A Rare Rant And Some Suggestions Please.

[gness]

I have now received a copy of the report on my mother's deprivation of liberty. This follows the long and laborious interview I had with the Best Interests Social Worker.....hard work that was..... ☺

It is depriving mother of her liberty to have bed rails....but they agree it's in her best interest.....we'd agreed to this with the home ages ago after falls from the bed and her ending up in hospital..

However, they want the home to investigate other ways of keeping her safe for the few hours she's hoisted into a big leather chair in the day room....the lap belt being used is.....yes, depriving her of her liberty!
Well, I guess they had to find something to justify the time spent on this report.

Now...I'm open to suggestions from you all because I can't think of another way to keep this frail old lady with severe dementia safe in the chair......I really can't.....
I wear a seat belt in a car...my children had reins.....if I had a dog it'd be on a lead where necessary.....

And to cap it all the report says that my brother and I couldn't decide which one of us was to be appointed Mother's representative to liaise with another appointed social worker.....(we had asked that both of us be appointed and gave the reasons) so the supervisory body has appointed....my brother......

Still....all this lasts only one year.....and we then have to go through it all again......☺

[andy-hughes]

This sounds like a nightmare when compassion and common sense are being buried under bureaucracy and right-on thinking.

I know from experience that the only way to deal with these people is to remain patient under severe stress and keep telling yourself that this is your mum, and you have vast reserves of love and emotion invested in her, but to them, she is simply a Patient Number, and their rules will always take first place over any ideas of doing what is best for an individual situation.

You can only chip away at their hard-headed procedure-based thinking, and hope that you will come across someone with the requisite levels of humanity and common sense to get your situation where it needs to be.

Keep us posted - we are here to try and support where and when we can.

xx

[anneasquith]

I'd think ,in the patients interest falling on the floor is detrimental and could lead to death ( if the fall were serious eg fractured bones ) . any device/solution to prevent the patient from injury is in her best interest, as long as patient suffers no I'll effects.

[gness]

Thanks, Andy.....fortunately I'm calm and patient.....which helped when the assessor was shouting at my Mum to "Read my name on this card, Bridie!...read my name for me!!!!"

I do understand why they are taking more care these days......there have been reports of abuse in care homes......but there are better ways of doing this....

I've also been told that a DNR can be overruled by these people....there is a court case in the next county about it.....so that needs to be looked at in our case......Gx

[gness]

This is what I said at my last interview, Anne....and I also said that even if she could no longer throw herself out of the chair I didn't want her slipping down and having to be hoiked back into a sitting position....

Her skin is too frail for constant contact.....x

[pixie374]

We use sheepskin liners and reclining chairs to avoid people slipping. We aren't allowed to use bed rails except in nursing units, belts on wheelchairs - unless they have been assessed for adapted wheelchairs, or belts on armchairs.
Does her chair recline?

[gness]

Her chair does everything except sing, Pixie......and whatever the woman who has seen my mum for fifteen minutes recommends......I want her sitting comfortably and safely for the time she's able to be in a chair in company with people to watch and things going on around her..........and the seat belt is the best solution........

A non slip rug wouldn't stop her throwing herself forward if the mood came on her unless she was reclined quite far back......and we like her to be sitting up and able to look around for at least a little of the day.....she spends so much time lying in a bed......

Apart from the carers....who are excellent....my brother and I are the ones who know her and what's best for her at this time in her life......and have cared for her for nearly ten years now........not the very shouty and uninformed social worker.......☺

[woofgang]

Non slip rugs can have the additional issue of transferring the “slip down” movement from the chair/clothing contact to the clothing/skin which can cause skin damage. Anything that keeps your Mum in her chair is going to deprive her of her liberty to the same extent that a lap belt does because it all removes her choice. I am absolutely not saying that this is wrong. Provided that the time in her chair is of benefit to her and she isn’t left in the chair for longer than it is of benefit, then a lap belt is probably the least invasive way of doing it. Reclining a chair can leave a person with only the ceiling as a view which is not pleasant. There is no one perfect solution for this situation...you have to consider all the options and choose the “least bad”
gness, does the residential care get visits from an Occupational Therapist as they may be able to make suggestions, or at least provide a report which you can use to beat the Social Worker with. I have worked with some lovely SW’s and some much less lovely ones!!

