Thursday, 28 November 2013

Ruby has Alzheimer's Part #2

Clean like you've never cleaned before.....

As expected, Ruby started regressing, looking for her small children (who were all now in their 50's) and she was upset that they were not home yet for dinner.

She can no longer turn the water on in the kitchen, she cannot boil the kettle, she cannot butter bread or toast, she can no longer eat soup from a bowl, but she can sip it from a cup.

Almost everyday she was voicing that she was in "Somebody else's house" and often thought she was in a 'motel' and was going to walk home. In these times I would actually take her for a little walk, and then back to the house, "here's home!" I'd say and she would once again be happy.

I would have liked a camera set up to see what she gets up to at night, bet swapping, often urinating on all the linen, unable to find the toilet or even recognize it. She is alone all night you see, from 5 PM until 8.30 AM.

Toilet signs and pictures no longer worked, for she could not comprehend what they were.

I often hear from co-workers who work in facilities, that their main job is to just clean up poop, and they are not kidding.
Just as a one year old might take poop out of their nappy (Diaper) and spread it around so does many people with forms of dementia.

As the days continued, we were greeted with a scene that included faeces actually rubbed into the walls, spread throughout the entire house, ground into the carpet, the bedding and all over Ruby. I cannot even describe the enormity of it all, and no matter how much you cleaned, the house still stunk like a public rest room.  We cleaned and cleaned and cleaned, everyday we cleaned her whole house from top to bottom, scraping poop off every surface.

Ruby became quite sexually explicit, something she would never have been in her former true self, "I've got a surprise for you" she would say, and whip out both breasts, or pulling down her pants.
"Lets go get a bra on" I would say, and I'd put the straps over her shoulders "Now you put the girls in and I'll clip it up at the back"

Social outings became an opportunity to "Find a man" not just for her, but she kept trying to find one for ME - upon passing a group of construction workers she points and shouts "Look! There is a man for you!" I smile, and we keep walking.
"Thank you Ruby, but he's not quite my type"

We do this job for the love of people, certainly not for the money. Did you know a checkout operator earns more than an Aged Care Worker?
Someone once told me "You never get rich working with people in need" and yet we do it, because we love people and want the best quality of life possible for them.

We are criticized in the news for not giving enough 'quality' in our care, or that this one or that one was left too long with soiled clothes, believe me, it's easy to criticize from  behind a desk, or a computer. We have very little time, little funding, and frankly, there is way more of the aging population who need care than there is care workers. We do our best. The majority of care workers strive to provide the best care possible with what little time and resources that they have. This is no different in the facilities or in the community.

The family is suffering......

Ruby's family are suffering, her daughter is worn out, she has a job and family too, and she is also trying to do her best for her mother, she and Ruby's son are mentally and physically exhausted, they don't know what to do.
They feel sad and humiliated. They are grieving. You see with Alzheimer's you loose your loved one three times.

1. When they are diagnosed.
2. When they no longer remember you.
3. When their actual body passes away.


Many Alzheimer's suffers are physically fine, it's their brain that doesn't work. They can go on for years, for decades, alive in their body, but their brains are not functioning. The loved one is gone and just a shell remains. It's cruel, it's horrendous, and families suffer so much. It is the living death.


Ruby falls asleep in the chair, her daughter stands at the window looking through at her much loved mother, tears are running down her cheeks. Her daughter has just been told that Ruby is beyond help at home and she must source a facility to provide care.


Ruby has Alzheimer's Part #3 (currently under construction, come back soon)

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Wednesday, 27 November 2013

Ruby has Alzheimer's Part #1

I have been a home and community care worker for Ruby for a year and a half. Ruby has Alzheimer's, she's 73 years old.

 When I first started visiting her she didn't need much care, she needed company. Her husband had passed away 10 years before, and now that Ruby could no longer drive she loved going out, doing shopping and having a cuppa at a cafe.
Ruby was fun to be with, she had a few memory problems but that's to be expected, Her adult children love and support her, she is happy in her own home.

