Tuesday, 20 November 2007

Dementia Blog - Part 3 - Slow Dawning

When last you left us, Mother-in-law (M-I-L) was in respite care up in Northumberland. We were still in a state almost of shock. The prognosis for Father-in-law (F-I-L) was not good, he had the worst type of leukemia. This meant we were responsible for caring for M-I-L for a good while to come while he went in and out of hospital.

We set to, trying to decide whether M-I-L could or should go into a care home or whether she could care for herself at home with some assistance. F-I-L had already said his target and motivation was to have the house and his wife to come home to.

Of course, we knew we might have to pay for care arrangements in the medium to long term, but weren't sure whether short term arrangements were provided and what they were.

Needless to say now we needed all our professional experience of large organisations to be able to assess which institutions were involved and what options they provided. This was not at all clear form the Social Services literature or available information.

Central Social Services formed the policy making part of the "delivery team", with long term dementia care provided by a special care unit with facilities to support significant physical and mental deterioration. In-house care was provided by an outsourced agency, ostensibly on a 3 visits a day basis. We gather this varies council to council.

We worried whether M-I-L was really safe to be on her own in the house, and decided to explore the option of the care home.

Having got through the logistical nightmare of getting M-I-L back from Northumberland whilst taking our children to school, we planned that we would leave the girls with our good friend in Croydon at the weekend, and see how M-I-L took to the care home, perhaps leaving her there if it seemed viable.

When we got there, we realised that most of the home inhabitants actually had quite severe dementia. M-I-L was not really yet at that point, so we had to change plans and stay with her one more night, again no change of clothes, and then arrange for the local care agency to start coming in on a regular basis.

We were still worried at this prospect. M-I-L didn't cook any longer, and was no longer dressing herself or washing with any great consistency. We knew nothing about the assessment processes that would be needed, feared M-I-L's response to it all, and were conscious that F-I-L was not keen having strangers trooping about his house.

What was clear though was that care had to be provided in the place of residence. The burden of tax paying has to be taken into consideration in these matters, and this did make sense. In practice, no other local authority would have taken responsibility.

What was quite astonishing to us was how basic the assessment test was. Hardly any of the questions we thought were relevant, and quite a number of concerns as to what provision would be made for M-I-L while carers were not present.

Whilst we had several concerns about such care, we were now committed to going down this path. How would we come to terms with our own expectations and the service that was actually being provided ?