Many years ago I was on placement at our main hospital as a student Social Worker. I was placed in the Orthopaedic Ward for a short time and a very experienced Social Worker taught me a valuable lesson. A young doctor – who looked about 12 – declared that ‘Mrs So and So, has dementia’ and would need to be placed in a secure unit. I relayed this information to my mentor and asked what I needed to do. Now, this particular lady had fallen and broken her hip and was not long out of surgery and was elderly and confused. Carolyn (my mentor) advised me to contact the facility where she was living and ask about how she usually was prior to her fall. I was advised by the Manager of the facility, that prior to the fall she had been living completely independently in a Villa on the grounds of the facility. She had not needed any help and was as sharp as a tack. I went to Carolyn and reported my findings. She said, ‘There you are! Someone does not go from fully functioning and independent person, who is fully lucid, to someone who suddenly has Dementia overnight. This woman has delirium after an anaesthetic and this should resolve in a few days’. Sure enough, she recovered in a few days and was back to her usual level of cognitive function and able to discharge with just a few supports till she recovered.
This taught me a valuable lesson. Just because someone is older, or on occasion might act confused, it may be that they have a short term issue like a Urinary Tract Infection (UTI) causing the confusion. Those making the assessments need to talk to those that know them to find out the background and what is really going on for them.
I had a patient recently who was being assessed for competency by one of our doctors. In an answer to one of his questions, the doctor decided that this patient was confused and may lack capacity. When his mother found out about the question asked, she reported that this was absolutely in line with the sort of quip he would have made prior to his health event. Again, someone who knew the person well had a different and valuable perspective to give on the patient, which changed the medical team’s perception.
As those who read this Blog will know, my husband and I have moved reasonably recently from a two-storey house to a single storey house to ‘future proof’ our lives a bit. In the other house, we had a bedroom upstairs with ensuite and a guest bathroom downstairs. He often used to use the downstairs bathroom if he was getting up really early so as not to disturb me. Since moving into our new home, he does the same thing and uses the guest bathroom if he needs to shower in the wee small hours. The thing is, he has accidentally said on more than one occasion ‘I’ll use the downstairs bathroom’. We have laughed and he has corrected himself. However, we have decided that we quite like referring to it as ‘the downstairs bathroom’ for a nod to our previous home.
So, if in the future someone comes to assess me for competency and I refer to ‘the downstairs bathroom’ I hope they check with my husband before they write me off!!