Caring for older people

[PinkandBlueDaisy]

My work has me studying a module for caring for older people.

I am not here in this group trying to get assignment information. Far from it.

I do have an aging parent myself and mother is showing signs of what I think is dementia but it's not presenting typically with a memory loss. It's other behavioural and mood stuff. Currently she has obsessions and complusions with buckets and basins and tubs of water. She currently has 6 tubs of water sitting in the kitchen on work tops filled with various things. This is something she is doing every day. She will stand at the sink several times a day and lift clothing up and down, up and down, up and down. We do have a washing machine too. But for some reason she's doing daily handwasing of clothes and other soaking like mugs, cuterly and other things she finds around the home.

This is definitely complusions and she's getting a sensory sensation from working with water.

I don't have a diagnosis for her because the last time I chatted to her GP the GP requested 'any memory loss' and memory is not the thing I see. I have a long list of other cognitive disfunctions.

I am somewhat traumatised with the course work that I have to do for work due to my own personal experience with my own aging mother.

Anyways the course would like me to complete a task for the week and it asks me - to reflect on what you think is important when caring for older people. It gives a list of examples from the course material that has been worked on to date.

I am finding it hard to do this.

My mind keeps going back to my own personal experience.

I know I don't have a diagnosis for my mother but I strongly suspect it is a form of dementia and there is a form of dementia that presents with behavioural and mood and comprehension stuff and it's called FTD. This is what i would think my mother has basses on the list I have. It's not showing as memory loss. It's a range of other stuff.

It seems as if everyone's idea of dementia is memory loss. As in everyone even GPs are looking for textbook style of memory loss before they consider an issue when my understanding now is that it's a cognitive decline and it's different for everyone.

I am experienced with autism and some of my mother's behaviours reminds me of autism even. She runs and hides from the postman, from food deliveries, she ignores plumbing issues around the home and becomes anxious and paranoid if anyone had to come to the house. This is only just a few small examples and it's not everything. She steals, takes and she's not able to read what is full or empty any more and everything gets chucked. These are not examples of what I am observing.

Back to my course work, I have no idea what to write about. Reflect on what you think is important.

The only thing that I feel very strongly about is how so many people have a perception of dementia being a memory loss only when it's so much more than that.

Money. Not being flippant, and I know it’s not what your assignment wants to hear. Money buys help, support, freedom to choose, effectively it buys us time to breathe.

That would be it from a families perspective and I agree money will help with support and care home etc.

However I need to write this from a healthcare assiant role.

Money isn't the answer.

It's just like there are so many ways to answer this question to reflect.

OK, what would you like more of when you’re at work?

I think there are a few care professionals on the board, but most of us can only answer from the point of view of someone who is working a full time job and then doing yours on top.

What do you want help with, many health workers have ageing parents, they are asking you to reflect on what's important when caring for older people, it's not asking about dementia specifically, what do you think is important, what do you think older people and their families and ealth professionals think is important.

I think you need to answer the course question from the position as someone employed in a caring role to older people & try to separate this from the relationship you have with your mother. Unless you’re her actual carer & the course is asking for your reflections & observations from your own actual practical work experience as one.

It is extremely difficult separating the two & your emotions re your DM & the behaviours you’re observing. But if you can take a step back surely you’ve a whole gold mine of information to use to answer the question?! Don’t get caught up in complexities keep it simple. I mean from what you’re describing awareness of & sensitivity to an older person’s cognitive state, seems incredibly important. Same for their other possible other health conditions or neurodiversity. What things are required in a person to help somebody with such difficulties? Ie Patience, empathy etc. Making things easy to understand etc. Building & developing trust. You can refer back to how dementia doesn’t only encompass memory loss but as you so clearly are seeing, other emotional & behavioural aspects (that you feel get overlooked by GP’s on the subject). Or that there is an assumption of dementia when it comes to elderly care, when that might not be true for the person you’re caring for/helping. Surely you’ve got it all there at your fingertips! Good luck.

