Author Topic: Risk taking  (Read 2159 times)

Sunny Clouds

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Risk taking
« on: 14 Oct 2012 01:12AM »
Opinions...but please be gentle with me.

I see that people I know on other sites have been discussing what's a reasonable level of risk for a parent with dementia.

I have a father who's taken a lot of risks in his life.  He's seized opportunities.  He's taken physical risks, be it cutting through cables, getting in a mess with fireworks in the living room, dashing out in front of traffic without looking etc.  One of my most vivid memories is from when he tried to steer a boat backwards under a bridge in a storm.  (Backwards??!)  At the age of eight I had to climb up a swinging ladder to safety in the dark with just beams of artificial light, howling winds, rain chucking it down, cold, slippery fingers on the ladder. 

That's the tip of the iceberg.

I want to be able to let him take risks now he has dementia rather than play safe but I have been pilloried elsewhere for suggesting it.

I thought I'd run the risk of asking what other disabled people think.

A decade ago, a mental health team was trying to persuade me to move into a nursing home.  A nursing home??? I asked.  Yes.  Not on your nelly!

Well, I get DLA (LRM, HRC) and I'm a chip off the old block - fiercely independent.  Leave me alone and if I want to go wandering around in the middle of the night, it's my choice.  Yes, yes, I do know I'm female and I'm slow and yes, I do realise there are some nasty, violent people around, but I understand that so I can take the risk.  Back off, wellmeaning people, this is my life.   No doctor, you don't get to tell me what doses I take, you get to negotiate what doses I take.  (Where's the emoticon for bolshy?)

So I tell Dad we'll muddle through, two dotty people together.  I nag him and he holds his own.  I get hacked off with him but leave my mobile on 24/7 and threaten him with dire things if he doesn't ask for help when he needs it.  And I make sure his taxi company knows I'll pay a big tip for any driver who takes him home when he's got no money and sees him safely in the house. 

I know he doesn't want to go into a home and I'll fight tooth and nail for him not to go into one until he's too far gone to know where he is. 

But he could get lost or injured.  He will probably have more falls, probably scald himself sometimes, get lost more often, certainly keep getting in a muddle with his pills.

Am I a lone voice in saying an old man with dementia ought to be able to live his life after diagnosis according to the same principles as before?

Please, please someone tell me I'm not completely bonkers to think a risk-taking man shouldn't have to live a risk-averse old age.
(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

devine63

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Re: Risk taking
« Reply #1 on: 14 Oct 2012 01:39AM »
Hi Sunny

I agree with you.  Remove or reduce the risks where you can (e.g. don't leave matches in plain sight, change a gas stove for something less risky) and warn other people as appropriate to allow them to manage their own lives accordingly, but allow him to live, as much as you can, the way he always has.  Perhaps consider getting him a chunky silver id bracelet with his name and address (and an emergency phone no) engraved on it, so someone can help if they find him wandering and don't happen to recognise him.

In this day and age we are told that people with serious physical impairments who, as a result, cannot get themselves out of bed, cannot get to the toilet or get themself a drink in their own kitchen and cannot open their own front door,  can "take the risk" of living in their own home and instead of having a 24 hour carer (as they should!) they can take the risk that the house might catch fire between carers' visits and the person won't be able to get out.  They can "take the risk" that the night time carer won't show up so the person goes without a toilet, or a drink or food until the next carer's visit is due....

regards, Deb

Sunny Clouds

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Re: Risk taking
« Reply #2 on: 14 Oct 2012 02:08AM »
At last!  Someone who isn't verging on telling me I'm cruel.

I shall check out the technology.  I've already got him fixed up with a panic pendant for in the house.  Unfortunately, he doesn't entirely understand that it doesn't work outside the house, but he can still cope with his Doro phone and when the time comes that he doesn't, I don't suppose there'll be any shortage of youngsters with weird and wonderful smartphones ready to call a taxi for him.  Further thought, maybe a letter to the manager of the supermarket with a photo and a reward offered if they call for help if he needs it.

