Sunday, 17 January 2016

YOO HOO… ANYBODY HOME?

What to Do when your Elderly Client goes AWOL


THE SIGNS
1.  An overflowing letterbox.

2.  A barking (and very pissed-off sounding) dog.

3.  Blinds that are down in the middle of the day.

These would be the winning top three indicators that tell me there may be something amiss as I arrive at the home of an elderly client.  Inevitably, one or all of these ‘clues’ will mean my client has either gone out, is in bed, or is laying injured (or worse…) on the floor hoping that someone, oh please god eventually, will find them.

From having a fall usually. 

A jam-packed letterbox I am immediately suspicious of.  Especially if there is distinct and varying shades of weathered-ness on the junk-mail spilling out of it.  Goodness knows how many days it’s been piling up for (or why the postie insists on stuffing more in). 

In my experience, this says ‘nobody is looking after me, I am all alone’ and it’s never a good sign.

That, or my client has been whisked away by a dutiful son or daughter for a week of family jollies at the beach house and, what with the excitement of it all… nobody thought to call the office to cancel mum’s scheduled services. 

A more common occurrence this one, over the festive season.

Similarly, an unrestrained Malti-Poo cross leaping about the furniture yapping its head off as you buzz the doorbell can be of great concern too.  If mum was OK and had been poised waiting for her Home Carer’s visit like normal, she would’ve already bellowed “OH SHUT UP, MITZY!” and had him tethered to the leg of the kitchen table by now. 


Elderly client not hoe for HACC service
Calm down, mad Mitzy-poo!


And observing blinds that are down or curtains tightly drawn still in night time mode when it’s well past 12 o’clock in the afternoon, doesn’t send me much of a positive vibe either.  A creature of habit Mr Bill Cornfoot, he should be sitting in his lounge room armchair munching a cheese sandwich, half watching TV, half doing the crossword at this time of day.

Why isn’t he calling out for me to come straight in like he usually does? 

And why is his door locked???

Ah, yes… waiting for an elderly person to come to their front door can be a worrisome few moments for a travelling careworker.  And tempting though it is to roll your eyes and say “Oh god, where’s he gone this time?  You know in reality, that there is every conceivable possibility that something untoward may have happened to your beloved client.

The more likely scenario though, is that they have merely forgotten what day it is and have instead gone out.  Doctor’s appointments, browsing the shops, getting their hair done, a day at the races, or been taken by friends to play the pokies at the RSL… we hear it all.

And that's fine.  As long as we know.

I have several repeat offender clients in this category who despite having had their Home Care service scheduled at the exact same time, on the exact same day, every week for the last two years, they continue their pattern of being frequently absent on service day.

Arrrggggh the frustration!  

So then we play the waiting game…

Because bound by a Duty of Care policy, as a paid carer I am obliged to take appropriate and timely action when a client fails to present at the door to ensure they are found safe and snug and free from harm.

The key word here being FOUND.



THE ART OF DOOR-KNOCKING
But before launching the official Sea-to-Air search and rescue mission, it's important to give your elderly client a fair amount of time to respond to your initial knock.  Followed by a calculated and respectful waiting period (depending on their general state of health and mobility speed), before you go leaning on buzzers or knocking more loudly-er for the second, third or one hundredth time.

Older adults too, can become exceptionally aggravated if they are pressured into hurrying unnecessarily - so use your discretion, count to to 20 or whatever it takes before you start ding-donging away furiously.

Remember the reason you are there.  And that it's not about you getting to your lunch break on time - keep your composure and STAY COOL!

Futile when they aren’t home of course, but as a process of elimination it has to be done.



Waiting for elderly clients to respond at the door
Knock, Knock!
Who's there?
Lettuce!
Lettuce who?
LET US IN OR WE'LL CALL THE POLICE!!!



And while some clients with gazelle-like reflexes are capable of appearing within seconds (they’ve been glued to the window since breakfast in anticipation of your arrival) other movement-impaired Pensioners can take many minutes to arrive at their destination. 

Handy if you know this because you visit them regularly, but hard to juggle your waiting time-frames if you’re meeting a brand new client for the very first time.  You don’t want to appear rude or impatient by knocking or ringing continuously, yet you also hope your client has heard the doorbell and is at least on their way. 

More often than not though, you’ll find these slower-paced folk will either call out that they are coming, or for you to “Come in, dear” which solves the problem and puts everyone’s minds at ease immediately. 

Lovely.



KEY SAFES
Some elderly clients however can be SO delicate or unwell (you actually wonder how they can manage to stay living alone) that their families conveniently arrange for a key-safe to be affixed outside the front door somewhere, perhaps attached to a step railing or post.

This brilliant contraption requires a secret code number to open it before: Hey Presto!  It pops open to reveal a key hiding snug inside for you to let yourself in.

Word from the wise here:  Make sure you knock first before you stride on in.  And also call out to announce your arrival.  You don't want your unsuspecting client, in mid-doze, dying of fright as you suddenly appear from behind the sofa!

(Oh and make sure you put the key back in the safe for other carers who might need to get in after you've been and gone.  The havoc you can create if you forget this will cause all sorts of headaches!)




STALK YOUR CLIENT
Once you’ve done the acceptable amount of knocking and ringing, and you still haven't had a response, there are windows you can peer through and gently tap on as well. 

