Posted in Safety, Working with Elderly

Yoo Hoo, Anybody Home?

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.

DING, DONG….. are you there, Mr Botherwell?

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. 

A typical Mad-Molly-Poo!

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.

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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).

Mrs Smith?
Mrs Smith?
Mrs Smith?

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.

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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.

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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?

A nosy neighbour can save the day
……OH, I KNOWWWWW

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.

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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.

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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:

STEP 1: Phone the Client’s Phone directly:

Fortunately, nine times out of ten, success is often achieved at this point because although your Client may not hear a Support Worker banging, ringing and hollering like a crazed loon at the front door – the sound of their home phone ringing seems to grab attention fairly smartly!

STEP 2: Ring the Rellies:

Failing that, and there is still no response from within the Client’s residence… the office will then call any Next of Kin/Emergency Contacts listed on file in the hope that somebody somewhere may know where your absent Senior is today.

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:

Last resort – Mr Plod to the rescue!

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!!!”

STEEEE-RRRRRIKE !!!

HAPPY CARING!

Cheers,
Dollie

Posted in Poem of the Day

I Had a Fall Upon the Stair (a poem)

Silly me, upon the stair,
On the rug I tripped, I fell down there.
Me hip busted, in traction today,
I wish, I wish I could get outta me own way…

The doc he said “You’ve bones broken three”
Me son, well, he sat sneerin’ at me
“Like Humpty Dumpty, Dad, you’ve had a great fall…”
Geez, I wished I wasn’t there at all!
To go home, go home… I ain’t comin’ back here no more!
Sweet home, sweet home, with me dog a-scratchin’ at the door …

Strange looks, and whisperin’… Life, she’s unfair,
“Sorry, Dad, but you’re not going back there”
Too old for surgery, the doc makes it plain,
Couldn’t put Humpty together again…

by Hugh Treadlightly, age 94

(and his little dog , Shorty!)

Woofity, WOOF!

HAPPY CARING!

Cheers,
Dollie

Posted in Aged Care, Exercise, Mobility

Letting Lettie Do It!

ACTIVE AGEING: Helping Older Adults, Help Themselves

Every day, our delightful neighbour Lettie-from-over-the-road, walks outside her front door, slowly down the steps and across the driveway to collect her newspaper from wherever it has landed on her front lawn.  It’s usually in the same spot every morning, give or take, depending if the delivery boy gets his projectile right and doesn’t instead end up riding his bike into the bushes!

(Three years on, you’d think he’d have this sorted by now).

On her way back towards the house, with mission accomplished and with paper stuffed purposefully under the wing of her arm, Lettie then likes to pause and glance over the neighbourhood.  She pretends to pick a bit of dead something off the Hydrangea bush at the bottom of her steps, then ambles cautiously back inside to (most likely) put her feet up from a job well done.

But it’s just painstaking to see!

Please come back, Grandma!

Nearing 94-years old, living alone and with seriously swollen ankles from kidney disease, ‘a bit of the diabetes’ and being almost totally blind thanks to advanced macular degeneration, Lettie has slowed down significantly in the last couple of years.

We know this because we have quite literally witnessed the progressive decline in Lettie’s mobility thanks to our lounge room windows facing directly opposite hers.

Needless to say, you can pretty much set your clock to Lettie’s daily paper pick-up ritual.  Unfolding before us almost like a big-screen movie, we get to watch all Lettie’s comings and goings – as she does ours. Which is actually kind of nice being that it offers a warm fuzzy familiar feeling to let you know all is right with the world.

But that doesn’t make it any easier to watch!

“Once I’ve had my weeties and taken all my tablets, it’s time to do the morning dash!”

Ummm, less of a DASH… more of an action replay stuck in serious slow-motion?!  Thankfully, Lettie enjoys joking that it takes her sooooo long and that tomorrow morning she’s thinking about packing a picnic lunch and making a day of it.

“I’ve got all day – may’s well take a cream bun and enjoy myself at the half-way mark!”

You want it?
COME GET IT!

Awkwardly steering her wheelie-walker to the top step, our hearts are in our mouths as her front wheels teeter close to the edge. Applying the brakes, just in the nick of time, Lettie then grapples her way down the steps in lunging fashion, by means of the metal railing installed by her family a few years back.

She then shuffles… barely lifting her puffy, slippered feet… across the driveway to the edge of the lawn where she then stops, statue-still with hands on hips, to peer at the grassy expanse before her.

Eventually, depending on the angle of the sun and the landing position of the newspaper on any given day, Lettie is usually able to perceive enough colour contrast to make approximate visual contact with her printed prize.

Ah yes! There’s actual science involved, don’t you know?

However… if the paper has made touch-down on the driveway instead of the lawn, poor legally-blind Lettie has NO CHANCE of finding it!  

As I guilefully explain to my pre-teen son, the grey-ness of the concrete doesn’t make the off-white coloured newspaper ‘pop’ like the bright green-ness of the grass does.

Lettie then ambles her way across the lawn and upon reaching her quest, snap-bends in half to scoop up the cellophane-sealed roll in a one-motion move. Turning stiffly, she then pauses to gaze at the street around her (more to have a rest than to actually ‘look’ at anything), before tottering her way back onto the driveway, then slowwwwwwly on towards the front steps.

It can be a good 20 minutes by the time Lettie has hauled herself up the steps to the security of her wheelie-walker at the front door, during which time I have hung out a load of washing, ironed the school uniforms, yelled at the kids and fed the cat!

My enthralled son can stand watching this senior’s snail-paced performance NO LONGER.

“Geez! Can’t we just go pick it up for her, Mum?” 

“Oh no, absolutely NOT, my child!” 

Then, chuffed that I get to impart my Aged-Carer’s industry knowledge on somebody (anybody will do) I then proceed to explain that as long as Lettie is able to collect her newspaper for herself – then let her, WE MUST.

And that regardless of Lettie’s diminished eyesight and her age-related health issues, it was important for Lettie, if she wanted to remain living independently in her own house, that she be able to do boring household chores such as this…  

… for herself.

I also knew, from conversations with her daughter Sue, that Lettie had very little other physical activity going on in her day.  Sue, therefore, felt it crucial that her mother be encouraged to continue this one daily routine, this one small piece of exertion, in order to keep blood flowing, muscles moving, her mind stimulated and hopefully result in a much better quality of life for Lettie all round.

In the meantime, Lettie gets to exist alone at home feeling good about herself; to know she’s maintaining independence, her self-respect and the satisfaction that she still (mostly) have control over her own future.

And that’s a really super important thing when you’re an elderly person, as I explained to my son (who oddly, has always been quite fascinated with Lettie’s activities).

“But what does she want a paper for anyway… I thought she was BLIND????”

I remember at the time staring blankly at Junior aware that with this last line of inquiry, he had actually stated the ‘blindingly’ obvious.  And as the wave of realisation washed over me… I thought it might be a good idea to give Sue a call for a bit of a chat.

“Nobody likes a smarty-pants, darling.  Go let the cat out!”

Move it – OR LOSE IT!

HAPPY CARING!

Cheers, Dollie