Wednesday, 22 May 2013

My illumination

If you have a number of light-bulb moments in quick succession does that make an illumination?  If so, then I had an illumination at 3am whilst trying to sleep in a hotel room, which I was sharing with my mum, on our way to London.  So, what was that illumination? I realised everything I had learnt and knew about being ‘person-centred’ I had just not applied when helping my parents plan for the future. 

My daughter, Erica left school 11 years ago and since then we have developed a comprehensive assessment and a good person-centred support plan, which offers her a diverse and interesting range of opportunities and activities with the high level of support which she needs. Since I started blogging and tweeting (about 3 weeks ago) I have read some wonderful person-centred blogs about older people (thanks to Beth Britton, Ming Ho and Martin Routledge) – yet the penny did not drop! With hind-sight I realise we have been carried away by social services who have applied a very traditional model of support visits to meet personal care and when you need more then it is residential care. Spending time driving with my mum to London and supporting her in a hotel made me realise that this is not what she and my dad want. 

So let me share those thoughts with you.

Last Friday I wrote a piece for Community Care outlining my journey to look for a long term solution to my parent’s living situation. (
My main goal was to try and find somewhere that my parents could continue to live together in their local area. As that option was not available at a price they could afford I felt the only answer was for my dad to go into residential care and my mum to remain in their home. 

On Friday my father also went into residential ‘respite’ for the first time. I took my mum to London for a family get-together. When we left Yorkshire at mid-day on Saturday my dad was not happy although beginning to accept his situation.  The main positive for him was that he was given puddings after his meals, otherwise he spent most of his time finding the doors out of the home or sitting in the entrance hall waiting to be collected.

My mum and I had some really good conversations on the way down. I asked her if she could have whatever support she wanted, what would it be. I learnt a number of lessons:

  •  She was not ready for my dad to go and live somewhere else (the quest for residential was about my anxiety) 
  •  She would like a weekend break about 4 times a year (I expected her to say every 2 months)
  • She felt she was wasting money by being forced to have separate calls for her and my dad, as there were some days when a shared half and hour was sufficient
  • She would rather spend her money on sitters so she could have more breaks during the day. She would need help to find sitters who would get on with my dad.
  • She would like help with meals, but she wanted to make the meals (cooking has always been her thing and she is an excellent cook). This one was interesting. She wants to buy more ready-meals from M&S. (I did wonder of I could suggest that M&S do a meals on wheels service for the discerning older person!)
  • Sharing a hotel room made me realise just how difficult she finds getting on and off a bed, going to the toilet during the night and how great the risks are of her falling.

It was only after I had helped her to the toilet at 2am and then could not get back to sleep did the light bulbs start going off in my head and I realised that everything I knew about being ‘person-centred’ I had just not applied to my parents situation. I had been co-opted in to a rather traditional model of care which as a social worker and a parent I no longer believed in.  It suddenly all came together for me and I thought:

‘Put on your campaigner’s hat and turn things around.  Develop a person-centred plan with mum and dad that they want, not what the local authority and health think they should have.  Challenge social care and health to think person centred in relation to dementia and older people.’

OK – so what is my plan of action?

  1.  Read their separate ‘service user’ assessments and support plans 
  2.  Use my contacts to find a sympathetic manager in social care who I can talk to and lay down the challenge: how do we turn this around and make it person-centred, as that is the government agenda – is it not?
  3.  Ask for a joint assessment of my parents as both service users, and my mum as a carer.  This is in the spirit of the new Care Bill – is it not? (See previous blog)
  4.  Develop a single support plan which treats them as a couple who have been married for 62 years and yet respects and meets their individual support needs
  5.   Then ask for help to find services that will meet their needs outlined in that support plan
  6.  As a post-script – arrange a reassessment of their sleep arrangement to ensure that my mother can get into and out of bed safely during the night (at the moment they are both sleeping recliner chairs in the living room – not a good idea!)

How difficult can all this be?  I am not asking for ‘the moon’ just what is laid down in law and regarded as current policy and good practice.

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