Diary Day 9
 Mafia Contract in a Dementia Care Home?

There is only one real troublemaker in Mam’s dementia care home. I think that she is an ex-Mafia hitman: too many incidents and too many falls.

argaret assaulted Vernon today and he has had to lodge a report. This report is important because it might indicate that a patient is deteriorating in his or her illness. There are after many types of the illness and the signs of dementia particular to that illness all have to be recorded and evaluated over a period of time.

All dementia patients are human after all

I ask Vernon if he thinks Margaret is slipping. He merely shrugs and says,

We have to allow dementia patients to be human. To be unhappy, frustrated or just plain bloody angry. It may be who they’ve always been. Tell you what though, there was no problem with her hand-eye co-ordination because I never saw that punch coming. I’m impressed. People don’t always know why they are angry. They just bloody well are.

I’m impressed too. Impressed that the caregivers have not become stale and constrained by all the facts about dementia that abound. Vernon and his colleagues deal with the human before them and use their very caring personalities and loving nature all the time.

And sometimes they remember to duck.

A toast for the departing

Rich (Richard) is still in hospital suffering pneumonia. Michelle popped across to see him last night after her twelve-hour shift. Pneumonia is a common illness for dementia patients. Most patients die of infections or COPD (Coronary Obstructive Pulmonary Disease).

As the illness progresses with its cruel inevitability, the patient becomes less and less active and so the muscular activity that would normally clear any fluid in the lung begins to fail. COPD or pneumonia is usually a late-stage indicator. However, Rich has always been a wanderer when I’ve visited. We have sat and talked many times and I immerse myself in his world because by lovely coincidence I know many of the same people he talks about.

I am worried about Rich being in hospital - as is Michelle. The caregivers do not have much time to ponder but their faces show their concern. They know that many of their patients will die on the ward because the family is aware of what is happening and do not wish to move the person to a strange and potentially fearful place in their final hours.

Three lovely people have died since I started visiting Mam here. One was very elderly and I could never understand a word she spoke, but she was the most loving cuddler – after Mam, naturally. Another family sat around the dying patient’s bed and drank white wine, touching some to the loved one’s lips.

Violence and Chocolates

There is still no sign of Sofia this evening. However, Gwendolen is about and she is being troublesome. Troublesome… hmm … I’d go as far as to suggest near violent. Her eyes are as dark as a shark’s pissed of with Lent.

Last night was a strange night at the home. As usual during the week I'd stopped at the Co-op and bought a small box of Roses chocolates to share. The rain was falling in heavy vertical sheets, the super drenching stuff. Maybe it was the weather that was impacting on Gwendolen’s mood.

There again, I remember Vernon’s words about being angry and frustrated without being able to fathom why.  I just made sure I aware where she was at all times. Gwendolen’s not the ex-Mafia hitman, by the way.

When I arrived, Mam was very emotional on seeing me, so I was down on my knees and gave my best loving hug to reassure her she was not alone and I was here. Leaving might be difficult tonight.

Mam likes the quiet and with Gwendolen apparently having just woken up it was near havoc. Gwendolen came up to me and demanded to know why I wasn’t working. I just told that she had a wonderful mischievous look in her eyes.  She was picking up whatever she could and aggressively rearranging the bottom cushion on the armchair next to Mam. This would be the cause of concern for Mam. Fear is one of the signs of dementia.

Chaos would be an appropriate name for Gwendolen at such times. Once she finished with the chair she went around picking up whatever she could and stuffing it under her jumper.

I took the tea order and had to keep coming back between boiling water and making tea because Mam kept calling for me. Mike the team leader came in and told me he'd moved Mam to the round table where he was busy with his notes. Clearly to get her away from Gwendolen.

Anyone who wanted one had a cup of tea. I handed out the box to share among the staff. Mike said that after Lent he seemed to have lost interest in chocolate. He took the sweet anyway, so that's the end of that daft assertion of his.

Vernon just grabbed the box out of my hand and poured them on the table pushing the coffee chocolates away. He needed a sugar hit. A specific flavour sugar hit. It was amusing.

Currying Flavour

I am more convinced that curries are no more than variations on Scouse. Michelle had brought her curry cookbook with her to work and so sat at the big round table, me next to Mam and Janine next to Michelle, we were all in turn scanning through the book. It definitely looked like 101 Lob Scouses to Delight, I suggested.

Mam was spooked this evening and wanted me to wrap things up so we could go soon because They would be here soon. For the first time in a long while she mentioned one of her childhood homes.

In the past, this has been the cause of great fear if not downright terror for her. There is this Woman of whom she is terrified. No-one in the family knows who she is. I dismissed the matter out of hand. Leave it to me, I said. I'll handle everything. I've never failed you, have I?

I reached for my iPad. Earlier that afternoon I had been searching for something that might bring pleasure and distraction to Mam and come across YouTube recordings of David Lloyd, a famous Welsh tenor. I played a famous folk song called Dafydd y Garreg Wen (David of the White Stone) and she assumed a very appreciative and relaxed posture, as did the staff.

I spent most of my visiting time this evening holding Mam’s hand and not moidering, raising smiles or making tea for the other dementia patients.

Mam's arthritic knees are a constant and cruel companion

Inexpressible Pain

Janine has been changed into her nightdress and dressing gown and is once again lovely in pink. Where she had been off balance and very unhappy earlier on, she was now one of the giggling girls sat next to Michelle and June. There was a lot of laughter and she was the main cause of merriment. No-one was laughing at her because her humour and responses were well-timed and very funny as she intended. We all moved into Janine’s world and embraced her there.

It was so nice. So much for Zombie dementia patients, I thought. I was growing to love being here in the dementia home much more than my horrible workplace.

Mam was finding it all a bit too much as the laughter and movement around the table increased. Her arthritic knees were hurting. I learned that Mam was wandering up and down the ward corridor all day, looking for someone. Me, I suppose, hence the emotional welcome.

The carers think Gwendolen’s got a urine infection and I am certain Margaret has as well. People become cranky. One of the facts about dementia is that patients cannot tell you where hurts.

There was still no sign of Sofia. In bed exhausted probably. She is another wanderer. More furtive than Mam’s convoy of lovely elderly ladies hopeful of arriving somewhere familiar if they keep following Mam.  I miss Sofia’s cuddle. I often wonder what is she after because her eyes are wicked. I’ve looked to Vernon before now and he suggested I get my coat because I’ve obviously pulled a girlfriend.

Postscript: There’s a Mafia Contract

Mary. Sweet Mary is the biggest troublemaker I've come across in quite a while – in and out of the care home. I think she is a Mafia plant. I tell Mike and Michelle that I am trying to find out who the contract is on.

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