Basic care or rocket science?

When did we as a society stop caring about our aged?  Why do people work in aged care when they really don’t care about the wants and needs of the people they are caring for?

Since placing Ma in care back on the 4th of July, I have been fighting to get Ma’s medical and hygienic needs met. What I think of as basic human needs.  Somebody to care about whether her incontinence pad is changed or her teeth are clean; that she takes her medications and that her wounds are dressed appropriately; that she is clean and comfortable.  Sounds like something we would all like? Basic care you think?  Unfortunately not.

I get so tired of fighting about whether Ma’s daily needs are met that sometimes I let things slide. Every day I walk into the nursing home not knowing what I will find.  Some days I feel like not going, as just walking through the door fills me with trepidation.  Will she be crying, in pain, staring into space or just the mother I remember?  My love for my mother and the situation I have placed her in weighs heavily on my conscience.  I go every day because I can’t trust the nursing home.  I’ve learnt from experience that I need to be there every day.

A conference with the nursing unit manager and the manager of the facility give me reassurance for 5 minutes until I visit with Ma and watch Ma’s leg being dressed by a nurse who clearly doesn’t know what they are doing.  We talk her through the dressing change and the words of the nursing unit manager ring in my head.  “I will walk all staff through the dressing of your mother’s leg to make sure they’re competent.  I will sign them off.”

Unfortunately the nurse who regularly does her dressings is on holidays.  Two more emails later and I’m still fighting for her dressing to be done correctly.  I’ve even offered to do it myself.  It’s not rocket science, even I can do it!  I dressed Ma’s leg for many years before she went into care.  The nursing unit manager is very good at telling me what I want to hear, but nothing changes and there’s no follow through.

Ma is a high falls risk and has a chair and bed alarm.  I would say that 8 times out of 10, this isn’t switched on.  One day I came in to find not only her chair alarm wasn’t plugged in but her hand buzzer wasn’t either.  Again and again, I report this.

Over half a dozen times now, I have walked in to find some of Ma’s medications on the floor because staff haven’t made sure she has swallowed them.  Three times this was Ma’s Targin, a slow release pain killer.  Ma hates taking her medications.  She can’t swallow very well any more and staff’s attitude sometimes makes her disinclined to obey their commands.  Staff have even given me her medications to give to her.  I’ve had staff complain about how difficult and time consuming Ma is.  Ma thinks she is being poisoned as she doesn’t know what she is being given.  I tell her what the medication is and what it’s for and use her favourite yoghurt to get her to take them.  More rocket science?

One of the things that makes me angry is finding that she still has a stinky disgusting incontinence pad on from the night before, but is dressed and ready for the day.  Thank goodness this has only happened twice.  But in my view, that’s two times too many.

How do you feel when your teeth haven’t been cleaned?  I’ve been told by the nursing unit manager that residents’ teeth are cleaned twice a day and soaked once a week.  Today, as on other occasions, she asked me to clean her teeth.  They were disgusting.  I soaked them first before scrubbing them.  Ma told me that may be she could now taste something.  I took photos and sent it through to the manager and nursing unit manager.   This makes me want to cry.

Ma now has pressure sores on her bottom because she sits in her chair nearly 24 hours a day.  She has only slept in the bed on a couple of occasions. When she sleeps in the bed she has a panic attack when staff don’t answer her calls and goes back to her chair.  I contacted her doctor to check her bottom and he ordered it to be dressed daily.  I am shown the dressing chart by the nursing unit manager but again, nursing staff don’t follow through.  Today her chair pressure pad wasn’t on her chair but leaning against the wall.  Ma was complaining of pain and felt instant release once I’d placed the pressure pad on her chair.

Why is this happening?  Why am I constantly fighting for Ma’s basic needs to be met.? I feel sick every time I think of what she’s going through.  She cries and tells me she wants to leave.  I feel like I’ve let her down.

