and ticking along, happy to stay back after class with another special Arthur ‘detention’ !!!)

In the meantime, the Geriatricians will without doubt, assess Mum for ‘Care-Home’ level care, and I assume officially diagnose her with Dementia. This should happen soon.  Hopefully, while I am still in the country – although I may be called up any day now so not sure what we do then… 

Thankfully, in this zippity-do-dah-modern-day (haha another one of her ‘funnies’) most stuff can be sorted online and organised via email etc.  And legally, I don’t need to go to the lawyers- which is just perfect.

The best thing is that the staff at the Respite home where Mum is now are all on the same page as I am.  And they have been concerned with her deterioration for a while – the head nurses have an amazing rapport with her, plus they’ve kept me fully up to speed on things. 

I am just SO impressed with the set-up there!

Win gets to stay in her current apartment WITH Arthur – and the Care Team actually comes to her! This includes 3 showers a week, getting dressed daily and undressed, breakfast, lunch and dinner, dispensing medications, clothes washing, housekeeping etc.

At the moment, Mum is just having shower and dressing assistance (extra $100 a week).  Once the new level of care comes through, we will apply for a subsidy as their combined total assets is less than $119k.

This new level of care will be paid from Dad’s deceased estate account (ie: $23k – and then the good old government takes over…PHEW).

I did have Mum come stay with me by herself last week (and my girls too, much to their horror), for a night recently. She spent the WHOLE TIME thinking Arthur would be coming to pick her up at any second – watching out the window, pacing up and down etc. 

I could tell she really would have preferred to go back ‘home’ to Arthur; we had to phone him a few times during the night when the panic set in. 

You should have seen it the next day, though, when they re-united.  I just about died… they had the biggest SNOG I’ve seen in ages….in front of all the staff…everyone…THEY DIDN’T CARE!!!

(I think I was actually JEALOUS!)

Arthur & Winnie’s ‘golf’ wedding cake
FOURRRRR!

Mum’s just fine where she is and like I said, Arthur loves her to bits. So as weird as all this is, Winnie’s definitely safe and cared for. She actually does realise her memory is bad (kind of), but quickly seems to forget she had that flash of realisation and so we just move on.

She happily accepts shower assistance, and for her own dignity and personal presentation, I’m terribly thankful for that.  Physically, Win looks and IS well.

Don’t know what else to say but I really hope this email doesn’t cause any concern for you guys.  I really feel she is in the right place and I think we should all feel blessed that she married Arthur last year – as crazy as that seemed at the time…. WHO IS THIS MAN WITH THE GIANT MOUSTACH WHO IS IN LOVE WITH MY MOTHER? 

Because it certainly takes the load off me – not that I’m complaining…

It’s just hard, you know?

Anyway, I hope all is well with you guys – sorry if I’ve rambled on but I wanted to put you in the picture seeing as you are her family,,, the people who love her the most. 

God, does she even remember?  

You know what…I really don’t know any more.  Today for example, she called me Geraldine.  As in Aunty Gerry, her twin, who died when they were in their 20’s.  And I can tell when she looks at me that she’s not ‘Mum’ anymore.  I hate that the most about this awful disease.

Anyway, I’m waiting for confirmation of my next placement abroad – not sure when or where that might be but I’m loving my Oncology nursing and the fabulous people involved in the industry so that makes it all worthwhile (as well as being the best distraction from the Win & Arthur show!)

Will keep you all updated as the rest of the saga of our gorgeous mum/sister/aunty’s life unfolds. 

Love you guys,

Rochelle

PS: please, don’t worry about mum.  She is fine, really.

PPS: we must all get together in the SAME room one day.  Life’s too short. – I could end up losing my mind, just like Mum.  ARRRGGGHHHH!

Winnie (and Gerry)
liddle widdle! 

HAPPY CARING!

Cheers, Dollie
Posted in Aged Care, Working with Elderly

The Lighter Side of Working in Aged Care

“It’s all fun and games… until someone loses their bladder!”

Laughing and Leaking
– both easier to do the older we get

I’ve noticed lately that a lot of jobs advertised in the Aged-Care sector are now listing ‘sense of humour’ as one of the more desirable personal characteristics required from potential applicants.

