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Health, Sports & Psychology
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  • 10 mins

Scene 4: 'Safety has to come first'

Updated Monday 12th January 2015

In the final part of Louise's story, we hear how Louise wants to go outside in the garden. However, care staff deem safety is more important than her freedom. 

Audio

Text

SCENE 4: 'Safety has to come first'
 
SCENE 4A
KATHERINE:
Despite the resistance to changing the way meals are arranged, I did manage to persuade Berenice to make some changes. The staff encourage residents to get more involved with preparing for mealtimes, they even let mum lay the table, although some of the residents must have been a bit bemused by the extra number of knives and forks – she likes doing things properly! 
Something I didn’t really think about when deciding on a home was how wide the range of the degrees of dementia in the other residents would be. I don’t want to have to move mum when her dementia starts to get worse, because I know it’s traumatic for people with dementia to have change and upheaval, but I’m not sure it’s doing her much good to be around people who are so much more confused than she is. 
And with so many residents with advanced dementia to keep safe that must affect how the rest of the residents are treated: not only the amount of time that can be given to the less severely affected but what they would call issues of safety. I was pretty surprised to find that even though there is no specific rule stopping residents going into the garden, when I asked if mum could go, the staff were pretty flustered because nobody could even find the key to the patio doors! 
 
SCENE 4B
LOUISE:
I used to be in the garden all the time, from first thing in the morning till dark. Look at those flowers out there – I planted those – can you see them? Oh and that tree over there and the bush – look at it! 
I think I need to water them now – I haven’t watered them today – but I can’t open this door – it  seems to be stuck – can someone help me to open the door? Will you help me dear? 
 
SCENE 4C
ROSANNA:
I have to admit I was a little bit shocked when I first came here, seeing just how far gone some of the residents are – I mean Nellie – she’s completely out of it. Doesn’t really know where she is. So could they be safely outside on their own? There’s no way! Even Mrs. Burns. She’s a bit more with it, but she’s still a bit wobbly some days and if she fell… it could be a broken hip or a gashed head. And then there would all the accident forms… It’s just not worth the risk for her or for me. 
RICK:
It is a fact - residents with dementia, in the advanced stages, become very dependent again and we have to protect them. Some of them don’t even know where they are – they could just wander off, cross the road, anything! It is our responsibility to stop them from harming themselves. 
BERNICE: 
Some of the young people that work here need a lot of support and guidance. It’s their first job, and they look to us as a sort of a parent figure almost. That’s why they have to follow the code of practice in the home, no exceptions! Safety has to come first. It’s no good having one person out gardening and then finding two others have gone waltzing down the drive. 
On the particular day that Mrs. Burns’s daughter asked for the key to the garden, I actually had three members of staff off sick. We don’t shout too loudly about this, but there is quite a problem with sickness– it’s the same with all the local homes, we have a high sick rate. 
There is a core of really good staff members – mostly the older women – who would never let us down. But some of the younger ones – some of them don’t stay in the job very long, and quite frankly you wouldn’t wish them to, but there are others…I have had some brilliant young staff who we’ve been very happy to see go on to do nurse’s training. 
SCENE 4D
KATHERINE:
It took some persuasion, but in the end, the staff did start taking some of the residents into the garden some days if the weather was fine, though I do wonder if it was only because I made a fuss. 
But whatever, one good thing that did come out of it was that a local group of volunteers offered to take the residents out on day trips occasionally. My mother had been a volunteer at the hospital herself once, so I know from what she told me – and the little bits I have done myself, that these trips are a lot of work for the home, having to organise the volunteers, and making sure residents who can go out are toileted and dressed on time and things like that. But..to me – if I was a carer in the home – I would think that it was all worth it to see the residents being part of the community instead of shut away. 
Mum is reasonably happy and settled now. I can see that the care staff work incredibly hard. One of them told me he’s thinking of doing his nurse’s training. The home isn’t perfect, and I shall probably have to keep an eye on things, I owe it to mum to make sure she gets some of the things she wants - but at least they’ve been willing to try some things out, for the better. 
I know it is inevitable that she will deteriorate, but the stimulation does seem to be helping and I have peace of mind knowing that she is safe.
 

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This podcast or article is part of the Dementia care: Louise's story collection and has been produced to give an account of what dementia care is like for the individual, the family and health and social care professionals. 

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