Within 4 months she needed help with her medication, and with breakfast. She still had excellent personal hygiene and could dress herself, but she suddenly couldn't remember how to switch the kettle on to boil, or use the microwave or even what day it is. So I started giving her the morning medication that was now kept in a locked box because a few times she had taken a few days worth.

She stayed quite stable but would berate herself "I'm so stupid!" "I just want to die!" "I want to be with Henry!" (Henry being her late husband). She didn't want to spend any money on food and eventually would accuse myself and her daughter of "forcing" her to spend money on food.

"Now Ruby, it's not your time to go yet, and Henry surely wouldn't want you to go before your time, nor would he want you to starve to death" ----- "I guess not" would be her reply.

We then went to the opposite end of the scale, she had visits from care workers and family no less than 3 times a day, but she would eat everything in the house when no one was there, maybe it was boredom, maybe she just forgot she had eaten, but whatever it was, we would turn up in the morning and there was literally maybe a jar of pickled onions in the whole house and nothing else.

She ate the frozen dinners - frozen! She was getting day and night confused, shopping became an everyday thing, we "hid" some food up in the pantry to distribute.

I also tried to take her to some daycare groups, once in there she would sit and pout, "I don't want to be with these poor old things!" - I would give her something of mine so she would know I wasn't going to just leave her there, just like a small child starting kindy, and it worked for a short time.

We come to these clients with big plans....

Myself, like many care workers, get to know (and love) their clients, we are in the field, we come up with great idea's to make a clients life more enjoyable, if only for the moment.
We often work unpaid overtime, and wake up in the middle of the night worrying about certain clients.

We have good idea's, but are usually never able to get them off the ground:
3 words prevent everything: LACK - OF -  FUNDING.
Tight time schedules, in which we have to complete tasks, half an hour to get a client out of bed, shower, dress them, give them medication, wash any wet or soiled bedding, hang them on the line, make them breakfast, half an hour... yeah right.

We care, but we haven't got superpowers!
Like most people, we work to get paid, to support ourselves and our families. You can only do so much extra.

I had good idea's to help Ruby, I just couldn't get most of them in place.

I made Ruby a folder, with the help of her daughter "Ruby's life story" where I scanned old photographs from 50 years ago right up until the present day, there is a little story attached to each photo that we could read to her, as it was apparent she had forgotten how to read.

Back to Ruby's Story.......

A severe UTI effected Ruby's Alzheimer's irreversibly, as is what often happens.
First we started to turn up first thing in the morning and everything is wet, often 3 wet beds. Her own, the spare double bed and the spare single bed and of course, Ruby. We had no idea who she had so much urine, it wasn't just a small patch, each bed was completely saturated even through mattress protectors.

We had her in the biggest continence aids, she was wetting right through them in the night, and then bed hopping into the other two beds, we washed, aired, remade everything everyday. Then it just all stopped. As quickly as it started and a whole new problem came to the forefront.

A new problem.......

It started out with finding Ruby carrying around a lump of faeces. Yes, she was carrying a large lump of poop.
 "What are you doing with that Ruby?"
"I don't know, I don't know where to put it"
"How about we put it in the toilet? Over here, lets put it in, flush it and wash your hands"

This escalated really quickly, I arrived at my usual time of 8.30 am, Ruby was naked when I walked in, covered in poop, head to toe. Oh dear.
But as a careworker, we just do what has to be done, gently encourage her to shower, clean up the mess, but I could not find her clothes.... Ruby was showered and cleaned, I helped her dress, started the washing machine and started on the sheets, still looking for her night clothes.

Ruby kept going outside, it was really sunny and getting hotter by the minute, she came in and said "Nope, it's not done yet" 

She has a large yard with lots of tree's and a beautiful garden, curious I wandered out to see what was "not done yet" and I found, on the newly mowed grass, her soiled night clothes, laid perfectly flat, baking in the Summer sun.
"Don't touch them! They're not done yet!"
"It's OK Ruby, lets take them in, we can wash them, we can clean them" - Ruby raises her eyebrows not quite believing me.

My heart truly goes out to Ruby, and I wish I could put my hands up and stop this bast**d of a disease in it's tracks. I don't want it to consume this dear sweet woman, but I know it will. I've seen it all before.

Click here to go to part #2




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