Grandad – then and now

By SIMONE JONES

The world Grandad was born into….

Grandad was born on the 21st February, 1923, at, 22 High Street, Welling, since there were no maternity homes in those days.

During the war, he trained as a pilot and flew Tiger moths and on DDay Airspeed Oxfords

After the war, He met and married Irene Moss, who he had first met when she was an ambulance driver in the early years of the war.

They had six children, three girls and then three boys. Sadly one daughter Hillary had a stroke and was paralysed down one side, compounded by epilepsy., also a son with a cleft palate, although through modern medicine, this was resolved.

He studied trained in engineering and became an architectural engineer eventually working on major projects in the London area. Working on until 1989, well over retirement age.

On for his 80th (2003) and he was showing signs of dementia, repeating himself etc.,  this apparently started to set in sometime between 75 and 80. 

Grandad

Grandads Wedding Day

The World Health Organization (1992) states that the primary requirement for a diagnosis is evidence of decline in memory and thinking which is sufficient to impair personal ctivities of daily living.

Common Causes of Dementia The four common types of dementia in

persons over the age of 65 include Alzheimer’s disease, vascular dementia, diffuse Lewy body disease (dLbd), and alcohol-induced dementia.

Defintion of Dementia

· Word-finding difficulty · Forgetting names, etc· Difficulty performing familiar tasks – · Personality changes · Uncharacteristic behaviour· Mood swings, · Poor judgment· Behaviour disorders – · Decline in level of functioning but able to follow established

routines at home· Confusion, disorientation

Leading to svere dementia which can show

Signs and Symptoms

Complete dependence on others for activities of daily living

May be unable to walk or move from place to place unassisted

Impairment of other movements such as swallowing - Increases risk of malnutrition, choking, and aspiration (inhaling foods and beverages, saliva, or mucus into lungs)

Complete loss of short- and long-term memory - May be unable to recognize even close relatives and friends

Complications - Dehydration, malnutrition, problems with bladder control, infections, aspiration, seizures, pressure sores, injuries from accidents or falls

Severe Dementia

Medical

Task Orientated

Psychological

Theories

UNIQUENESS• Regardless Of Illness, All People Are Unique• And This Must Be Acknowledged For People With Dementia

COMPLEXITY• Humans Are Complex Beings• And A Myriad Of Factors Influence The Way We See And• Respond To The World Around Us.

ENABLING• We Need To Recognise The Strengths And Abilities Of People• With Dementia And Ensure Opportunities Exist For Them To

Be Utilised.

Person Centred Care

PERSONHOOD• The Recognition Of A Sense Of Self, Who We Are

And What Place We Hold In The World Around Us.• It Places An Emphasis On The Positive Effects Of

Daily Interaction

VALUE OF OTHERS• PCC recognises the personhood of all people.

roles of direct care staff, the formulation of policies and procedures and staff and managers supporting each other.

Person Centred Care

His Diagnosis was February 2010 (Dementia in Alzheimer’s disease and Pituitary Adenoma) his family was present.

Whilst he was still at home he ate very well and was co operative with his daughter Hilary dressing him whilst at home he was able to shower himself, but needed prompting. 

He was distractible, but very cheerful and humorous. Grandad recognized people he sees frequently. 

He didn’t require long term follow up in the memory clinic but the door was left open if case the family needed further help and support.

Memory Clinic: 

Staffing

A care plan was put into place by the memory clinic whilst Grandad was at home.

Telephone numbers given for on going support Carer’s hours for daughter to attend group Referral made to district nurses for incontinence

pad Information given on direct payments scheme

and respite care Council Tax forms given for capital call Information giving on “choosing a care home”

and “paying for Care homes”

Care Plan

Mental Health and any behaviour Management

Diagnosed with Dementia which has affected his ability to manage his own daily living tasks.

At times appears restless and fretful, this is usually cause when he needs to go to the toilet in which he paces and removes his clothes and in inappropriate places and resents intervention to redress.

He becomes very restless at night because he is not tired and is prone to entering other peoples bedrooms by mistake, which they find intrusive.

Care Plan: Health

  He likes to be supported in the management of all his

personal care and other daily living tasks.

When he remove his clothes staff to guide him to his bedroom offering him reassurance. And explaining to him that this may offend others if not dressed properly.

Like to be involved in activities that interest he and to prevent him from becoming bored. He likes ball games.

Night staff to monitor his activities at night support to use the toilet and prevent him from entering other rooms

Care Plan: Health

Good appetite, enjoys porridge - to be offered choice off a cooked breakfast. Dislikes new potatoes and tomato soup. Food to be prepared for him and his meat cut up. And to be given an option of choices at all meal times. And show the choices available from the photo menu.

Family provide him with biscuits and sweets which are kept in a tin.

Weight monitored monthly

Care Plan: Food

Washing needs guidance and support staff support him through the process.

Bathing - Like a shower daily Shaving doesn’t remember to shave daily -

staff to remind and support daily Guidance to the toilet and wears

incontinence pads day and night

Care Plan: Continence and Personal Care Activity

Gets up around 8 am and has shower with support

Very sociable and like to joins others for meals

Spends time in the lounge interacting with others and cat naps in the arm chair during the morning sometimes sleeps too much which could be why he has restless night

Care Plan: Activities of Daily Living

Like to play card games, enjoys a game of bingo, darts dominoes and ball games

I like watching crickets and other sports on TV

Like joining in in singing and enjoys a shandy in the evening

Care Plan: Activities of Daily Living

He sometimes has difficulty finding the words to express himself.

Inclined to repeat what is said to him

Is able to give yes or no answers to question

Care Information: Communication

He will often hold his head in his hands when he feels he needs to use the toilet

He can become unsettled and fidgety when he needs to use the toilet and cannot locate the facilities

Care Information: gestures and Body Language

Is inclined to remove his clothing and pace the floor he is anxious about needing to use the toilet

Care Information: Behaviour

  Like snacks and drink before retiring to bed

Support to use the toilet and wash, change for bed

Wears a moliform extra pad to bed for comfort and dignity

Care Information: Night Routine

He has a sensor mat on the bedroom floor which alerts nights staff when he is getting up, may not always be able to call for assistance if he needed help but would like the call button place where he can easily access it at all times.

Staff to check on him very ½ hours to make sure safe and comfortable if wandering guide back to bedroom if still unsettled

Care Information: Night Routine

Quality outcomes for people with dementia: Building on the work of the National Dementia Strategy 2010

I was diagnosed early I understand, so I make good decisions and provide

for future decision making I get the treatment and support which are best for

my dementia, and my life I am treated with dignity and respect I know what I can do to help myself and who else

can help me

Conclusion Department of Health

Those around me and looking after me are well supported

I can enjoy life I feel part of a community and I’m inspired to give something back

 I am confident my end of life wishes will be respected.

I can expect a good death

Department of Health Outcomes

IF YOU HAVE ANY QUESTIONS, PLEASE USE THE TIME AVAIALBLE TO ASK

THANK YOU

SIMONE

THANK YOU FOR LISTENING