On the other hand, I share the anger over people being forced to take risks they don't want to take and to have a poor quality of life to save money.  Dad's fortunate enough to have money. 

If you're old, they'll stick you in a home and sell your house if necessary.  If you're young, they'll leave you to rot because you've no house to sell.
(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

Yvette

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Re: Risk taking
« Reply #3 on: 14 Oct 2012 09:35AM »
Quote
If you're old, they'll stick you in a home and sell your house if necessary.  If you're young, they'll leave you to rot because you've no house to sell.

So true.

seegee

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Re: Risk taking
« Reply #4 on: 14 Oct 2012 10:11AM »
You can remove some risks but never all of them, no matter how hard you try (unless you have 1-1 24-hour supervision). 
A nursing home will lock away all tools, stepladders, cleaning chemicals,etc. from sight of the residents; but if a resident climbs onto a chair or bed in their room to change a lightbulb or clean the top of the door, they might fall... and there will never be enough staff to watch everybody all the time.  There are fewer staff at night but most residents don't need to sleep from 9pm to 7am, so some will be active & unsupervised in their rooms, if not elsewhere in the place.
Age shouldn't be a reason to be debarred from taking risks; dementia should only be a reason when it is far advanced enough that the person is unable to make the decision or have any idea that there is a risk (so maybe if found trying to wash an electric toaster that's still plugged in, that might be a reason to remove things like irons & toasters?). 

oldtone27

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Re: Risk taking
« Reply #5 on: 14 Oct 2012 10:55AM »
Life is a risk. Mostly we can manage that risk. I took a risk by going outside yesterday and nearly slipped up on some wet moss on my path. If I drive my car I take a risk, not because I am any less safe than other drivers, but driving does have its inherent risks.

As your father gets less able to manage risks himself then you are gradually trying to reduce those risks. That seems entirely fair and reasonable to me. We do, as a society, seem too eager to try to make everything 'safe' but mostly that is an illusion.

Most people would not consider locking away folk who go horse riding for instance, but that is a very high risk activity. Why 'lock' your father away because he may be exposed to a little extra risk. That is no life. I say go with your instincts.

Try to mitigate the risks by removing obvious hazards, providing alarms, and a means of trying to get him home if he strays. He might put himself in harms way but at least he is able to do something. The ultimate risk mitigation might be to strap him to his bed, which of course is unacceptable, and anyhow inactivity can cause its own harm.

Perhaps the tipping point comes when you can no longer stand the risk of him coming to harm. That should be your judgement not anyone elses in my view.

Mabelcat

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Re: Risk taking
« Reply #6 on: 14 Oct 2012 01:20PM »
Sunny, I agree with you. 

Sunny Clouds

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Re: Risk taking
« Reply #7 on: 14 Oct 2012 02:14PM »
Thank you for the feedback.  I've been feeling utterly bolshy about this.

I get hacked off with Dad over some things, but he's fighting hard for his independence and I'm trying very hard to facilitate, and, ok, nag, but not to take away his independence.  So I've taken over his filing, which he'd lost any hope of continuing to handle by himself, but his paperwork isn't locked away, he can still open his filing cabinet and for so long as he can manage to make sense of tabs on hanging files, he can find stuff. 

I will interfere over practical stuff.  I've been rather insistent over his medication, nagging him to try different ways of reducing the risk of getting in a mess with it, but it's negotiating all the way.  Eventually, he won't have a clue with his medication at all, so I'll just gently remove his spare pills. 

It's hell to tiptoe round a person's independence, helping but not hurting.

There were a couple of times after my mother died when I wanted to shout "I'm not your (expletive) wife!"  I didn't.  I've now reached the point of wishing I could say I was his wife because then it would be easier for him to do what I want him to do without loss of face.

 

(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

bubble

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Re: Risk taking
« Reply #8 on: 14 Oct 2012 04:36PM »
Aww, you are a very caring and thoughtful daughter, to want dad to live as he would want is roght. As been said, reduce risks, as much as poss,  and, yes everything in life is a calculated risk, what seems risk to one is not to others.