What do people do without an advocate?  If Ma’s chair alarm isn’t put on; her wounds dressed correctly; her teeth cleaned etc what happens to the others?  How sad that we have forgotten to care for our aged.  How I regret placing her in care.  I feel like I’ve let her down on so many levels and yet I’m so angry that her basic needs aren’t met by the people that are supposed to care for her.

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The Saga of Ma’s Ulcer – Vigilence

One of my biggest concerns when I put Ma into the nursing home was the care of her chronic leg ulcer which has been ‘going’ for 5 to 6 years.  On the two previous instances Ma was in respite care her ulcer has gone downhill.  In one case ending up with a hospital stay.  So, when Ma went into care I tried to circumnavigate any problems by being proactive.  I supplied instructions from the Ulcer Clinic, dressings (Acticoat Flex 3 – a silver dressing) and talked about my concerns to the registered nurse (RN) and anybody else who would listen.  They are all very good listeners and ‘agree-ers’ but unfortunately not very good at following through.

The first two weeks passed without too much incidence… I noticed Ma didn’t have the Blue Tubifast applied to her leg (as per protocol) and was informed that it would have to be ordered in.  One month later and no Tubifast appeared.  I kept on querying…

The point I want to make with this post, is the need to document things and be proactive. This nursing home is one of the better ones…

  • On Saturday 16 July, I noticed the bandage had only been applied over the ulcer site and that it was leaking through the bandage.  I reported it in the morning and again in the afternoon.  On Sunday, 24 July, I reported it again. No response.
  • On Saturday 23 July, I noticed the ulcer had leaked through the bandage (bandage still being done just over ulcer site).  I was told I could contact Ma’s doctor and I did.  He attended and looked at the ulcer and prescribed Keflex for possible infection.  After waiting around 40 minutes for the Registered Nurse (RN) to come and dress her leg I chased it up and was informed that it wasn’t time for the dressing trolley and we would have to wait.  I watched the RN bandage her leg (she informed me she had never done it before, so I talked her through it).  Again I expressed my concerns over the ‘care’ of Ma’s leg.
  • On Wednesday 27 July I arrived to find only Acticoat Flex 3 on Ma’s leg with the soiled dressing on the floor, there was no sign of a bandage.  Ma told me it had fallen off on Tuesday night.  I reported it.  The RN dressed her leg as per the protocol, I explained to the RN my concerns and was told they would talk to the doctor as they were concerned about the oedema in her leg.  I sent a photo of the ulcer to the doctor and explained that the RN would call him.  The doctor attended Ma the next day, Thursday 28 July morning with a RN attending.
  • On Friday 29 July afternoon, I asked what the outcome had been and was told somebody would ring me.  Nobody did.
  • It was then I realised I would never be listened to at this level and rang the manager of the nursing home. He listened to my concerns and promised things would change.
  • My sister queried Ma’s leaky leg again on Saturday 30 July and was told the RN would dress it again after her lunch at 2.  I arrived on Sunday 31 July and found the dressing hadn’t been changed (to our knowledge).
  • On Monday I met with the manager and discussed Ma’s treatment. I showed him photos and he agreed that the treatment of her was unacceptable.  He promised he would see to it that  a care plan was drawn up for her leg, with consultation with me, and that all the RNs would have to sign off on it.  If I noticed any deviations from this, they would discipline the person responsible.
  • On Tuesday I arrived to find that Ma’s other leg had a dressing on it with blood still on her leg… The injury had apparently just occurred. The new aide had brought Ma back from breakfast and had been a bit too enthusiastic in her care causing Ma to stumble and cut her leg on the wheelchair.  (Ma is down for a tray in her room for breakfast but they keep trying to force her into the dinning room…)
  • I received a phone call while I was there, reporting the damage to Ma’s leg. The RN came and talked me though ma’s dressing plus her care of Ma’s leg and that she’d reported it to the doctor… this was the same RN who’d previously had no time for me… somebody must have put a burr under her saddle!!
  • Later that day the Nursing Manager called me wanting to meet and discuss Ma’s care. She told me Ma’s treatment was unacceptable.  She also wants to show me a couple of dressings she feels may give Ma some relief.  We meet tomorrow.

