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Daughterly Care Blog

When it comes to dementia …

(By Frank Featherstone – the husband of one of our clients)

No means no – but it ain’t necessarily so…

Once upon a time it was easy for a husband to lead his lady up the garden path and she’d go with alacrity. But like many things now it would seem that the “No” word is used more often and in an involuntary way to resist doing the things that were once dear to her heart – like gardening for instance.

So, do you take that refusal as final?

It doesn’t make sense because it would get her out of that perhaps too-comfortable chair for needed exercise; the blooming of the flowers would delight her and neighbours would get more than a lovely bunch of coconuts. But “No”, again, ‘You do it!”, is the reply.

So what do you do?

Remembering the old adage: “Faint heart ne’er won fair lady” you take a different tack.

One of the ladies in our Narrabeen retirement village is a professional gardener who works at Flower Power. She accepted the brief to be both carer and gardener several hours a month, and create what she calls a “show garden “.

The result in springtime is a delightfully varied garden and you can see the pleasure in Trish’s eyes as she takes ownership. In actual fact Trish might only do a bit of weeding and pruning but both of us most days enjoy stepping out onto the patio and appreciating “Our garden”.

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The study option

Like all lovers you seek to be a better one. When I found out that in home care Approved Provider Daughterly Care Community Services ran a course for their Caregivers in the Montessori method of helping to support people with a dementia diagnosis I signed up for the three-stage program eager for tips on how to do things better. It was obvious that Trish’s panic attacks and depression were more than she could bear.

I found that there were things I could do to make her happier and that would involve me changing my way of thinking – while retaining it – and learning the do’s and don’ts of dementia. You can’t always win of course – for always read sometimes – but when you succeed there’s an un-imagined surprise and happiness that takes you through to the next day.

Below is one of the moments. (This photograph taken by Daughterly Care carer, Annie P, who also prepared our meal).

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Learn more about how Daughterly Care uses the Montessori Method when supporting a Loved One.

Learn more about Daughterly Care’s Joyful Living Approach by enabling meaningful and purposeful activities likes gardening.

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Frank Featherstone

Categories: Dementia, Frank Featherstone|0 Comments

It’s hard for a husband but worse for a wife

(By Frank Featherstone – the husband of one of our clients)

Suddenly you’re as old as the calendar says you are. And you’re starting to feel it. You’re no longer a threat to tennis champion, Federer, and young women offer you a seat in the bus. But much worse is the realisation that things aren’t the same at home.

Now, let me talk personally. Trish, my wife of 54 years, over the last 12 months has developed many of the signs of dementia.

And this is the indefatigable wife who organised me, six children, played tennis too, sang with Sydney’s Philharmonia Choir as well as in the local church’s one every Sunday. Trish was also a better driver than me but no matter, that helped me to catch up with sleep in the lay-back passenger’s seat.

Suddenly the dementia thing

I think it was a series of painful operations that kicked the dementia off but suddenly Trish could no longer find her way around the kitchen. Trish completely lost her desire to sing, spin, knit and sew and didn’t want to leave the house. Trish lost her will to lap local pools and didn’t want to walk whereas in 1990 she trudged in snow on the Great Wall of China.

Then the Polio came back as The Polio Syndrome.

Now we fight the mobility battle together. Fortunately Trish can still ride a battery-operated invalid scooter with me “riding shotgun” alongside.

Being a typical male, albeit, 82, I soon found that doing everything: the cooking, washing, vacuuming, answering the ‘phone and just being on call was a bit too much although my two lovely (in every sense) local daughters did what ever they could, whenever they could subject to the needs of their own three-children families. I started to investigate part-time help but was shocked by the hourly rate.

Organising the hours

Suddenly I developed pneumonia, almost died from diabetes “lows” and other medical complications.

There was no alternative was there?

Mona Vale Hospital did an ACAT Assessment which meant I could access some free carer respite paid for by the Government. I booked Daughterly Care for three-hourly shifts and so far have experienced the different caring natures and individual talents of three different ladies. One even makes capsicum soup!

Perhaps I can continue this story in Kate Lambert’s blog next time and let you know my wife’s reaction to other women coming in to our home? Also I can pass on a few tips about Dementia not being as bad as some people say it is.

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Frank Featherstone

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We started Daughterly Care 20 years ago…because home was a better option than the Nursing Home

Today is the beginning of a public reckoning of Australia’s aged care industry with a two-part program called “Who Cares?” airing on 4 Corners on ABC TONIGHT at 8.30pm, revealing their findings from a special investigation into Australia’s Aged Care industry. The 4 Corners aged care investigation feels so much more important to watch after a care worker was charged by Police for allegedly beating an elderly man in the Bupa Nursing Home at Seaforth with a shoe, which was caught on video by the family who hid a camera in their father’s bedroom, after they had sighted suspect-bruises on him.