The family/carer needs to be prioritised ,not fobbed off ,not 'dumped' with the person by social services ,the hospital etc, no assumption that the family have the means ,the facilities ,the knowledge and patience to be a carer.
Otherwise the person with dementia is up shit creek when the family /carer is burnt out into oblivion .
Being a professional carer needs to be respected and paid accordingly, there are amazing people doing this job on low wages ,but unfortunately it can attract people who perhaps shouldn't be anywhere near a vulnerable person because its 'just a job' and 'i need the money' .
I agree with the pp saying money helps absolutely yes.
My mother has a diagnosis and gets attendance allowance ,she's doing just fine thankfully at the moment but i realise that even though i am very grateful she has this money it's not going to go far between the period of time that she wants and chooses to be at home but needs help and the time that she may need to leave her home to be cared for, obviously the home has to be sold then.
To be honest the whole situation for sufferer and carer is pretty shit ,i hold my hands up i am not carer material , i dread what may come, i can't imagine some of the situations i may have to face.
I am aware you may think me selfish but after a certain point i think the family/carer are in a much worse position than the elderly person.

What examples have they give, and they asking you to read the examples and reflect on those?

Not the answer to your question OP but your DM needs a full assessment. A psychogeriatrician would hopefully be able to figure out what's going on for her. Keep notes of what's happening.

Empathy, kindness, patience, touch, cheerfulness, positivity and showing an interest. I struggle sometimes with some of these, but you need to make your cared for feel as if they are the most important thing, that they are cherished and valued. Even if they forget you as soon as you are out the door, in that moment you are with them, they matter. They are not useless or a burden. Accept their reality, what they were before is gone, live in the present with who they are now. They do odd things that make perfect sense to them.

kindness, compassion, routine, things to be predictable, stability, safe environment, regular good quality meals.

To be honest, I think that’s really hard to achieve with carers popping in at home. There should be more residential care homes.

@PinkandBlueDaisy I cannot give you a direct answer as I have tried everything from patience and kindness - didn’t work-to getting upset - didn’t work - to getting angry - didn’t work.

What did strike me from your post was you alluding to autistic traits. I have spoken about personality on this board before. What was your mother like in her earlier life personality wise. Is her behaviour ‘different’ now or is it simply an exaggeration of her personality.

My mother is certainly her ‘old self’ ramped up. Over complicating things and obsessing has always been her personality. Always knowing better than everyone. Always having a contrary opinion.

Now she is older it is just a worse version of what was a challenging personality anyway. There seems to be a myth that if someone ‘looks’ like a sweet little old lady/man that they are. They are not.

One thing that's true in my family was that, just because someone's old and frail, doesn't mean their childhood and earlier life experiences suddenly stop influencing who they are.
In your Mum's case it does sound like there's something haywire in her brain (IANAD).
But I can think of a lot of people where, what's the term, adverse events 50, 60, 70 years ago are still responsible for mental and emotional problems in their old age.

I was listening to an episode of More or Less recently, about the “Autism curve”, and how much higher numbers are being diagnosed in childhood and middle age but not in older age groups.
But no one is testing them, are they?! And the coping mechanisms someone has learnt through life start to fall apart when they become more dependent on others.

Why don’t you reflect on the need to recognise that conditions manifest differently in different people because every person is unique. Expecting someone to follow a “one-path-fits-all” subjects the care provider to unnecessary stress if the person they are caring for doesn’t behave in the expected way. A carer may start feeling they are doing something wrong and doubting themselves. Remembering that every diagnosis is unique can help overcome that.

That's a very good point. I did read and see of middle age adults getting diagnosised with autism in adulthood but you made a good point about older people - who is testing them.

I don't think this would be autisim though in relation to my own mother. I am inclined to lean towards the possibilty of dementia.

That's an interesting point to.

I don't know what happened in my mother's time before I was before. So that would be 50 years ago. I do know her marriage didn't last long and he was abusive but I remember when I was small she was well able to give back what he was dishing out and targeting him when he was in a vulnerable state himself. She would wait until he was several hungover and unable to move from his pillow to stand over him and give back the trash he was dishing out.

How can something remain with an individual for so long. You wrote 50/60/70 years. If it was war related or child abuse I could understand how something traumatic can remain with someone but how about other incidents.

Whenever I experience something I consider bad I am inclined to write it off and learn from it and park it there.

This, I relate to this so much.

She was able to be a beast in my younger years. She did mellow but now she's ramped up. It's like she is on steroids sometimes.

I am not a care assistant, i just look after a relative who is in a care home.
Important things:
Being near enough to respond when they call, and checking frequently in case they don't call, and not having more people than you can respond to.
Having the same Carer do the same jobs as often as possible so the person can get to know them.
Having time to encourage the person to do the things they do.
Helping them go outside in daylight.
Keeping them able to do things like get their own breakfast.