After one month of fighting, we have come to this. Why?

What about the other residents that have no advocate?

Lessons learnt:

  • Document, document, document and document some more.  Photos and dates and notes.
  • I had learnt from previous experience that things will probably go wrong.  Be prepared!
  • If you are concerned or worried, express your concerns.  If nobody listens at the lower levels, go higher.

 

 

Memories of dementia

During the past 12 months I’ve learnt more about dementia than I ever wanted to.  Ma’s deterioration has led me to research and learn as much about this syndrome as possible.  After being seen by several Geriatricians, Ma is still undiagnosed.  Yet, her doctor and I remain convinced she has dementia, probably Lewy Bodies.  When I think back through my childhood I now realise the friends of Dad’s that were ‘acting funny’ had dementia.

As a kid growing up with older parents, Ma was 40 when she had me and Dad was 50, I was always worried my parents would die earlier than other ‘normal’ kids (ie kids with younger parents).  My parents like to tell the story of the day they found me crying my heart out in my room.  When they asked me why I was crying, I responded, “you’re going to die soon”.  Such was my worry of having older parents.

My parents were very active socially, Dad belonging to Rotary and Ma to Innerwheel.  They were always entertaining or going out to different functions.  In this way my sister and I were exposed to a variety of people from a very early age.

There was a man that was fixated on Dad and would visit him at every opportunity, presenting him with various gifts.  Dad’s best friend, who was a very highly strung man, one day visited and was convinced that he’d just disembarked from a warship and that Ma and I were there to greet him.

I will always remember a good friend of Dad and Ma’s visiting after she’d been diagnosed with Alzheimer’s.  She was my first real introduction to the disease.  She sat in a chair and tried to carry out a conversation.  She would become stuck for words and then shake her head and say, ‘no, no’.  It broke your heart to realise that she knew what was happening to her.  She knew that she would soon forget who she was.

It was about this time that the media reported a connection between Alzheimer’s and aluminium saucepans.  Being quite young, I was terrified I was going to catch it, as we had aluminium saucepans!  It was probably not long after that that it was reported that white bread caused cancer…

I look back at my Dad in his later years and I know now that he had dementia.  Most probably Alzheimer’s (the most common type of dementia).  He would ask the same question over and over.  He would sit and fiddle and dismantle transistor radios until they wouldn’t work.  He could no longer write the newsletter for his Probus Club and he could no longer give an ‘off the cuff’ speech at the drop of a hat (he found this out the hard way when he got up to give a speech and became very muddled).  His driving was appalling and he couldn’t pass the test to get his licence renewed.  That broke him.  They were his legs and they were taken away from him.

I remember being impatient with him for his constant questions. I remember Ma yelling at him for leaving soiled pants in various places in the bedroom as well as other things. I remember helping him clean up after soiling himself as he didn’t want to tell Ma. I only told her after he’d passed away.  I showered him in his undies when he was too impatient to wait for the carer to come and shower him. Things that would have appalled him if he was himself.  My aunt and uncle wanted Ma to place him into care, Ma refused to do so.

I took him to the ballet as he once took me.  He became more affectionate and spoke of how proud he was of me.  The last Christmas he had with us he became very upset with the noise and confusion a big family Christmas can bring.  Ma promised him that that would be the last Christmas and he was happy.  He had bought Ma and I perfume but had addressed both gift tags to Ma.  It’s funny that throughout all of these signs, I just remained oblivious in my own little world.  He dropped dead suddenly from a heart attack on 5 January.  Looking back, I’m glad he went that way.  We were spared the agony of losing him twice and of making decisions on his care.

