Dad and fluids.

[TNJJ]

I got a text message the other day to say that there was no squash and they were going to buy some as he hadn’t drank anything that morning. This was at lunchtime.
Dad will drink his coffee normally but he hadn’t.
Over the last few weeks I have noticed that he is forgetting to drink. He says he isn’t thirsty. Even I am finding it difficult to do so. He says he wants it but then doesn’t drink it so it goes cold. He has always needed a lot of prompting but even that is not having an effect.
Last week wasn’t great either.
After the lunch carer had gone he needed the commode as he had messed himself. I had to use the Sara Stedy to get him up which was ok as it was the recliner.
However to get him off the commode using the Sara Stedy took 5 times. He doesn’t have the strength to get himself up. I could only do the best I could in a space of a few seconds before he sat back down. The Sara Stedy is being used for single visits when needed for toileting or exercises.( Dad won’t do them) I also put him in pj bottoms as i couldn’t be bothered to put on clean trousers.
I managed to get him back into his recliner but it took me 15 mins to clean everything up. I think it was overflow as it was diahorrea with some formed stools. But it had happened 3 days earlier with a carer as well.

 

[canary]

What a worry @TNJJ .

Could you contact the care agency and explain that you do not think that care at home is meeting his needs now? When you phone you will get the admin staff, but all agencies have senior carers who assess their clients for the care plan. See if you can talk to one of them. What would really be the best outcome would be if the agency contacted SS to say that they can no longer meet your dads needs. This will place your dad into a whole new level and SS will be more likely to override his "capacity"

 

[TNJJ]

What a worry @TNJJ .

Could you contact the care agency and explain that you do not think that care at home is meeting his needs now? When you phone you will get the admin staff, but all agencies have senior carers who assess their clients for the care plan. See if you can talk to one of them. What would really be the best outcome would be if the agency contacted SS to say that they can no longer meet your dads needs. This will place your dad into a whole new level and SS will be more likely to override his "capacity"

I contacted her this morning after yesterday. She has already asked for dad to have another assessment but they won’t do one as they have already done one in the last few months.We are getting to the stage with them but the carers have said they are coping.. just.. I think it will be a case of hospital admission if he drinks less and output is less.

 

[canary]

Sad to say, but hospital admission might be the trigger for him getting the care he needs and deserves

 

[TNJJ]

Sad to say, but hospital admission might be the trigger for him getting the care he needs and deserves

That’s what I think as I’m not getting anywhere else.

 

[Violet Jane]

I’m afraid that something is more likely to happen if someone goes into hospital as the ward will be keen to discharge him but will have to get a SW to look at his care needs first. Whilst the person is in the community there is little urgency for SS to do anything.

Having said the above, my friend has been in hospital waiting for another assessment for nine days now. She had been medically fit for discharge last Saturday but developed an infection on Wednesday. I had opposed her discharge last Saturday because this was the third time that she had been taken to hospital in15 days and the number of falls, ‘bumps’ and injuries had increased a lot in the last two months. I just can’t understand why it is taking so long…..

 

[Lemondrizzle]

This really resonates with me as it is what happened with my auntie. After bouncing back and forth from hospital she was finally discharged to a palliative care bed in our local care home. Even when she was desparately frail she was discharged home only to be returned to hospital by ambulance a short time later.

 

[Emmcee]

I got a text message the other day to say that there was no squash and they were going to buy some as he hadn’t drank anything that morning. This was at lunchtime.
Dad will drink his coffee normally but he hadn’t.
Over the last few weeks I have noticed that he is forgetting to drink. He says he isn’t thirsty. Even I am finding it difficult to do so. He says he wants it but then doesn’t drink it so it goes cold. He has always needed a lot of prompting but even that is not having an effect.
Last week wasn’t great either.
After the lunch carer had gone he needed the commode as he had messed himself. I had to use the Sara Stedy to get him up which was ok as it was the recliner.
However to get him off the commode using the Sara Stedy took 5 times. He doesn’t have the strength to get himself up. I could only do the best I could in a space of a few seconds before he sat back down. The Sara Stedy is being used for single visits when needed for toileting or exercises.( Dad won’t do them) I also put him in pj bottoms as i couldn’t be bothered to put on clean trousers.
I managed to get him back into his recliner but it took me 15 mins to clean everything up. I think it was overflow as it was diahorrea with some formed stools. But it had happened 3 days earlier with a carer as well.

