The Cockroach Cafe 🪳 Spring 2023

[MereDintofPandiculation]

Welcome! I’ve done a really good clean of the place overnight, and brought in daffodils from the garden to remind us all that spring is around the corner and better times on the way.

Come in when you want to share good news, or to rant, or to ask a small question that doesn't warrant its own thread. Or just to hang out with others who understand what you're going through.

For newbies: why cockroach? Previous long term resident of "Elderly Parents" Yolo's DM attended a 'small animal event' in a nursing home, and was presented with a "small animal with a hard back" the name of which species she couldn't remember. Her ever helpful DB suggested cockroach, and it has become a toast on here. So 🪳 mes amis/amies, and may you all live to fight another day.

@SheilaFentiman I've been alcohol free for about 18 months now so this could work for me. Is it having a positive impact?

@Newmum738 yes, I think it is. The waves of anxiety come less often, last less time and seem less intense. I also have therapy where I can talk about things, but it wasn’t enough on its own.

Re the bins
Is the problem more about contaminating the recycling?
It seems incredibly harsh to judge anyone for accidentally putting recyclables in the general waste...especially as a lot of councils just put everything in one dump anyway.

What happens when you call the council to explain?
i'm in a block of flats but actually, with bins in the street, a passerby could open a bin and put rubbish in.

@EmmaEmerald unfortunately it's a bit worse than that as they are mixing used incontinence waste with the recycling. The council have been very understanding up until now as my parents have always just thrown anything into whichever bin they fancy, but this time it was open bin liners obviously containing used incontinence pads, so unsurprisingly they refused to touch it, mum's answer was to put more next to the bin rather than in either bin.

Care home asked for our thoughts on treatment for dad if he goes into hospital. We asked for a meeting to discuss properly. Dad has alzheimers, no capacity, we have LPA. Has anyone else been asked about this? Are we talking possible DNAR and advance directive? Could we do those, if we wanted to? What else might they mean?

@GordonBennett345 i visited my dad today at his new care home (he moved last month) and have been given those same forms to discuss with DBro and DM

Ah, they haven't given any forms (yet)

https://www.resus.org.uk/about-us/news-and-events/resuscitation-council-uk-introduces-version-3-respect-plan was the respect form discussed with us when dm was in hospital.
I think it has to be done by a medical professional with patient/ lpa holders.

@GordonBennett345 let me see if I can photograph them without identifying details

These are the key questions, the rest is heath-care professional details

I made it “sensitive content” in case others didn’t want the questions in their feed

So you can have as well as DNR what is known as a peace plan so the person with dementia isnt admitted to hospital unless the actually actively break something. My mum was admitted to hospital as they thought she may have sepsis by her care home. She didnt it was her dementia. It caused her extreme distress crying out constantly asking where she was etc laying on a trolley in a corridor. It caused everyone extreme distress to be honest for no gain as there was nothing they could do. They asked us about signing for a peace plan so that she didnt have the upheaval and distress again. Best thing we did. It also meant when she stopped eating etc she wasnt admitted into hospital she had her end of life in her care home in familiar surroundings with staff her newher well and treated her with care live and respect. It was February so bitterly cold and it meant she could stay put in her own warm bed and warm room at her care home. Definitely something to considerxx

@orangetriangle thank you that is really helpful to discuss with DBro

And I’m sorry about your mum

It has reminded me that when I took dad for a heart scan, he was distressed at the discomfort as he didn’t know why.

Thanks for the info. Are LPA holders able to set up DNARs, advance directives and peace plans?

I didn't have health Lpa and I was asked to agree to care at home unless there was an actual emergency. I was happy to do so because it was what mum and I had been doing in her last years at home. I didn't call an ambulance every time she fell, we decided together how bad the damage was, made a cup of tea and had another look and usually decided it would be better by morning. The care home had her whisked away for every bump. By then she didn't know where she was, couldn't hear what people were asking her and it all seemed such a waste of time.