My awareness has only awoken due to Ma’s deteriorating condition.  The search for answers to Ma’s behaviours has led me to become more aware.  As I’ve learnt more about dementia I’ve wanted to raise awareness.  I want more support for sufferers and their carers.  I want people to stop turning their back on people who suffer with dementia.  And more than anything else, I want a cure for dementia.

People don’t want to talk about dementia.  It’s too scary.  Fundraising for different cancers achieve more funds than dementia yet dementia numbers will increase as the population ages (the risk of dementia increases over the age of 65). Dementia is the second largest killer of Australians, surely that’s enough reason to find a cure.

I am currently raising funds for Alzheimer’s Australia for the month of April who provide support services, education and information about dementia.  If you would like to support me, go to: Memory Walk.

 

Life of a carer

Time for a pity party!

You know when you’re just tired? Just tired to the bone so that you can’t think straight and your motivation just dries up? You sit there knowing there are things to do and yet you don’t do them.  You just want to curl up in a corner and not exist any more… well at least not for a few hours or days or?  The responsibility of somebody else’s life weighs heavy. Mothers and fathers will know this.

Life beckons… I used to travel, I used to be able to go out to dinner, I used to be able to go out for a few hours without worrying, I used to go to work 5 days a week.  When you become a carer these things disappear.  Your life revolves around bowel movements, dressing, showering, medications, incontinence, doctors appointments, wound dressing, mental stimulation, reassurance, and trying to grant their every wish and desire.

You love them so much it hurts yet resentment crawls in.  My life has disappeared and I’ve now become a satellite which revolves around my Ma making sure her every need is met. But I’m burning out.  I know this.  Every time I lose my cool because of something; I know this. I never saw myself as a bad person in the past but those days are gone.  Every time I yell at her, I really yell at the disease called dementia.  The thing that will ultimately take her away from me if some other health issue doesn’t take her away first.  Every day I see small changes which take her further away from me.

For the last few days she has been fixated on scones and talks about making them.  She then asks questions about the stove and how long it take to heat up etc. Today scones called too loudly to her and she went into the kitchen with the purpose of making some. Knowing she can’t turn the oven on, has forgotten where all of the utensils and ingredients are kept AND that she’s never been able to make a decent scone, I go into the kitchen with her and make them while she looks through a recipe book.  I didn’t know what else to do.  I didn’t want her to realise she didn’t know where anything was and how to turn the stove on.  So I just did it.  What else do you do?

Of all the changes, I think the spatial displacement thing is the worst.  Night and day don’t exist in her world as we know it.  At 2pm in the afternoon she is saying it’s night time and that she needs to get ready for bed.  She comments on how dark the night is.  I can’t convince her otherwise.  The other day she left her bedroom with her book on ‘Cyril’ (her wheeled walker) and I asked her where she was going.  She told me to her room and turned around and went back in to her bedroom.  She will lose her bedroom and the toilet. Yet find them other times.  If I take her out driving locally she will not remember many places even though she has lived in the area for over 50 years.

I can cope well with the physical stuff but the mental stuff is a real challenges.  One that I’m not coping with well.  Carer’s of dementia sufferer’s have a set of ‘rules’ that I read periodically.  I think I break most of them every day.  “don’t say they’re wrong”, “don’t say remember” blah, blah, blah.  I know these rules are supposed to make our life easier but unfortunately they just make me feel more guilty when I break them!

Caring for somebody with dementia is a day to day thing.  It’s like riding a roller coaster. On some days or hours, you may have sane moments and others… well and that’s just me!

Lessons learnt in respite care

As I’ve found out in the past, nursing homes are never going to deliver the same care that you do. Unfortunately this is something a caregiver has to accept, as hard as this is.  The reason why there is a couple of year’s gap between Ma’s stays in respite care is because of the bad experience she had the first time.  Hopefully with some preparation and preparedness your loved one’s stay in care will hopefully be uneventful.

