Chapter 374 - A Cock-up
Here I am at 0600, awake since 0400, unable to return to sleep, even though I have minimal responsibilities for the next fortnight while she is in respite. And therein lays a tale.
Somewhen between Xmas and New year I rang the coordinator who handles the home care at Wild Dog, asking what we need to do to organise a week's respite. You know the advice easily given that "carers" need to take care of them selves? Well, I had decided to accept the advice. I am unable to shake off my feeling of tiredness, I am more irritable and short with her, I suspect I stumble a little (although no one has noticed), I am not relaxed while driving and have reservations parking in busy car parks and prefer one in a side street, my Lumosity scores are dropping but not by much. Possibly all due to lack of sleep and stress. The coordinator said she would ask the responsible person to call me. No one called, but then it was the slack holiday season after all. So on 7th January I sent the same co-ordinator an email; she replied that she had sent an email with my contact details and ACAT assessment to the responsible person, mentioning the name. Still no response by the 9th say I rang Wild Dog's number which was politely answered by the person I needed to speak to. Knowledge of any messages from the other co-ordinator was denied. After I described what we needed the response was "Only shared accommodation is available" to which I replied "NO!"; to which I was asked for my contact number while management was contacted for a decision about a single room. Puzzled me that the person needed no other information from me, causing me to believe she already knew my PWP's situation. So much for not getting the message. Shortly after I was called back. A single room was available from next Tuesday (that is yesterday as I write). Then I mentioned the Apo pump and self medication of Parky Pills. Another call back; senior staff knew all about pumps and meds needed to be in blister packs, I protested but we would sort it out on the day.
By Sunday I decided that blister packs may not be a bad thing. So I called into the chemist asking that her meds as per my schedule (you know, the small spread sheet I attach to some of these posts) be packaged into a blister pack for two weeks to pacify the Wild Dog management. No problems I was told EXCEPT that directions to say what was in the pack had to be authorised by the doctor, otherwise Wild Dog will not accept it. So I needed to have the doctor FAX the schedule to the chemist before they made the blister packs. The chemist also said that due to the number of meds and the number of doses they would need to join several blister pack sheets together. I left a schedule with the chemist.
Monday morning, a little after 0900, I gave a copy of the schedule (in which the PD meds were highlighted in red), on which I had added instructions for the doctor that my PWP was going into respite, to the doctor's receptionist. Then I continued to the chemist, telling them what was in train, leaving all her meds with them (since I am a pessimist, she had made up sets of meds for all of Monday and Tuesday) and buying some op-sites for the Apo infusions and ointment for the old infusion sites. The chemist said they would ring the doctor's surgery by lunchtime. Mid-morning I took completed admission paper work to Wild Dog, I was told that staff had determined that I could administer the Apo, I pleased them that blister packs were being prepared for her conventional PD pills.
Mid-afternoon Monday I contacted the chemist; they had called the doctor's many times but no FAX. I rang the doctor, the receptionist said she had sent the FAX "15 minutes ago"; rang back the chemist, no FAX even after double checking; rang back the doctor's receptionist who then resent the FAX; rang back the chemist - FAX just received. Time was then about 1630, chemist there until 1830, I said I will collect at 1800 (that way I was sure of no delivery foul-ups). At 1800 I collected some 6 sheets of blister pack, including the doctor's FAX to the chemist.
At home she looked at the blister packs, declaring "these are all wrong". Included were doses of Sifrol (she was weaned off the stuff during February - March if I recall correctly, included were doses of Sinemet which had been reduced, also Motilium. As I later figured out, the doctor had simply FAX'ed to the chemist the list of current scripts, in use or not, that he had listed on his system for her. I thought I was ensuring that neurologists, GP's, hospitals and associated medical staff were all being kept on the same page about her current medications. Obviously not, which explains why sometimes I need to say "that's for your records" when a medical professional goes to hand me back the sheet of paper. If she was a dippy demented old lady and had gone to Wild Dog with those packs without argument she would have been fed pills like a battery hen until she was over medicated. I wonder how often that happens?
So yesterday, Tuesday, I took her to Wild Dog a little after 1000, about the usual time I take her for day respite. We were escorted to her room where we waited for nursing staff. I told them the blister packs were incorrect and she will self medicate as at home, putting pills in labelled containers for each day. Too difficult for the two nurses to handle; a more senior one called, officious, "Must be in a blister pack" she says. I point out that were she to take the pills in the packs made up by the chemist then she will be over medicated. She needed to consult with management; I heatedly stated that if this was not sorted quickly then we were going home. Management person arrives, takes a higher stance "Leave it with us, we will contact the doctor to correct the schedule and organise for the medications to return to the chemist". I am slightly pacified. I tell them I will return about 1600 to change the pump; no one shows much interest; I can do it any time it suits me. They leave us, I help her unpack a little, then take her up to the day respite room for lunch.
I went home, prepared an Apo syringe leaving it in the fridge, had some lunch then down the street for a coffee and checked with the chemist. I asked to speak to the chemist involved in this saga and he passed me to another who was now handling the matter (did I detect some animosity?). She, a chemist I had not seen before, told me that no FAX had been received from doctor. Well, I thought still early days, or hours.
Back home to collect the made up Apo syringe, spares and accessories packed into the ANSSR back pack and off to Wild Dog by 1600. The Day Respite people said she was feeling weary so had returned to her room. The Day Respite manager wished to speak to me about her attending Day Respite each day she was there. I said yes to provide her with company and activities; also discussed and agreed to discounted fees during her residence. The doctor rang me to verify her meds schedule; can't those ranked by society above engineers and technicians understand a simple spread sheet? Here am I, a retired aged buffoon, explaining to a doctor who will send a formal message to the chemist who will neatly package pills in a form acceptable to Wild Dog so that my wife can swallow them at times defined by ourselves? Is this comedy or actual farce?
