A YEAR ON.
It is now over a year since Isobel went into residential care at Broadwater Lodge, just a mile from home. So a review of where we are may be due, although it is difficult to disentangle the objective from the subjective factors.
To recap: The decision in March 2011 to arrange her admission was not because of the problems immediately associated with her dementia, though there may have been some interplay between the psychological and the physical factors. A series of unexpected falls from bed in the middle of the night was the trigger. We did not have theresources to help her with her basic needs of dressing, going to bed, rising, eating and the toilet, and whilst we are not present at crucial times there is evidence from sustained observation on day time visits that the home has performed well. Recently a daily “help sheet record” has been available in her room. It is largely repetitive but it does indicate that she has care during the night as well as the day. She has had several falls from bed but these were regularly reported to me by telephone next morning (None reported for the past six months.)
How well does Broadwater Lodge meet Isobel’s and our needs?
I think that we were all a bit hesitant at the outset, butdoubts have either been dispersed or diminished, so far as is possible. We (and in this context I hope I can interpret for the family) always recognised that this was a second best option. The most important single factor – which has been reinforced over the year – is the kind and patient handling of residents by the staff – almost all young and from overseas – has impressed me very favourably, and I have no anxieties on this score.
I presume that there are in place procedures for calling on medical help when it seems needed. In one instance, when I suggested it, this was immediately taken up andimplemented. I have an impression that the owners (Care UK) are like other operators aware of the bad press their industry has received and are anxious to dispel this.
The general admin of the homeleaves something to be desired, but this is of much less importance than the quality of personal care. For example, the standard of laundry seems excellent, but the efficiency of return of items to the rightful owners less good. One of the benefits of daily visits is to be able to keep the management on their toes.
What about the emotional deficit? (a term I use hoping it does not sound too dramatic.)?
In almost 60 years of marriageboth Isobel and I had active, and sometimes separate, agendas, so we were not in-bound. But the past year has been completely different, not only in the circumstances of the “separation” but on our day to day routines. Looking back over the nine yearssince she was diagnosed with Alzheimer’s, they have glowed as a treasured part of our lives, despite occasional aberrations and crises linked to the disease. Perhaps this has led to a heightened sense of loss in the past year.
During the first few months in care Isobel showed a degree ot “rebellion” alongside the evidence of her reduced ability to implement the rebellion. And here was one lesson that we reached. Early on in her stay she could be quite sparky – such as “Cut the cackle”, or when I explained thatI had no longer the physical strength to cope with her falls, she responded “Then YOU ought to be in here.” Progressively her manner has been more subdued, with occasional flashes of humour and acute perception. The contrast is very marked.
The environment of the lounge where we normally talk is not ideal, and sometimes there are slightly disruptive other residents. Once or twice we have met in her room and this is probably preferable, as, sadly, rational conversation with the other residents is rarely feasible.
There are periodic meetings between the management and relatives, but these have not been very managed; signs of lack of experience by the management. Most recently (April 2012) there was the usual emphasis on physical aspects (building modifications and baked beans on the menu), but I managed to insert a concern for some privacy when visiting.
There was one incident, about three months after admission, when Isobel said that she felt quite relaxed and willing to let events unfold so long as she could see me. Comforting though that may have been it was not repeated. Almost always she asks about coming home (without having a clear idea what or where “home” is). My response is rather reluctantly accepted, but the sense of sadness that she is unhappy invariably persists after visiting. Coming home is invariably linked with a feeling of my having taken the easy way out for myself.
One thing which I think we haveall learned from visits is that we are probably looking too hard for some signs of optimism, however small. This, it is clear to me, is looking for something to cheer up ourselves, hardly commendable. But it is a temptation that is hard to resist with someone we still love and cherish for her normally vibrant character. The shadow that is the present falls heavily, and evenings often hang heavily – hopefully not for her.
To take a wide perspective our situation is probably replicated thousands of times elsewhere in the country, with the increase incidence of dementia, as I sense from the few other relatives whom I have met at Broadwater Lodge, but that is little comfort.
Len. April 2012
Len Clark 