These are some of the lessons I learnt and thing to be aware of from Ma’s couple of stays.

  • If you are going away while your loved one is in care make sure you allow a couple of days before going away to visit them and iron out any problems…
  • Make sure your loved one is having regular bowel movements. The staff assured me they logged (no pun intended) Ma’s bowel movements on computer.  Ma didn’t go for six days as they hadn’t written her up for a daily laxative even though I had informed them of her dosage and what she used.  Constipation can lead to confusion in the elderly so it’s important this is under control.
  • Make sure their teeth/dentures are being cleaned. I would usually wash Ma’s dentures when I visited her.  Ma said that the staff had only done this a couple of times (can’t prove or disapprove this because of Ma’s mental state) but she did came home with a sore mouth.
  • If they have an ulcer or any other medical condition that is usually seen to by a community nurse you will have to rely on nursing home staff to see it is dressed as you can’t access two services at the same time. Unfortunately on both occasions she’s been in care, her ulcer has suffered from not being adequately cared for.  Make sure you provide as much detail as possible on its care.  We had to provide her special silver dressing but wasn’t told this until the day she checked in.  Make sure you ask up front whether they require your loved one to supply their own dressings.  Take a photo of the ulcer so you have a comparison of how the wound is doing.
  • Ensure your loved one is being dried properly after their shower, especially under folds of skin. Ma suffers from chaffing under her breasts and stomach.  I asked them to ensure this was done and provided a zinc and castor oil cream to treat any sores.  When I got her home, I found red welts where they hadn’t dried her properly or used the cream.
  • Make sure they are getting their proper medications. Going into care you have to use the doctor the nursing home has.  This doctor may have a different idea on whether your loved one should be on the same medications.  Ma ended up having her pain medication cut by the doctor at the nursing home as he thought he knew better.  She spent a miserable time in pain.  If you don’t think they are getting the right medications ask to see the list and speak to the assigned doctor if you aren’t happy.
  • Make sure you keep copies of all the paperwork including the application form.
  • Make a list of questions you want to ask:
    • What does your loved one need to bring?
    • What does the nursing home provide eg. incontinence pads, dressings for wounds, Panadol (I must admit that I ended up giving Ma her own to take when she wanted as she wasn’t getting pain relief)
    • Can they bring alcohol (Ma so loves a brandy)?
  • Have a look in the room they will be staying in. Are there mirrors that could cause a problem, depending on their mental state?  Ma still wonders how the lady is going she shared the room with…
  • What can you bring to make your loved ones stay a bit more comfortable? Ma had her big numbered clock, pictures of her kitties and her kitty calendar (sigh, I didn’t get a look in) as well as books, magazines, and munchies (the food wasn’t very nice) AND of course her brandy.
  • I’m sure there are plenty of other considerations that I haven’t thought of… feel free to add.

The lady in the mirror

The day before Ma is due to go home I arrive to find Ma sitting in a chair with a towel on her leg, with the ulcer, and an ice pack on the floor beside it.  She tells me that an aide has ‘bumped’ her leg on the wheelchair foot plate getting her out of the chair.  There are big bruises and her leg is swollen.  I try and find somebody to tell me what has happened and what the damage is.  They have another story, saying Ma has knocked her leg on her wheely walker.  They are going to dress her leg but after waiting for a half hour they decide to take her to lunch instead.  I don’t get to see her leg ‘undressed’ before I leave.

Day 19 – Escape at last.  Arrived at the nursing home to find Ma sitting next to the mirror with piles of her stuff everywhere.  She had tried to pack up ready to go home.  I brought her a coffee to distract her which she sat and enjoyed while I packed everything up.  Now and again she would nod to the ‘lady in the mirror’ and talk gently to her.  She told me she had become good friends with the ‘lady’ and that she’d miss her when she went home.  She mentioned how the ‘lady’ would wear everything that Ma wore and even had the same books Ma had!  When I asked Ma if the lady had purple hair like Ma did, Ma said she did not… Ma bid farewell to her new ‘lady friend’ smiling and waving as we took her out.

