Maintaining Routines: Nights, Mornings and Social Services

On Sunday night after I had gone to bed, mum had a fall in the care home. Going to the toilet, groggy with sleep, she tumbled forward and banged her head on the basin as she fell. The care home staff alerted me after they called an ambulance. I pulled on some clothes and drove the 25 minutes to the care home to wait with mum for the ambulance to arrive. On seeing mum, I felt a wave of distress and helplessness. The sight of mum lying in her bed with a bandage on her head signalled her vulnerability. I tried hard to manage my emotions, as they are not helpful to mum.

Four hours later, the kind and caring ambulance crew had done thorough checks and gave mum the thumbs up. She didn’t need to go into hospital. Apart from a cut and large bump on her forehead, and a headache, she was fine. Surprisingly resilient she was keen to get back to sleep (helped by a sleeping tablet). I was grateful that I could go back home to bed.

Adapting to mum’s routines

When mum comes home, I’m conscious I’ll have to adapt my sleeping and morning routines to accommodate her frequent night-time trips to the bathroom and early starts. Mum gets up around three times a night to go to the loo and rises in the morning between 5 and 7 am. As mum’s balance is off in the middle of the night, I will be alerted by a sensor that she is awake, so I can make sure she gets to and from the toilet safely.

At night, I can generally get back to sleep quite easily so mum’s many trips to the toilet shouldn’t be a problem. What might be more of a challenge is retaining my pre-breakfast routines: meditation and exercise. Meditation helps me be more mindful, less caught up in emotions, and more present for my mother (and me) so keeping it up is an essential part of my coping strategy for when mum comes home. Also, if I am to preserve my own health it is essential I stay active and fit.

Maintaining my routines

To keep up these activities, I was initially hoping to find private carers from the Social Services approved list, that would come in to support mum each morning between 6 and 8 am my preferred times.

The local care agencies that cover mum’s area don’t start that early, and anyway don’t have the capacity. They say they struggle to recruit enough staff to meet existing demand.

I was already aware that Social Services would support mum with task-orientated visits several times a day. However, I didn’t have high hopes for this help, imagining they would turn up for a fifteen-minute slot, for example, to get mum ready for bed. I feared that a short visit would mean mum was rushed; and anyway I would prefer carers who have the time to enable mum to do what she can do, rather than doing things for her.

Bridgeway: Social Services dementia support team

That was before I met an occupational therapist from Bridgeway, Bridgend County Council’s social services dementia support team. After discussing mum’s needs with a woman from the team last week, I now have a much better idea of their approach.

Bridgeway seeks to support and enable someone living with dementia to do as much for themselves as possible. Bridgeway’s own “picked and poached” care staff will visit us four times a day to help mum in the first six weeks, while continually assessing her needs. With a fully informed assessment, they will provide ongoing support via a care agency. If families can pay for this support they do, but there is a cap on what we pay irrespective of how much help is needed. Bridgeway is unique in the country. It is the only social services team that includes a cognitive impairment specialist, and that recruits and uses their own care staff for the critical six-week assessment phase.

It was a joy to speak to someone who had in-depth knowledge of dementia and a positive approach to enabling the person, rather than simply doing things for them. I am excited about what this could mean for mum and I.

Working around new routines

Now I know more about this support, I have decided to sit tight and see if I can use the time during their visits to do my meditation and exercise routines. Obviously, I will have to work around their visits which will start later than I hoped, and provide less time than is ideal, but it’s a start. When we switch to a care agency I might be able to extend the hours and pay the additional costs. Or if capacity continues to be a problem, I have the option of getting direct payments to employ carers privately. This will be more difficult to organise, but perhaps more flexible in the long run.

If this support is as good as it sounds, I will conclude that mum’s home county is one of the best places to be if you, or a family member, has dementia and wishes to live at home.