CARING FOR JACK

CARE IN THE COMMUNITY

John Samuel Tarling was 90 in November. Actually, everyone calls him Jack which causes confusion at times with the professional services who are now involved in his welfare but they get over it. Jack is my wife"s father.My wife is a twin ,so it falls to them to be cares in chief. Jack has Prostate Cancer and also blood clots on his lungs and has developing Dementia, which restricts his short term memory greatly. He has had two spells in Hospital this year and now has a catheter to take care of his urine. Fiercely independent, Jack is determined to stay in the home he had for the past 40 odd years and where he and his wife Valerie brought up their eldest daughter Sue and the twins Sandra and Julie. Sue died tragically at the age of 26 over 40 years ago,and Valerie passed away 3 years ago at the age of 80, leaving a massive void for Jack. However, he moved on with things until this year when age has caught up with him in a big way. His independence is severely curtailed but nevertheless, he refutes his GP "s assertion that he should retire to a Care Home. Thus, he is now cared for in the Community, by a mixture of families and agencies.

THIS IS THE BACKGROUND TO THIS HUB AND TO THE GOOD ,THE BAD, AND THE UGLY REALITY OF GROWING OLD IN THE UK IN 2012.

A HEAVY INVOLVEMENT.

Governments espouse care in the community mainly because it is cheaper than hospitalisation on an ever escalating scale as the UK becomes a heavier older age population. However, having been involved in coordinating care for Jack, This Hub may surprise some readers as to the heavy involvement that is involved in just keeping one aged person alive, safe, secure and as well as possible in their own home.

Essentially care is split between two groups, namely family and friends and the professional services. Jack,as we are told is "lucky" because unlike some he has a committed family around him who contribute fully to his welfare. The main brunt is born by his twin daughters who are responsible for both his general care, the organisation of his household affairs, his washing and cleaning {required daily} and also the organisation of his pharmaceutical affairs, including the maintaining of the relevant drugs, and day and night bags. His shopping for food is undertaken by Julie"s husband Jim, who also takes care of his evening meal needs generally. Liaising with the agencies is largely done by myself and as will be seen later, that can be quite extensive also. The family also provides the vital holistic care ,so essential to well being. Jack, as well as having the physical ailment problems outlined earlier also needs to be assisted psychologically to avoid loneliness and a feeling of being a prisoner in his own home. Thus, jointly or severely, we take him out for meals or for a ride and a short walk to break up the pattern of the days which otherwise would be spent sitting in his chair staring out through his patio windows or at the Television which often irritates him. Other members of his family visit when they can along with his great grandchildren in some cases, all of which builds up to give him as varied a scenario as possible given the situation.

Jack is fortunate that, at my last count over 12 members of his family contribute in various ways to his welfare each week. He also has a key neighbour who visits him early each day to make him an early morning cup of tea {he rises around 6am each day} and a bowl of porridge in these wintry times. We know, from some of the professional agencies and from my wife's experience as a professional care some years ago that many old people sadly, do not have the family support that Jack has and see only their carer each desultory day after day. The saddest face of care in the community.

The input of the professional agencies is ,of course, vital and varies in quality. One of my chief activities is to monitor and keep on top of the services provided. Again at my last count, Jack has11 agencies or organisations involved in his welfare and it is vital, in my opinion that we establish communication with the key decision making personnel in each involved. Experience teaches that it is vital to draw up your own key worker list of personnel at each agency and to have there contact details set down for use as required. This ,to me is the difference between getting things done or where necessary, put right, and merely whinging when things, as they will, do not function as intended or wished.

To look after Jack, the following list of professional agencies etc are currently involved in no particular order of attendance or importance

1. District Nurses to administer daily injections to thin his blood to avoid more clotting.

2. Carers x 4 who attend morning, lunchtime, tea time and bed time to administer medications and if need provide a meal or snack with tea. They are allowed 15 minutes per visit on the Care Plan.

3. McMillan Nurse. A key person who casts a professional and caring eye over the whole spectrum of his care and who has the knowledge to influence and guide GP"s

.4. Hospice at Home. Another key professional who comes weekly to spend 2 hours or more with Jack and provides a new voice for him to communicate with.

5. Hospice Day Center. Jack now has the chance of going there for 4 hours or so each week where there is a social atmosphere, good food and Doctors and Nurses on tap for any requirements.

6. GP"s. Key personnel but sadly in this case not particularly efficient or caring. We tend to by pass them if possible.

7. Hospital Consultants. Jack is currently under the care and scrutiny of 2 Consultants in Oncology and Urology.

8. Occupational Therapy. This team attends to check on any items that may be provided to help the ongoing of independence. Jack has benefited from a perching stool and a toilet frame to date and more aids are available if requested.

9. Physiotherapy Team. Jack has been assessed for mobility and provided with a rolling frame for use outside if he wishes to use it in place of his usual walking stick.

10. NHS Palliative Care. This agency calls to check on Jack from time to time but the McMillan Nurse and her excellent input seem to have negated the need for involvement by this agency for the moment at least.

11.Social Services. The carers services are paid for by local Government so the Social Services call every 3 months or so to review with family and the Carer Agency, how things have panned out. We find this a very useful aid.

12. Papworth Trust. This is an excellent Charity providing practical assistance to people like Jack who wish to carry on living in their own homes safely and securely. When a down pipe came off the house wall, they came out and re fixed it efficiently and for a nominal £10 charge.It is good to know that if anything needs attention in the House, that they are able to assist at a very reasonable cost.

The list above relates to the services provided but if the total of personnel involved is to be considered then the figure rises from the above to over 20. Thus, to keep Jack going over 30 people are actively involved. I state this not in any critical manner but to emphasise the fact that care in the community for the aged has to be an essential partnership between family and professional services to be a real force for the good of the recipient. Jack is fortunate in this respect but sadly many, many others are not.

SOLDIERING ON.

Jack was a paratrooper in World War Two and had to be a resourceful character to survive. He still carries shrapnel from a lucky escape and tries hard to maintain his original resilience. Time takes its toll on all of us and Jack is no exception. Nowadays he becomes very emotional at times, for no apparent reason to the onlooker. He still relishes the fresh air and his mental attitude improves markedly when out and about, though these days it has to be with supervision. Effectively he is still "soldiering on". In other words, just as in his war days he is dealing the best way he can with what is in front of him. Memory failure means that he remembers scarcely nothing of what he did the day before and as a result can say things which could upset those not aware of this. For example, he will say that he has not seen a family member for months, when in reality they were with him the day before. Coming to terms with things like that is a learning curve for all the family of course. Jack is no poet, so unlike John Donne, he does not say "Send not to learn for whom the bell tolls. It tolls for thee" No, not that but in his own way his advice is just as apposite. Each day he gets out of my car he says the same thing ! "Don"t get old " !

We do not know how long Jack will be with us, but we do know that whilst he is, he will soldier on in his own way. It may be irritating at times but then, care in the community has to rise above such feelings for in all truth his family would not have him be any other way.

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