Read about the Seaforth incident in full and watch the video by clicking here:
http://www.abc.net.au/news/2018-09-06/aged-care-worker-allegedly-assaults-elderly-man-in-sydney/10207202

I strongly suggest that you watch “Who Cares?” on 4 Corners on the ABC tonight at 8.30pm so that you can be a more informed consumer of aged care services. If you miss it tonight then watch it on ABC iview.

I am sorry to say this, however it needs to be said 

Some blame does lay at the feet of our Coalition Government. Aged care in Nursing Homes is seriously underfunded which means staffing levels are too low. As I wrote in this blog, the Coalition cut funding to Nursing Homes without consultation with the Nursing Home industry and with no notice. Of course, the effect was staffing cuts as I wrote in this second blog.

Why aren’t minimum staffing levels mandated in Nursing Homes?

Why aren’t Registered Nurses mandatory in Nursing Homes?

The Government knows subsidising in-home care is cheaper than subsidising nursing home beds.  The evidence is that quality in home care and utilising primary health care such as GPs and Specialist Drs prevents hospitalisations and delays, or prevents altogether, Nursing Homes placements.

The Government knows that 97% of older people prefer to stay at home rather than go to a Nursing Home.

So why are over 108,000 elderly people on a waiting list for a Government Subsidised In Home Care Package? In our experience, older people are very stoic and they don’t ask for care support until they are PAST the point of needing it or they have a health crisis and they are hospitalised. At that point, to make Elders wait 1-2 years for the Home Care Package level they were approved for is just cruel. Many seniors, especially pensioners who do not have investments to draw down on, are placed into a Nursing Home while waiting for their Home Care Package to be assigned.

4 Corners have published this article today to give some lead-in information for tonight’s show.

You can read the article by clicking here:
http://www.abc.net.au/interactives/agedcare/

Remember that Daughterly Care was started 20 years ago by Verlie and myself because Verlie had worked in a Nursing Home. Verlie saw first-hand the neglect and she decided that older people were better off staying in their own home and so we started Daughterly Care. How we started Daughterly Care.

Is today’s ABC article a few disgruntled ex-employees “getting their own back” or is what they have said aligned with our experience of aged care in nursing homes? We agree these are relevant issues even in 2018.

Nurse Verlie says, “Well finally the truth is coming out”

The case of the 82 year old man being hit repeatedly…in fact he was hit so many times that he fell off his bed trying to get away from his abuser…that is an extreme case and today’s ABC article contains none of that extreme behaviour. It’s the wider spread, everyday, poor-quality care that employees of Nursing Homes are sharing.

Yes, people do suicide in Nursing Homes

We had a 99 year old client who was a well-educated lady who had worked all her life and could afford to stay at home. She was so looking forward to her 100th birthday and her letter from her Queen. She had a Government Subsidised in Home Care Package paying for her 3 hours of in home care a day and she could afford to pay for extra care if she needed it.

She was happy at home. She had no cognitive issues. She loved her food especially when it was freshly cooked and extra tasty. She had a very small fall with NO INJURY. This was the excuse for her relative to place her into a Nursing Home:

  • against her will;
  • against her care needs; and
  • against her ability to continue to lead a quality life at home.

She suicided in a very nice Nursing Home on the Northern Beaches. How? She told us her relative “doesn’t care about me” but she didn’t want to “go against” that person by saying “thank you for placing me in this nursing home but I AM going home today”. She would not stand up for herself. Instead she chose to stop eating, chose to stop walking, chose not to get out of bed even though she could do all these actions. It doesn’t take too long to die that way.

“It’s regular, if you’re on a night shift as a registered nurse, to be in charge of 100, 120, 150 people”.

Last week, one of my own office staff told me she was the only care worker (not a Registered Nurse) when she did a night shift on her OWN at Northern Beaches Nursing Home and she had to attend to 80 high care need elderly clients.

Just think about that.

One careworker to assist high care elders who need to:

✓ go to the toilet;
✓ who fall whilst trying to mobilise on their own;
✓ who are confused, or scared or anxious or worried because of their dementia – or maybe just because they feel alone and are scared because there is no real assistance overnight.

It’s just NOT possible.

She told me “I did one shift and never did another one– it was too stressful, too sad”.