Monic1511

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Re: Risk taking
« Reply #9 on: 14 Oct 2012 06:24PM »
Sunny
 >bighugs<
Life is a risk and I know I take one every time I go out of doors ( I wander when I'm in a fit but  >fingerscrossed<)
If your dad is content and you are managing then continue as you are.

If we allow "What If" to rule our lives we would never do a thing.
Monic

Sunny Clouds

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Re: Risk taking
« Reply #10 on: 14 Oct 2012 07:59PM »
He's not as content as I like, but he'd be an awful lot less content if someone put him in a home.  I don't want him to go into one until either he doesn't know he's in one or he wants to go into one.

I'm seriously stressed out looking after him, though.  Earlier today, I phoned and he was very upset that there hadn't been any pills in the morning or lunchtime compartments of his electronic pill dispenser.  Yes there were, I checked yesterday and showed him.  It's a question of trust and he'd rather trust his failing memory than mine.  We'll see how it goes.

It's such a difficult balance.  Last year, I practically bullied him into using a walking stick.  For him, that was a loss of his independence walking without one.  Once he clocked that it wasn't walking with stick vs walking without stick, it was walking with stick vs falling over without stick, we made progress.  But it took some negotiating.  I could have tried to stop him going out, but better that he fell over a few times and weighed up the options.   

He wasn't passive about it, either.  He stopped a stranger in the street with a walking stick with four feet to ask if it was helpful.  He looked in catalogues at sticks with seats.  He looked curiously at my four-wheeled trolley.  Then he picked out one of my late mother's sticks and started using it.

I've queried the length.  She had a collection of sticks and I've nagged him into trying different ones.  He's decided that he likes the one he's got even though it's longer than the one the physios measured him for and his technique for using it is, well, not smooth.  He sort of  jabs the ground aggressively.  I won the battle of the stick and he won the battle of the length and type and how he uses it and he's stopped falling over. 

I got him home from hospital where he was last year.  Some people at the hospital talked about him going into a home.  I turned up at the hospital with a whiteboard and started drawing little diagrams.  I drew his utility room, wiped out the freezer, the coatpegs, the shoerack...and drew a shower, a washbasin, a towel rail.  I drew my late mother's sitting room, then I rubbed out most of the chairs and most of the coffee tables and most of the bookcases and drew a bed, a couple of wardrobes and a dressing table.  I moved a few bits around.  He sort of got the gist.  I interfered but got him home. 

He can't remember hospital at all, he can't remember what the rooms used to look like, but he can remember he can make his own cup of tea and that he can put on his jacket, pick up his mobile phone and walking stick, check he's got his wallet and his keys and the world's his oyster.  Well, not the whole world, but the whole village.   :-)

And now sometimes he phones up and asks where he is.  We play twenty questions.  Sometimes he's in his sitting room.  I explain that he now lives downstairs and that if he does a bit of exploring, he'll find a bedroom that he'll know is his because he'll recognise his dressing table, he'll find a shower room, he'll find a loo and he'll find a kitchen.   Why not spend a penny and make a cup of tea?

So far, it's working.

He asks repeatedly who his landlord is.  I think it's about time I stopped telling him he owns the place so when workmen turn up on the doorstep he can tell them he doesn't know who the landlord is.

OK, I'm interfering, but the choice is still his wherever possible.  Facilitated independence rools ok!
(I'm an obsessive problem-solver, so feel free to ignore any suggestions or solutions I offer, even if they sound terribly insistent.)

Yvette

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Re: Risk taking
« Reply #11 on: 15 Oct 2012 07:45AM »
He asks repeatedly who his landlord is.  I think it's about time I stopped telling him he owns the place so when workmen turn up on the doorstep he can tell them he doesn't know who the landlord is.


Good idea. It may also drive off cold callers who want to sell hiim double glazing.

Sunny, you are *not* interfering.  Please remember and keep telling yourself that you are enabling your Dad to retain his independence by continuing to live in his own home instead of a nursing home.