Hospital blog, 1:4:2011
byon 01-04-2011 at 01:33 PM (1333 Views)
Walked into Brian's ward this morning to comments of "Oh, what perfect timing": they were just about to wash and change him. I stood beside him while they washed his face and chest, and then when they moved on down I held his hands in mine. I could feel the stress building up in him as they removed his pad and washed him and began to shout "No, stop that." And it went on.
(And yet I had been told by one of the nurses that during the night he had been very good, all smiles and even blowing kisses at the nurses. "Hey, that's good, Bri" I had said, and he had looked pleased. That was clearly all forgotten during this particular wash and change.)
While the curtains were still drawn, Dr. V., who had spoken to me on Tuesday a.m., popped through them to speak to me. "He seems a lot better on this pill than the other, doesn't he. I gather he was very good through the night." "Yes, so I've heard. But - which other exactly? I thought he was on Olanzapine." "Oh, we took him off that on Tuesday. He's now on the tiniest dose of Haloperidol." (spelling?) "Oh. Right. He still seems very drowsy in the mornings, though." "We'll keep him on it for a week or two and then ask his GP to review it when he's settled at the care home." "That's fine." I had been wondering WHO would review it.
She never got around to mentioning the change of medication on Tuesday morning. We had just covered the same ground about Brian being difficult at night. It occurs to me now as I type this, my letter of complaint had possibly reached the ward that morning. Had she been so eager to reach the question "And is there anything else you wish to discuss with us, Mrs P?" that she forgot to even mention the change in medication? Can't help thinking that is quite possibly the case.
Anyway, if Brian was happier and easier to handle through the night, that can only be good. But he was very, very stressed this morning.
[Was going to post at that point but got up to answer the 'phone.]
Have had a 30 min. talk with the Head of Nursing at the new care home. Covered who would be his GP (for convenience and practicality I think she wants me to switch Brian to a GP surgery across the road from CH. Had anyone talked to me about "end of life" plan? Said it had not seemed appropriate a few months ago but that I could see Brian's "quality of life" had hugely altered over the last six weeks and I was still trying to come to terms with it. (Told her of the 3 falls and chest infection within his first month in residential care.)
If there was anything at all I wished to ask her ... Decided to ask her if she thought I should tell the hospital about the incident when Brian was 14, apprenticed electrician, when the two chaps he was working with (who were nearing retirement and therefore born in around 1880) decided it was time to "initiate" Brian. They had had it done to them and now it was Brian's turn - to be humiliated in some fashion. They had chased him up a ladder and one of them made a grab for his trousers. Brian had threatened to punch the chap in the face but the chap tried to drag him down. So Brian punched him in the face. (His parents removed him from the job and found him another, going to sea on a private yacht.) I explained to her (but said I didn't really need to explain, did I) that because of his dementia, some of his oldest memories now seem very recent and I thought that perhaps that this would account for a lot of his "challenging behaviour" during personal care.
She was very appreciative of my having told her but said that she thought since Brian was leaving the hospital in a few days' time, it was perhaps not necessary to tell them - not necessary for them to change medication - which I had not expected them to do anyway. For me, it was more a case of them UNDERSTANDING what might lie behind Brian's unwillingness to submit to "personal care". But as the CH now "knew", but in all confidentiality, it would help them understand that they needed to gain his trust. (My words.)
I am still wondering whether I should perhaps tell the ward - not so much to influence their dealings with Brian as he will be with them for not much longer - but for the nursing staff to understand that there may be other underlying reasons for a patient to present with challenging behaviour.
Nothing happened to Brian, but the fear of it was huge, and very, very real - and there are others out there to whom far worse things happened and I gather (from a recent TV programme) that they are never forgotten.