Here here Margaret!
I second that.
Now I am going to be inexcusably cynical:
I don't know any documentation that was kept on Dad that was ever very useful. Most of the time what documentation was in existence was put there to restrict his freedoms:
Main Documentation:
* Tom choked once, never feed him anything but mush again.
* Tom had a fall, he should not be allowed to walk as we can't have carers hurting their backs if he should fall again.
* Tom has been angry, up dosage on anti-psychotics so he can make like a vegetable and not cause us any more trouble even though he was probably justified in being angry cos we leave him sit for hours in soiled pants.
* Tom has had a fever on and off for weeks we keep giving him painkillers (but didn't bother to get the infection properly investigated) - oops they left that last bit out...
Care Plan Updates??
Bit like work performance plans, where you write down all this airy fairy stuff that you say you want to do, but never really get round to cos work needs to get done, then when end of year comes round and you get reviewed you manage to somehow make it sound like you did something worthwhile. In Dad's case, they never really could come up with much of a plan, really didn't know what to write when their patient couldn't talk and didn't really interact with others. I would have liked to see a care plan that said something like:
* Talk to Tom even though he doesn't talk back because the human interaction is nonetheless good for him.
* Smile and joke with Tom for the same reasons.
* Ask Tom how he is, even though he probably won't respond cos deep down inside he will possibly recognise that you care.
* Encourage Tom to interact with you.
* Put the tv on for Tom so he has something interesting to watch and listen to instead of only crazy talking and moans of despair.
* Compliment Tom.
* Encourage Tom to use his hands.
But even when such a care plan is in place just because it is written doesn't necessarily mean it is being done...
Daily progress records??
Aren't we generally dealing with regress here? Or does 'progress' refer to the progress of the disease? And as I said above each time a regression or incident occurred that record just sat in place to ensure Dad never improved or was given the chance to. There was always a certain amount of doomsdayism in his treatment, an attitude that things we just going to get worse so why fight it? I wish that they could have tried to have an attitude that he ain't dead yet, so lets encourage living as much as possible even if that may seem foolish and illogical.
If they have a standard operating procedure in place,i.e. follow medication regime specified by doctor, bathe patient, involve the patient in activities, put patient to bed, feed patient recommended diet, toilet patients according to schedule or when needed, ensure patients are given fluids # times a day, what is there to record other than exceptions?
As for carers having to record all these things and more, I have to say I thought homes here in Australia were understaffed but its sounds like its far worse in the UK. In Dad's home there were delegated staff to do that sort of work. The carers just had to take Dad to the delegated staff member to record such things or that staff member came to him.
I know that being able to check records can be comforting, but what good is it to me to read about it other than so that I can say to myself, phew at least they know what they should be doing and someone is ticking off that they are doing it, even though I don't really know if they are doing it as well as they should be because geez Dad's looking worse and worse...In fact documentation in this situation
disempowers us as so long as it was written down I could not claim that my father was not being cared for in the best way possible. It also didn't escape my attention that the most documentation occurred as a reaction to an incident that never should have occurred if caring had of been being performed as it should be.
Often when the staff had documented that an incident had occurred with Dad, the next shift didn't read it anyways. His care plan did nothing for him, he lost the ability to feed himself, he lost the ability to say any words, he lost the ability to stand by himself and of course the home can say well we tried its there in writing, and unfortunately this is just a natural progression of the disease... But now Dad's living at home, he's walking, he's started to say words again, and he's starting to use his hands again. The fact is that one thing can be written but the act written about may not exactly be delivered with the 'care' one would expect given the documentation. How can it be, when all this time is being devoted to writing about it??
Do we document all this stuff when we care for our loved ones at home? No, and thats because the documentation is there not to ensure that the person is cared for but to ensure that the home can cover themselves when things go wrong. Unfortunately for that reason it is a necessary evil but that doesn't mean we shouldn't be upset if we feel that the actual hands on care is becoming a second priority. That we feel that the homes need more staff, that we feel that the governments need to provide more funding. Afterall we're next in line, one day it will be us that's sitting in the home, and I know for one, that I'd be wanting someone to change my dirty pants that I've been sitting in rather than write about how my incontinence has evidenced itself 5 times today!