Right up there alongside the usual skill-set buzzwords: compassion, empathy… yadda yadda… time-management, communication, etc etc etc it seems that a lot of Care providers are now recognising the merit to be gained in employing Support Workers who are capable of seeing the lighter side of their roles.

Not that we ‘funny-bunnies’ don’t consider our work with older adults as meaningful or important. Ahhh no, quite the opposite.  In fact, more is the case where those who CAN have a laugh (and don’t feel they have to take everything so seriously all the time), end up with far greater job satisfaction as a consequence of receiving such fabulous positive feedback from their much-amused clients!  

Because there’s little doubt how beneficial humour can be when meeting an elderly client – especially for that harrowing first time.  Not meaning you need to perform party tricks or stand on your head and act the clown. More just in understanding your client; seizing those unexpected instances as they occur and utilising them to develop a good happy, healthy relationship.

You know… tell them the silly story about your wheelbarrow at home with the dicky wheel or how your new kitten got into your knitting bag and found itself tangled in a ball of red yarn under the sofa – and then let them share similar humorous anecdotes with you.

We all know that there’s nothing like a good ol’ laugh to improve overall wellbeing, to strengthen friendships or just to promote a jolly good mood.

Are we having fun yet?

So, as a care-worker in your client’s home, merely being observant and discovering what interests your client has, understanding what makes them tick… can make it a heck of a lot easier for you to change tactics if required, and direct your game plan accordingly.

As a coping strategy, too, an intuitive carer should also understand the benefits of how a funny story, or a witty one-liner can be tactfully used to distract an ageing adult who is clearly agitated that you have arrived at their home in the first place. They’ve decided in advance that they won’t like you and therefore will be totally resistant to your charms. No matter what!

“I DON’T NEED YOUR HELP, MISSY!”

In my experience, discretely changing the subject, injecting a fresh but genuine perspective into the conversation can diffuse most potential challenging behaviour before it gets a chance to gather momentum.

Just by sharing a refreshingly waggish viewpoint in a senior’s often mundane existence can be enough to crack even the hardest of old nuts (yes, a lukewarm smile still counts).  Achieve this and you’ll gain trust and win them over before they’ve had a chance to realise how much they actually DO like you after all.

The awkwardness of nudity at shower time is always a good test of a carer’s inter-personal communication skills. But be brave, just chat away and show how you thoroughly enjoy the company of your new NAKED client, ever so much!

In fact, I’m often surprised, how even the most insignificant occurrence or absurdity, can turn a stilted situation into a side-splitting laugh feast in an instant!

Take my new client from yesterday morning: a frail and reluctant 91-year old Gladys Liverspot. Obviously already annoyed and feeling quite indignant that “my-regular-girl-Angie” was not available to help her shower – she’d been informed by the office that she was stuck with me instead.

Oh, I’d attempted to initialise conversation for sure. I was bubbly… yet professional. I showed genuine interest in the brand new kitchen cupboards she’d just had installed. Plus, I’d admired the heck out of her grandson’s never-ending pile of wedding photos.

But as we progressed through her showering routine I got nothing back from Gladys.  Instead, she seemed damned determined to remain cool and aloof.

That is, until it came time to wash her ‘lady bits’ and, as I do, I asked Gladys if she wanted help with that.

“Oh, you mean my Fanny-by-Gaslight!” 

Well, that was it!  Such a random unexpected thing to hear a little old lady say – I cracked up big time.

And blow me down… Gladys clearly LOVED me for it!  In fact, she joined in too!

Seemingly, my hysterical response to her quirky turn of phrase was just the reaction Gladys needed to accept me into her world.  It showed her that I understood her; that I was on her wave-length. I was someone who could appreciate her inanely dated comment and therefore I was worthy to be part of her day.

Before I left (and still giggling like schoolgirls), I was rewarded with a nice cuppa and the ginger crunch slice that Gladys usually reserved for her special visitors.

So there! Take that, “My-regular-girl-Angie”...!!!

Sometimes I laugh so hard
– the tears run down my leg !!!

Ironically too, there are days where laughing at yourself can be all that keeps you sane.  Nothing like putting your foot in it with a slip of the ol’ verbal faux-pas; those unintentional moments when you haven’t thunk before you’ve opened your gob. 

Here’s a couple of my finest:

Offering left-arm amputee Sheila Greensleeves to help wipe down her bench top… “Can I give you a hand with that?”