[gness]

Thank you, Woof.....your thinking is very much on a par with ours. When Mum is sitting we want her to be able to look at the room and the people in it.....reclining to a safe position would be the same as being in bed....
One thing we have found interesting is that although she doesn't speak or engage with people the one thing she will still do is to say....bed..bed....after a few hours in the chair......
I see that as still making a little decision....almost as if for a moment or two she knows where she is and where she wants to be......little things eh....

We have, over the years, looked at all ways of keeping her comfortable and safe and as engaged as possible....and thought we'd achieved that as best we can in this situation...........

I will ask more about the input of the Occupational Therapist.....my Mum clouted the last one who tried to engage with her....but she's calmer now so thank you for that suggestion.......Gx

[woofgang]

gness..oh dear...well Ot’s are used to being thumped occasionally.... I haven’t kept up with the options (retired nine years ago) but from what Pixie says, not much seems to have changed, indeed I can’t imagine what other options there could be in the circs...I mean there are loads of ways of positioning people but in your Mum’s situation they will all have the same effect of restraint. So long as she seems happy (or at very least not unhappy) when she is sat in her chair then that is the main thing. I was thinking that an OT’s comment that what is being done is the best option might be ammunition to use against Miss shouty snootypants Best Interests idiot woman.

[gness]

I will see what the OT has to say, Woof.....communication with everyone at this home is excellent.....and those with frequent contact with Mum are those who know best....I think....

It's easy to tell from my Mum's expression how she's feeling and sitting upright in her chair......even strapped in......has always seemed fine....

She will look at people......raise an eyebrow...grimace or put her hands to her ears and pull a face if someone is noisy.....

Such pitiful things really......but they are responses and we like to see that......not being able to sit up and just staring at the ceiling isn't what we want......neither is being watched and hauled back up when she slips....I know this will damage her skin as you say.....

I feel that Alzheimer's is what has deprived her of her liberty....we can do nothing about that except make the very best of a bad situation.......

Thank you for your input, Woof.....I appreciate it as I seem to be treading treacle some days....x

[ubasses]

Oh dear Gness. I have been there, got the T shirt, so as to speak. I am not sure whether these people actually care about their comfort, only if they are being deprived of their liberty is necessary.
Myself and Mum's Care Home along with her Gp, District Nurse and Critical Care team have decided that it is no longer safe to get her out of bed into a chair. She is checked every 20 to 30 minutes depending on whether it is a good day or a bad one, turned every 2 hours, and they try their best to get her to take fluids and eat. It is classed as abuse if they tried to force her, yet I had to go through an hours interview to determine that she was not being deprived of her liberty against her will. She can no longer speak at all.
At this stage why are they wasting taxpayers money that could be used for peoples care. A decision that they things will never improve should receive a final sign off. If anything is going wrong in the Home I will shout very loudly and involve any appropriate Authorities.
My apologies for using your rant thread for my own rant.

[jourdain2]

With you all on the way, gness, on the question of whether restraint should be used on safety grounds and in order to give an enhanced social experience - i.e. better quality of life. I take issue with your bro. being solely appointed - is he older? I'd still argue. Ain't life fun (have you seen my thread on law?)!

[gness]

Oh you rant away, Ubasses...and I'm with you......we can't understand why so much time and money is being put into this assessing form filling for people who are being really well cared for.

My mum is clean...always smells fresh and the carers take such good care of her hair, skin and nails....and that's not easy.....she has had no bed sores since being in this home......her clothes are pristine and she's dressed nicely whenever we visit.....

It does make me cross that money is being spent in this way.......x

J....my brother and I have always done everything together.......and we will do this together....
He is eight years younger.....out of the UK often on business....I take my holidays when he is here....we explained this and gave it as a reason for joint representation....but he's a man.....☺

I will look at law....x