As we had no instructions on signing anything or doing anything besides taking Ma, we went to leave.  We were stopped at the door and were told we had to pick up Ma’s medications.  So we waited. The nurse came to say goodbye and I asked again about Ma’s ulcer and how her leg was after her mishap the day before.  He told me that her ulcer looked better and that her leg looked good. We hadn’t been home for an hour when the nursing home rang to ask that we return as they had forgotten to give Ma a box of medication that had been left behind… SIGH

Ma made it up the two flights of stairs better than I’d hoped and went straight in to say hello to the cats.  She was so happy to be home… I think only because of the cats.  She’d often tell me how much she missed them.  She has a small toy cat and photos of the kitties which she had on her bedside table while she was in care.  That night I made sure she got back on her bowel regime.  She was very very tired.

Unfortunately we were up and down more times than a bride’s nightie with her bladder.  I was a wreck come morning being out of practice.  Her bowels also decided to co-operate to great fanfare unfortunately soiling her pants in the process.  The next night was much better even though we had a midnight bowel movement.  I think she’s making up for lost time! Thank goodness we weren’t up as much as the bowel pressure on her bladder had been lessened.

The community nurse came to change her ulcer dressing and I was absolutely horrified and angered to find that she had a new ulcer and that the other ulcer had deteriorated.  And yet nobody saw fit to tell me even though I specifically asked.  They had even taken photos when she’d arrived so it’s not as if they didn’t have anything to compare it with.  How can they not tell you there is another new ulcer? AND that the other ulcer is so much worse?

I look to the future and I am afraid.

Ma’s name is down at the nursing home just a couple of blocks from here.  I am not working full-time but am using carer’s leave, for which I will be forever grateful for, while we wait for a vacancy.  When Ma was in respite care I tried to make sure that she would be looked after.  I wasn’t happy with her care.  Even though I wrote notes to ensure her special health requirements were met AND even though I talked to the staff including the registered nurse, she came out with bruises on her legs; welts under her breasts and ‘apron’ where they didn’t dry her properly and put cream on; constipated; and with new and deteriorated leg ulcers.  Everyone I talked to at the home said they were listening but they weren’t.  I only saw the aide put the brakes on Ma’s wheelchair once when they were putting her into it.  Her legs got bruised because they would push her chair into the table but not check where her legs were when they pushed her in.

So what now?  I rang the nursing home she wants to go into and where she has been on a waiting list since September.  The tell me to ring back every two weeks because when you don’t keep ringing, you drop down the list (thanks so much for telling me this!).  I’m now petrified about placing her into permanent care.  If a reputable nursing home can do that much damage in three weeks how am I supposed to trust that she will be well looked after in the nursing home of her choice?  This is the home where she also had problems.  A few years ago when she spent five days in their ‘care’ she ended up in hospital with an infected leg ulcer.  This was the first time we had tried respite care and I’d been too scared to try it since… until this time.

So I’m left with more questions than answers.  Do I keep on caring for her until my leave is exhausted and losing my sanity or do I do the ‘selfish’ thing and place her in care; fingers crossed?  Will the nursing home she has chosen be any better… or worse?

Ma’s respite care diary…

…not the most exciting read in the world.

So, what to write?? I was going to condense all of the following into a shorter version and then I realised that it doesn’t give a full picture.  If you are needing to put your loved one into aged care you need to be on the ball.  I’ve been called a pedantic b*tch in the past because I like my i’s dotted and my t’s crossed… that’s just the way I am.  It’s my mother and I know that nobody will be able to care for her as good as I have but I need to know that somebody is going to care enough to try… So here you go… warts and all.