I agreed with the doctor at the hospital that they would tell the home that in future the GP should call rather than there being an automatic ambulance.

When MiL feel 2 days after hospital discharge DH and cater were able to get her up and check all was OK. Second fall 5 days later I rang GP who said they couldn’t come and said to call 999. Result 2 more weeks in hospital, no actual injuries, delirium, worsening of confusion and refused food for 2 days. Discharged home and a few weeks in screaming as agitated possible infection rang rehab nurse who said call 999. I refused so she rang GP who once again couldn’t come and said ring 999. Paramedics scored too low to need hospital. 4 days later DN worried at delirium rang 999. DH went round and once again paramedics came and said hospital wasn’t needed but stayed 2 hours until they could speak to a doctor and arrange void tests. Paramedics have always been kind and thorough and ran all tests possible. Told DH they feel they have taken on Social work with more and more elderly. GP eventually visited and checked cough etc and on recommendation of dementia services asked him to refer MiL back to memory clinic because of rapid decline. Likely 2 month wait. GP surgery has 8 GPs. Half are kind thorough doctors, one has sent me with MiL to A&E twice not including above. 🤔🙁

Escuse typos 🤣

We had the same a couple of years ago with dad. He kept falling and was complaining of pain in his knee. GP refused to see him either at home or in surgery (covid rules). Eventually mum couldn't get him up and called 999. Ended up in hospital on intravenous antibiotics for a joint infection that has a higher fatality rate in the elderly than covid did. Could have been avoided if he'd had antibiotics earlier. He was in hospital for nearly weeks that time. He kept going in after falls and the consultant wrote to the GP twice saying that phone consultations were not appropriate for a 93yo with complex comorbidites and severe hearing loss before the GP would see him face to face.

I think it's all about assessing if a trip to hospital is going to be much benefit to them and is it actually going to do more harm than good and for what gain. With mum we all made the decision it just was too much for her to go into hospital at end stage dementia.

Sheila thanks for your kind words still very raw as mum only died end of Febxx
Hope I could be of some help thoughx

to add we did have medical power of attorney in place that being said she would have been unable to decide for herself in any case so just as well but I am sure if someone has limited or no cognitive ability next of kin can decide if a peace plan can be put in place

MiL has gone from being said to have capacity to not, but when paramedics arrived she perked up and said ‘do I have the privilege to say no to hospital’ and he said of course you do. They were great with her - and She calmed down and was told drink more water 😁. I think she is told that twice a day or more, she tells every medical person she meets she loves water and drinks loads - she doesn’t - but she sounds so convincing🤣. Looks like SW will suggest she goes into a nursing home. Pros and cons, peace of mind but not what she wants and fear she will deteriorate from the anxiety and more change.

Not my decision or choice….

I can only share what happened to us when dad was admitted after breaking his hip. Mum and him had LPAs set up for each other, created before his dementia.

In A&E the doctor discussed DNR with us as they would have to operate and replace his hip as an emergency, a major operation by anyone's standards. Dad was by that stage far too deep into dementia to realise what was going on. We all (mum, me, sibling) discussed the DNR again and decided it was for the best.

Long story short but dad never recovered really from the hip op, his dementia made him forget he'd had it done and kept trying to get out of bed and injure himself again, he needed a catheter as he couldn't use the loo, wouldn't cooperate with physio and just starting losing weight, sinking deeper into dementia and it was clear he hadn't long. At that point we had another conversation with a lovely consultant about palliative care being the only option and she again mentioned the DNR, along with withdrawing active "treatment" and just keeping him comfortable.

It's really hard. But you need to take advice from the medical staff at the time who will have seen it all before and can share their experiences.

I wouldn’t have thought an Attorney could set up an Advanced Directive, since the point is that you write down your wishes in advance of a time when you may not be able to express them.

An Attorney can certainly agree a DNAR