Move stealthily around the outer rim of the house, calling out and rat-a-tat-tatting as you go, just on the off-chance that your client is in another room, in the shower, or maybe just finishing up important business in the loo…

No pressure!

Or perhaps they haven’t got their hearing aids in?

Or they’re having a bit of a zzzz after a poor night’s sleep?

Keep knocking and also check out in the back yard and garage areas too, if you can access them.  I once had a client whose life revolved completely around her magnificent garden so I knew I'd always find her out back in her wide-brimmed hat digging away in her veggie patch… head down, bum up!

Sometimes too, at this nomadic point, you’ll find a neighbour can often lean over the fence and offer you their ten cents worth on where they think your client is (or isn’t). 

“Oh I saw the ambulance there early this morning.  Mary's daughter said she’d had another heart attack so I think they’ve taken her in for some tests.”

Although not to be taken as gospel, you at least know that something serious has happened which explains why your client is not going to be home no matter how hard you knock.

At this point, you’d report in to the office and let them take them wheel.



HELP!  I'VE FALLEN OVER!
The other less than ideal scenario, is discovering your client on the ground from having a fall.  As unpleasant as this thought is, it is very much a reality considering the age and health status of the older adults you are dealing with. 

I once found the gorgeous Mr Jeffery Bonecracker out by his clothesline one afternoon after he’d tripped over the peg basket and gone for a skate.  Although he swore he was OK and ‘please don’t make a fuss, Dollie’, turns out he had a shattered hip, a dislocated shoulder and required two months in hospital (throw in a further six weeks in Rehab).

Fuss?!  Very glad I chose to ignore Jeff's plea and immediately called emergency services for a whole ambulance-load of fuss! 

Note:  Never hesitate in calling for an Ambulance if you feel it's warranted.  Better safe than sorry - you don't want the alternative on your conscience.



PASS THE BUCK
So once you’ve explored all the accessible surroundings of your client’s property (and checked under the clothesline) and you STILL haven't made contact, it’s time to officially launch into plan B – ring the office.  

Here is the typical procedure a care co-ordinator or administrator might follow when they receive a report that a client has not responded for their scheduled service:


STEP 1:
Phone the client directly.
Fortunately, nine times out of ten, success is often achieved at this point because although your client may not hear a support worker banging, ringing and hollering like a crazed loon at the front door - the sound of their home phone ringing seems to grab attention fairly smartly!

STEP 2:
Failing that, and there is still no response from within the client’s residence… the office will then call any next of kin/emergency contacts listed on your client’s file in the hope that somebody  somewhere knows where your client might be today.

Often clients, in all the fervour of a better offer, just downright forget to notify their care provider that they won’t be home today and to please cancel service.  Annoying, but understandable and as we all know in life – stuff happens.

STEP 3:
Finally, the last ditch effort in pin-pointing the whereabouts of your missing Senior is to bring in The Law.  Meaning yes, the Police are informed and a Welfare Check is systematically conducted by them at your client’s home to ascertain if they are in there or not. 


Police assist in locating elderly client
Last resort - Mr Plod!



STORY TIME
I remember one day not being able to locate my client Mrs Doreen Appelblatt... to pick her up and take her for her regular weekly hour of shopping.  I’d felt quite concerned at the time when she didn’t answer her door as she had complained only the week before of experiencing dizzy spells and feeling ‘odd’ recently. 

The office too, had exhausted all avenues of contact but had managed to locate Doreen’s daughter Ellie who had also become quite anxious.  So much so, that she had jumped in the car and driven the two hour trip to Doreen’s house to see for herself where mum was.

“I rang and reminded her last night that Dollie was coming today to take her shopping – she should be home!”  

Oh god, what if she was on the floor, had slipped in the shower and passed out unconscious in the bathroom?  Perhaps she’d banged her head on the dresser and was slowly bleeding to death after crawling on hand and knee trying to haul herself to the phone? 

As peppy as Doreen seemed, she was 88 years old and was no spring chicken! Perhaps her number was up and she now lay slumped dying in a chair from suffering a life-threatening INTRA-CEREBRAL BRAIN ANEURYSM???

(Honestly, the things that fly through your mind.)
               
Just then, whilst waiting in a nervous clump on the porch for the Police to arrive, as I stood with Ellie and neighbour Jim (who'd kindly sent out a search party of his own via the canary club) a taxi roared round the corner and pulled in to Doreen’s driveway.  

We then watched as four high-spirited old ladies wearing matching blouses piled out of the car, all yakking at once and juggling platefuls of pikelets and sponge cake.

“Pop the hood, if you would kind Sir!” sang Doreen, oblivious to everything except producing an enormous gold trophy from the boot of the cab.

I remember daughter Ellie looking relieved, as were we all, but at the same time she was fuming that her absent-minded mother had missed yet another valuable council-provided service, wasted everyone’s time and caused a whole lot of bother. 

Not to mention having the cops called out too!

Apparently taking out first place in the ladies senior division at the Regional Ten-Pin Bowling comp just wasn’t going to cut it this time.

“I’LL GIVE YOU A BLOODY TROPHY, MUM!”

  

 
Elderly clients missing from home
Doreen's Devils...STEEEE-RRRRIKE!



Cheers
Dollie




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