Day 2 – I see Ma and find out that she’s had a bad night, no surprises there.  Apparently she woke during the night asking for me and of course I wasn’t there.  She tells me that the nurses take too long to respond to her call.  Indeed I take her to the toilet as soon as I get there and a nurse comes in 20 minutes later to see what she wants.  I talk to the nurse again about Ma’s bowel habits and how to dress her leg ulcer.  I take Ma out into the courtyard for a breath of fresh air where she meets a couple of the ‘inmates’ and watches the BBQ lunch being cooked while having a brandy.  I ring that night to see how she has settled and mention her bowels again.  The nurses have a cordless phone they can take to Ma so we can talk but unfortunately the nurses can’t find it…  I never do get to talk to her on the phone during her stay.

Day 3 – Early visit this morning she had breakfast in her room which she didn’t eat.  I’m able to bring her a cappuccino in an insulated mug and she is very very happy.  She was waiting to go to the toilet after pressing her buzzer but all of the staff were busy collecting breakfast trays and didn’t have time to take her so I take her.  The aide comes in and wants to know whether I also want to dress her as well!  Ma has a ‘lady’ in the bathroom that copies everything she does.  If Ma lifts her hand, the lady lifts her hand.  I point out the mirror which Ma says she knows is there.  The mirror on the wardrobe door also shows a lady in the room… and even in her bed!  (Sigh, I knew it would be a problem).  Ma tells me that the lady wears the same clothing that she does AND she also has a stuffed toy kitty just like Ma!  Ma is frustrated and upset because nobody lets her move without assistance and when she presses the buzzer nobody comes.  She still hasn’t had a bowel movement and nobody is giving her the medication that we use to keep them going.  I mention this again to staff and ring again that night and tell the nurse.  The nurse says all the right things to me and I have hope in my heart.  But I should know better.

Day 4 – No poo – I talk to staff again about her bowels….

Day 5 – No poo

Day 6 – No poo – Repeated discussions I have with nursing staff fall on deaf ears although they respond nicely to my concerns…

Day 7 – Ma has poo but not the kind to get her excited… I text my sisters and boyfriend to tell them of the ‘arrival’… we have all been waiting for.  I ask to speak to a nurse…. Again.  Ma’s leg ulcer is leaking and I’m worried about her bowels and the lack of ‘movement’.  You talk to them and they agree with what you’re saying and then do their own thing.  Before Ma went into respite she was achieving a bowel movement every 1 to 2 days.  The nurse tells me that Ma wasn’t written up for a laxative every day… she acknowledges that my notes told them about the need for every day but still they didn’t do anything.  She tells me that they are now going to give her Movicol every day.  Not what I’ve been giving her or what I’ve supplied or what has been written up on her medication sheet attached to her doctor’s report.  I also ask the nurse about Ma’s ulcer and she informs me that they’ve changed the days the leg is being dressed on… and that they’ve ordered the stuff to do Ma’s leg with.  Deep breaths…

She speaks to Ma like a child saying in front of me ‘she really enjoys her meals, don’t you?’ Ma looks to one side and doesn’t respond to her.  She has already told me that there has only been a couple of good meals and the rest is inedible.  Sometimes the whole table doesn’t eat the food and they complain.  I can’t see that they get much if any fibre in their diet.  Ma says its tinned fruit with artificial cream. Ma doesn’t know anybody there and doesn’t feel like she ‘clicks’ with anybody that she’s met.  I go to take her outside and to get her hair cut but she doesn’t want to move in case my brother visits…. He doesn’t turn up.

Day 8 – No poo. I arrive to take Ma for her hair cut and find her still sitting at the lunch table along with the other ladies.  They are all staring at each other with no conversation.  I have brought Ma ice cream which she devours back in her room and then has a brandy.  She asks me every 5 minutes whether it’s time to go for her haircut.  My brother arrives just as we are leaving… great.  I’m sure we won’t see him again.  Ma is upset but leaves to get her hair done.