“There were residents who didn’t get fed”

True.

I wrote about attending a Leading Aged Care Association Conference in 2014 where a dietician presented evidence-based research on malnutrition in nursing homes versus hospital versus elders living in their own homes.

Nursing Homes were found to have the highest malnutrition rate of 40% to 60% of residents. The research found one of the main reasons why residents were malnourished was lack of staff at meal times. More information on this page of our website.

That’s why families pay for Daughterly Care to visit at lunchtime on the days they cannot attend, to ensure their Loved One is fed.

One of my best friends volunteered in 2017 to visit a lady who had no relatives in a Sydney Nursing Home and she noticed the lady opposite was never given a cup of tea when the tea lady came around. After observing this for numerous weeks, she broke the rule, she advocated for a person who she was not assigned to help.

Nicely she asked “Can I ask you a question? I notice that this lady, opposite the lady I visit, never gets offered a cup of tea, can I ask why that is?”

Answer from the tea trolley lady: “Because I asked her if she wanted a cup of tea and she didn’t answer, so I don’t ask anymore”.

Through gritted teeth my friend said “She didn’t answer you because she CAN’T talk. But I can see in her eyes that she wants a cup of tea. Every time you come around please give her a cup of tea”.

The lady was given a cup of tea and she held it with both hands and sculled it! She gave my friend a big smile.

That’s a Sydney Nursing Home in 2017. Seriously? How would you feel never being offered a cup of tea, watching everyone else drinking their tea. It’s appalling on such a basic level. I bet that tea lady received no training on common issues like “aphasia” – the inability to speak because a tiny part of your brain is damaged.

“We could only use three continence pads for any resident on any day”.

Nurse Verlie says: “True years ago and still true today.

Three was the limit when I worked in a Nursing Home over 20 years ago and I asked someone working in a national brand nursing home in 2018 and was told that 3 pads per 24 hours is the limit per resident.

Why is there a limit?

Why should an older person have to sit in urine or faeces to meet a pad limit? Then the Government wonders why so many elders get urinary tract infections and end up in hospital being treated, and sometimes dying, from their Urinary Tract Infection which has spread to their blood.

There is no dignity or quality of care with pad limits.”

Verlie Hall - Founder Daughterly Care

“Just go in your pad”

“I visited my Aunty in a “lovely new” Nursing Home. She was in her mid-90s. I always described my Aunty as “the lady of the family”. Her whole life she presented elegantly, well dressed with beautiful hair and make-up. She took care of her appearance and she spoke well and was full of love and grace.

My brother was in his 50s and I was in my 40s when we visited my Aunty in the nursing home. We were literally sitting at her knee, along with my cousin, my Aunty’s daughter.

My Aunty waved down a caregiver or nurse and asked to go to the toilet. In front of us – her guests – my Aunty was told “you have a pad on, just go in your pad”. Where is the dignity in being denied being taken to the toilet when you know you want to go and you can walk with assistance?

To consciously have to urinate in your pad with your adult nephew and adult niece visiting you, sitting so close, at your knee.

There is no dignity.

It was humiliating for my Aunty and it was humiliating that we heard it.

Worse still it flies in the face of all the best practice and what we were taught at university – prevention is always better health care and cheaper than curing illnesses. My Aunty quietly held-on but I could see her looking around for another nurse. I tried not to take over but I couldn’t stand it anymore. I asked my Aunty’s daughter if we could please take my Aunty to the toilet, which we did.

I asked my cousin why she didn’t speak up for her mother and she said “I don’t want to ruffle any feathers, I need them to be nice to Mum when I am not here and this is a small issue, you pick your battles”.

Nail on the head.

Older people themselves are afraid to speak up for their basic rights for fear of reprisals, and so too are their loving families. They are worried what will happen to their Mum or Dad when they are not there. People shouldn’t feel that way.

Some years back I was invited by COTA to attend a meeting with KPMG, who were collecting information about Aged Care Facility experiences, to feed it back to the Government. I heard such awful real world experiences that I decided if you were taken to the toilet when you wanted to go and you were fed in a Nursing Home – you were doing decidedly well – isn’t that a poor reflection on the system.

It is imperative that all Daughterly Care clients, including self-funded elders, who have eligible care needs are in receipt of a Government Subsidised Home Care Package or on the National Queue waiting for a Home Care Package. Not sure if your Loved One has eligible care needs? Ring us for a chat.

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Kate Lambert
B.Ec F.Fin

Daughterly Care CEO & Co-Founder

Categories: Dementia|26 Comments