Or saying “Gee that IS a big one!” …  the exact same moment Terry Wang drops his tweeds at shower time (I was actually referring to the giant mutant cactus plant towering outside his bathroom window, truly I was)

And just out of habit, to my new and totally bald-headed client, Jim Wiggington… Are we washing your hair today, Sir?”

As soon as I pop these humdingers out – I kick myself.  But at the same time, it shows I’m only human and, as unbelievable as it may seem, I make mistakes too.  Thankfully, all my clients (thus far) have forgiven me whenever I’ve let slip and more often than not, we end up having a bit of a cackle about it as well.

It’s all in the way you handle the situation and anyway, they know it was not intended.  I’m just happy that my dear clients can relax enough and feel at ease around me to have a laugh in the first place.

“Oh Dollie, you are a ONE”, they say.

And I guess I am.

Reciprocally, I love those unexpected humorous one-offs that my clients can spring on me, too!

Incidental quips they throw in along the way like an off-the-wall remark that takes you by surprise and makes you realise that being old, doesn’t necessarily mean you are any less witty than the rest of the wacky world.

And you are most certainly not laughing AT your clients; you are laughing either with them or it’s just the situation at the time when something comical has occurred.

Like the time I was applying skin lotion to the legs of a very fragile and diminutive, Mr Eddie Shuffleboard.

Sitting patiently on the edge of his bed one morning, I squatted in front of Eddie, fiddling about with the pair of most unyielding compression stockings versus his clammy freshly-moisturised skin (the bloody things never want to play nice).  After several minutes battling away, huffing and puffing all the way, I finally managed to wrench the stockings into position on Eddie’s legs.

VICTORY SHALL BE MINE !!

From the sheer exhaustion of it all, I then went to plonk myself on the bed beside him. As I landed on what had to be the world’s most ultra-springiest single mattress, like a stunt gone wrong out of Cirque du Soleil… up poor old Eddie went BOINGGGG!  Catapulted straight into the air he ended up falling squarely onto my knee in a position similar to a toddler sitting on his mother’s lap.

Then, without missing a beat, Eddie announces with the cheekiest smile on his face:

We really have to stop meeting like this, Dollie!” 

Surely one of the most hilarious (and perfectly timed) moments I’ve experienced on the job and after chuckling our way through the rest of the shift, it was locked in that Eddie and I were to be bestest of buddies from then on.

So, don’t feel guilty about enjoying the funny side of your client’s antics or worry that you’re being disrespectful or insensitive to their needs…OH MY GOD, YOU DON’T CARRRRRE!

Because of course you do.

Will we laugh about it later?

And don’t forget, encouraging laughter during a tense or delicate moment can actually offer relief to a fraught pensioner who may find solace in seeing you appear so calm and unflappable.

Embarrassing little interludes too, can have the edge sliced off them with a nifty bit of light relief.

Like the time I went to assist the delightful 94-year old Reggie Windbottom out of his armchair, just as he let rip an extremely loud FART that startled us both and made his trusty Border Collie leap up onto the couch.

“Outside, Wally!” Reg and I both bellowed at the same time. (If in doubt, blame the dog).

Oh my, how we laughed!

But most of all, and because it reminds me a lot of my own grandfather and the funny stories he used to tell us growing up… I love it how some of my elderly gents (hardly ever the ladies it seems) have a wide-ranging repertoire of good old-fashioned punchlines that they love to rattle off whenever you visit.

For example, here’s a couple of pearlers from 92-year old Dermot O’Farrell, one of my favourite yarn-spinners.  Of course, his Irish accent makes them that much funnier – even better when he has his teeth in!

Did you hear about Bruce who lost his whole left side? He’s all RIGHT now.

What do you call a fly with no wings? A walk.

What time did Bob go to the dentist? Tooth hurt-y.

A mushroom walks into a bar and orders a drink. The bartender tells him to get out.  The mushroom says, “But why… I’m a fun-guy?!”

A blind man walks into a bar….and a table… and a chair… and a door… and and and…

To conclude folks, laughter may not be the best (and only) medicine your elderly client has to take, but if you can lift spirits by slipping a bit of jocularity into their day, it’s a grand way to start.

As the irrepressible Dermot so eloquently likes to put it: “If you can’t have a good laugh at yourself – then you’re just a miserable old sod!”

HAPPY CARING!

Cheers,
Dollie