Day 9 – No poo.  I could tell them that using the Movicol doesn’t work but what’s the point when they don’t listen?  Walked in to be handed a statement for her stay.  $1,627.24 for 34 days… she is only there for 19 days.  Deep breaths times two… When I ask administration they tell me that they always take the money out in advance and refund it later… Really? I wasn’t told this… of course.  She tells me that she can’t see the sense in it and that many people complain… really? SIGH, I just walk away.

Ma tells me she has spent most of the night in her chair as her back was hurt getting out of bed.  The night staff apparently found her sleeping there during the night and moved her into her bed.  Not sure of whether this is true but she is sitting in the chair when I arrive and a bit confused.  Apparently somebody turned a bus over in front of the facility.  She asks me to see whether the ‘old lady’ is still there.  The ‘old lady’ has been absent since I moved the opaque door forward of the mirrored door.

Day 10 – No poo.  I decide to give Ma her own ‘movement’ medicine – two lower bowel stimulants and one Coloxyl with senna.  Ma’s leg ulcer is leaking and is looking very messy. SIGH

Day 11 – We have poo!  Arrived to find Ma has had a movement and is sitting on bed looking very pleased with herself.  She said she couldn’t get help so cleaned herself up mostly before help arrived.  There is poo all over toilet and basin and poo on her quilt.  How anybody could not see it and walk away is beyond me.  I’m very very angry.  I clean the bathroom and ask the aide where I can get another quilt for Ma’s bed.  I’m given a bag to dispose of the other quilt and after requesting a quilt twice from two different staff members, I leave.  My brother-in-law succeeds in getting her a quilt when he visits in the evening.

Ma tells me that she had soup for dinner the night before with no bread and she asks for some as she is still hungry.  She tells me she doesn’t like it there at all and that some of the staff get angry with her when she needs to go to the toilet during the night.  I can get up with Ma three and four times a night.  She can’t help it, how dare they get angry with her because she needs to go to the toilet.  She had the same problem in hospital.

Day 12 – I arrive to find her trying to get her heavy dressing gown off as she’s too hot.  She has been pressing the buzzer but nobody has arrived.  I take it off and dress her for the day.  The aide arrives and gets very defensive explaining herself.  Ma tells me she’s pooed again as she took more stimulants last night.  Nurse came to ask about Ma’s bowel movements and I had to bite my tongue as they reckon the Movicol is working!

I notice her dressing is leaking and her leg is very swollen.  The aide comes to take Ma to lunch at 11:45 and says she will be back in 5 minutes, 25 minutes later and we are still waiting and press the buzzer for somebody to take her to dinner.  When the aide finally arrives I tell them about Ma’s leg.  I check later and find that the dressing has been re-done… my sister was informed as soon as she walked through the door… oops I’ve seemed to have made my presence felt!

Day 13 – I’m going to work for five days this week!!!  It’s the first time since I can’t remember when.  I don’t shut up all day.  It’s like I’ve been let out of a cage… there is some normalcy which I haven’t experienced for a long time.  I don’t visit today… I feel incredibly guilty but my nephew is visiting along with my sister…. I decide I need to stay away.  It doesn’t stop me sitting and worrying.

Day 14 – I visit after work.  Ma is sitting on the bed half asleep slumped to one side.  She tells me what a horrible time she is having.  She says she is ‘leaking’ more than usual and that she’s very sore and that her ulcer has been throbbing.  I notice that her leg is looking quite swollen although not red.  She tells me again how horrible the food is and that there were sirens going all night and she’s being walking the corridors.  The tv show, ‘The Farmer Wants a Wife’ apparently turned into guns and shooting…. So she doesn’t what to ever watch it again.  I notice she hasn’t got her slippers on (the floors are very slippery… go figure in a new aged care facility) and she tells me that her feet have been sore.  As I go to put her slippers on I see she has a blister on her toe and ask if she can have a band aid.  The aide tells me she will tell the nurse… Ma tells me that the nursing staff keep asking her when she will be leaving…