An exploration of the UK unpaid carer's world

Caree assessment 17 August 2015                                                      Home page here 


Update 24 Nov 2016 - an annual retest has not been carried out yet. 


               5 Feb - now in good contact with the Memory Service and this updates the test.  


                             Six-item Cognitive Impairment Test (6CIT) here

                             



Present: caree, carer, SH, JT. [staff]  Retest on 3 Feb when SH and LB were only able to ask Qs 1 to 4

SH & JT. JT was new in a managerial post but didn't last long as far as I knew  would benefit from reading    -    TDH (Mrs) - Medication list and medical history here

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Bristol Activities of Daily Living Scale - BADLS - here here    

 

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Medical scales here

The Mini Mental State Examination (MMSE) here.  

Alzheimer’s Society - Assessment and diagnosis pdf   Factsheet 426LP   here  

Assessing cognition in older people: a practical toolkit for health professionals here pdf

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Q & A conducted by SH  additional text and editing in italics  "Yes"/"No" not in "    ".

AFH updates in red text.


1

Do you have visions of strange people?   No.  Google    No at the time but elder daughter reminded me that caree two weeks ago asked who is that man in the garden.  

2

Do you see shadows, feel agitated?  No.  No

3

Do you worry?  No.   Yes, definitely - if there's but the hint of me going out while a carer  etc is here, there's a fair amount to deal with.


Under normal circs, if I get up to start the next meal etc, I am instructed to stay.  Often, a deal ofpersuassion is needed.


4

Are you happy to get out of bed?  Yes.  Yes

5

You don't say anything you wouldn't like to?  No. ie I don't say etc.  Curious Q wording for the situation.


Did not ask the question.


6

Are you irritable at times?  No.   see above

7

Do you play with objects over and over again?  No. Yes   [Caree is  Not still obsessional about proportion of bedding between us, doors, fluff, and folding clothes and napkins. source C1  Caree - three days in Worcs Royal Hospital and the 1.6.5 item here. ] [Update 5 3 2016 - Caree is not obsessional about proportion of bedding between us, and is less so re fluff, and folding clothes and napkins.  


The lastest obsessions include, however:

  1. positioning her clothes on radiators - a pair of socks etc must be exactly placed

  2. caree now only uses a commode v travelling herself down the corridor.  She takes 10 sheets of toilet paper by carefully muttering each number.  These are then folded twice.  The new package is folded in two and the rough edges are meticulously removed onto the floor if a wpb is not to hand

  3. Lately, it's TV monkey programmes but she can only ask for "those people at the top".  At first, I needed to work out what she meant.  In her mind - the top - = something swinging from tree branches.

  4. These progs and several others such as Cops, Downton Abbey, Upstairs Downstairs can be watched over and over again but caree never comments.

  5. Some are recorded so adverts are eliminated.  However, when on live, caree constantly says she doesn't want "that" pointing semi-angrily  and often thinks that gas people or whoever are part of Downton etc and says get rid of them.

8

Sleep well?  Yes.  Yes "Mrs H has broken all records!  Three night consecutively and no hour-long session of getting up." Day 4 here.  On return, our nights were and are still broken by at least one session lasting an hour of caree on the commode.  Letter given to GP on 1 Sept.

Not Yes.  Every night is broken by at least one commode session.  4/7 and saturation.  With dom-carers, DNs and OTs who drift in and out, no one has advised me.  I went online and found Boots does a special pad.  I bought to @ £25.  They have saved the day (or night).  The entire bed doesn't need changing.  

9

Appetite?  Ten minutes on food.  Much better at tackling normal food

10

Adapted cutlery? "No.  I eat everything with spoon and fork."  More here.  

11

Carers in the morning?  "I can do most of my personal  washing. Not any more.  Caree spends 15 mins before dom-carer arrives drying a dry basin. Can't put my  trousers on."  Carer spoke about the main paid carer.  She went with caree/carer on a Canal-boat holiday.  However, illness struck. here

12

JT - any mishaps in Porthcawl?  No.

13

Clean your teeth?  Yes.  Never and intractable

14

Go shopping?   staff should read file before event - wife 100% dependent on wheelchair with fewer trips out than husband hopes for.  "My husband does it all.  Our elder daughter also takes me."  [Retail therapy but three times a year. Now going out 4/7] Carer said he does all the household organisation and shopping etc and it runs on the large scale into his respite time. 

15

Your finances?  No.  [Carer said that their elder daughter has £ LPA.] 

16

Games, hobbies. No.  

17

Three words to remember - lemon   key     ball                use pictures in your mind  


18 

7 from 100            92      No ability  

7 from 92              97        

7          97             14

7          14               7


19

Repeat    -   All that glitters                 is not gold I asked her to say first 3 words - caree completed

20

Wear glasses?     Some of the time.  Reading                No longer.  Only wears sunglasses in the car

21

Three words to remember?    - lemon   key     ball    Nothing  - I prompted lemon  - still nothing


Conversation 

Included carer asking     Where did we live after Scotland?     Couldn't remember.   It was Canterbury.  No improvement

JT How long in Ross?      Couldn't remember.   11   years    Nothing today but caree can respond at other times within two years

Carer said he had asked staff for tests  No response  25 September update - absolutely nothing done in carer direction but a third party had been involved.    

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Carer asked about the test.  

SH said                         Herebrooks Test. Unable to source here.   no response

                                     The Mini Mental State Examination (MMSE) here.  Unable to source example.   no response

Carer did not say again in front of carer that such tests have been requested.


C1.3  Request

Lists of the “What year is it?” No response today  questions and similar are just one approach I assume are used by staff and I ask to be given as much as possible to help caree.  No response  Also, please supply record sheets so that performance can be tracked and fed to you, No response CPNs, in GP discussion, perhaps DNs etc.   

25 September 2015 update - absolutely nothing done  24 Nov 2016 ditto and until Feb 2017


 


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                                               Six-item Cognitive Impairment Test (6CIT) here

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