Hi there, Forgetting to drink seems to be such a common issue and I wonder if it's maybe worth asking for his urine to be checked for signs of an infection (UTIs can also present as changes in bowel habits in addition to changes in mobility, confusion etc.)
With regard to the difficulty you are experiencing when transferring your Dad off the commode with the Sara Stedy .... it may be that the Stedy is no longer the most suitable piece of equipment for him and he may also need support - at times - from two carers as opposed to just one. Would his care manager be able to review the package of care and additionally refer him to an OT to look at equipment/ transfers etc?

 

[TNJJ]

Hi there, Forgetting to drink seems to be such a common issue and I wonder if it's maybe worth asking for his urine to be checked for signs of an infection (UTIs can also present as changes in bowel habits in addition to changes in mobility, confusion etc.)
With regard to the difficulty you are experiencing when transferring your Dad off the commode with the Sara Stedy .... it may be that the Stedy is no longer the most suitable piece of equipment for him and he may also need support - at times - from two carers as opposed to just one. Would his care manager be able to review the package of care and additionally refer him to an OT to look at equipment/ transfers etc?

Hi. Dad also has a stand aid for getting him up in the morning with 2 carers. Dad was originally 2 carers at lunchtime as well as teatime with also 2 at nighttime. But it got very expensive as he could walk until a few months ago so didn’t need it. It was the OT that said dad should use the Sara Stedy for exercises. On the day that she came to assess him he got up perfectly. But after 4 lots of exercise he started learning. Dad refuses to do the exercises . After 51/2 years it’s a bit late now. He has also refused all the other exercises by physio and OT. Even with 2 carers at lunchtime it would be a struggle and they would have to use the stand aid. Plus there is no guarantee that he would want to go then. He really needs to be in a home 24/7 but refuses to go. So we wait. Dad has CKD and always has had a problem drinking. It has just got so much worse.

 

[Emmcee]

Hi. Dad also has a stand aid for getting him up in the morning with 2 carers. Dad was originally 2 carers at lunchtime as well as teatime with also 2 at nighttime. But it got very expensive as he could walk until a few months ago so didn’t need it. It was the OT that said dad should use the Sara Stedy for exercises. On the day that she came to assess him he got up perfectly. But after 4 lots of exercise he started learning. Dad refuses to do the exercises . After 51/2 years it’s a bit late now. He has also refused all the other exercises by physio and OT. Even with 2 carers at lunchtime it would be a struggle and they would have to use the stand aid. Plus there is no guarantee that he would want to go then. He really needs to be in a home 24/7 but refuses to go. So we wait. Dad has CKD and always has had a problem drinking. It has just got so much worse.

Oh, it can be so challenging, can't it? The Stedy can be such a fantastic piece of kit when the person is able to weight-bear, hold onto the handles and follow basic instructions but it does sound as if he probably needs the stand aid at all times. It's also so sad that there just isn't an easier way to encourage folk to participate in exercise programmes when they live in the community. Does your Dad still have capacity or is he just thran (stubborn/ feisty/ independently minded) ? Slightly off topic but would his furniture & commode allow for a sideways/ slide-board transfer if his clothing was adapted? (Sorry, the ex-OT in me was trying to think out of the box).

 

[TNJJ]

Oh, it can be so challenging, can't it? The Stedy can be such a fantastic piece of kit when the person is able to weight-bear, hold onto the handles and follow basic instructions but it does sound as if he probably needs the stand aid at all times. It's also so sad that there just isn't an easier way to encourage folk to participate in exercise programmes when they live in the community. Does your Dad still have capacity or is he just thran (stubborn/ feisty/ independently minded) ? Slightly off topic but would his furniture & commode allow for a sideways/ slide-board transfer if his clothing was adapted? (Sorry, the ex-OT in me was trying to think out of the box).

He has fluctuating capacity. He wouldn’t be able to do a side transfer as he had a stroke a few years back and leans to the left .?

 

[Emmcee]

He has fluctuating capacity. He wouldn’t be able to do a side transfer as he had a stroke a few years back and leans to the left .?

And transferring leading with the right? (Just thinking about repositioning things and using commodes and chairs that have drop sides)....... Please don't get me wrong, I'm not negating the use of stand aids or hoists that are often necessary.

 

[TNJJ]

And transferring leading with the right? (Just thinking about repositioning things and using commodes and chairs that have drop sides)....... Please don't get me wrong, I'm not negating the use of stand aids or hoists that are often necessary.

That would be difficult. Dad has a small bedroom . I have taken all removable furniture out as at one time he couldn’t move the bed. He has a hospital bed already. You can still only get in one way as the bedroom is not much bigger than a box room. But at least the carer can get to the other side.