I found her there sitting quietly. Sweating like a pig. Although the A/C control was set at 18C the window of the room was open. I was soon sweating as well, on this warm humid afternoon. If at home the air conditioner set to 21C would have kept her reasonably dry. I drew the curtains and closed the door while I changed the Apo pump and syringe. No staff disturbed us.
Later, after 1700 as I was leaving the Management Person saw me, called me into her office to speak with a senior RN. They had contacted the doctor and the chemist who said at that late hour nothing could be done since their pill packaging person had left for the day. It seems Wild Dog management were in a bit of a quandary. The RN said she assumed I thought she was being pedantic about the medications; I said "Yes, you are". She asked whether my PWP usually self medicates and whether under the circumstances, if specimen bottles were provided, we could make up the medication batches to tide us over until the blister pack fiasco (my word) can be resolved. I said yes, pointing out that we had come prepared for this situation with batches of meds for 1000, 1400, 1800 and 2200, which my PWP had been taking since arriving at 1000 this morning.
So I went with the RN back to the room, some labelled specimen jars were given to us. The RN left us to conduct our sordid activities unobserved, asking that either she or a senior shift nurse be called to collect the container of meds and blister packs when we were finished. I complied with her wishes and left for home.
A day of learning experiences. My Potential Problem Analysis skills (the unwashed refer to such as pessimism) need to remember this day for I was too optimistic in only allowing for only one day's allowance of pills. I should have allowed for maybe 3 days supply.
From home I rang her several times but she was unable to reach her mobile where I had positioned it on the charger. She rang me about 2000. The staff experienced difficulty assisting her onto the loo, an attempt with a lifter failed because the previous resident of the room had used fittings which obstructed the lifter.
When I see her later today I will lie that I enjoyed a good night's sleep.
In hindsight, the Wild Dog staff do a good job, being flexible enough for the patient's welfare needs to be met. I suppose I shouldn't ask for more than that.
But any more days like yesterday will nullify any benefits of respite for either of us.
Today is one of bureaucratic anticipation.
Somewhen between Xmas and New year I rang the coordinator who handles the home care at Wild Dog, asking what we need to do to organise a week's respite. You know the advice easily given that "carers" need to take care of them selves? Well, I had decided to accept the advice. I am unable to shake off my feeling of tiredness, I am more irritable and short with her, I suspect I stumble a little (although no one has noticed), I am not relaxed while driving and have reservations parking in busy car parks and prefer one in a side street, my Lumosity scores are dropping but not by much. Possibly all due to lack of sleep and stress. The coordinator said she would ask the responsible person to call me. No one called, but then it was the slack holiday season after all. So on 7th January I sent the same co-ordinator an email; she replied that she had sent an email with my contact details and ACAT assessment to the responsible person, mentioning the name. Still no response by the 9th say I rang Wild Dog's number which was politely answered by the person I needed to speak to. Knowledge of any messages from the other co-ordinator was denied. After I described what we needed the response was "Only shared accommodation is available" to which I replied "NO!"; to which I was asked for my contact number while management was contacted for a decision about a single room. Puzzled me that the person needed no other information from me, causing me to believe she already knew my PWP's situation. So much for not getting the message. Shortly after I was called back. A single room was available from next Tuesday (that is yesterday as I write). Then I mentioned the Apo pump and self medication of Parky Pills. Another call back; senior staff knew all about pumps and meds needed to be in blister packs, I protested but we would sort it out on the day.
By Sunday I decided that blister packs may not be a bad thing. So I called into the chemist asking that her meds as per my schedule (you know, the small spread sheet I attach to some of these posts) be packaged into a blister pack for two weeks to pacify the Wild Dog management. No problems I was told EXCEPT that directions to say what was in the pack had to be authorised by the doctor, otherwise Wild Dog will not accept it. So I needed to have the doctor FAX the schedule to the chemist before they made the blister packs. The chemist also said that due to the number of meds and the number of doses they would need to join several blister pack sheets together. I left a schedule with the chemist.
Monday morning, a little after 0900, I gave a copy of the schedule (in which the PD meds were highlighted in red), on which I had added instructions for the doctor that my PWP was going into respite, to the doctor's receptionist. Then I continued to the chemist, telling them what was in train, leaving all her meds with them (since I am a pessimist, she had made up sets of meds for all of Monday and Tuesday) and buying some op-sites for the Apo infusions and ointment for the old infusion sites. The chemist said they would ring the doctor's surgery by lunchtime. Mid-morning I took completed admission paper work to Wild Dog, I was told that staff had determined that I could administer the Apo, I pleased them that blister packs were being prepared for her conventional PD pills.
Mid-afternoon Monday I contacted the chemist; they had called the doctor's many times but no FAX. I rang the doctor, the receptionist said she had sent the FAX "15 minutes ago"; rang back the chemist, no FAX even after double checking; rang back the doctor's receptionist who then resent the FAX; rang back the chemist - FAX just received. Time was then about 1630, chemist there until 1830, I said I will collect at 1800 (that way I was sure of no delivery foul-ups). At 1800 I collected some 6 sheets of blister pack, including the doctor's FAX to the chemist.
At home she looked at the blister packs, declaring "these are all wrong". Included were doses of Sifrol (she was weaned off the stuff during February - March if I recall correctly, included were doses of Sinemet which had been reduced, also Motilium. As I later figured out, the doctor had simply FAX'ed to the chemist the list of current scripts, in use or not, that he had listed on his system for her. I thought I was ensuring that neurologists, GP's, hospitals and associated medical staff were all being kept on the same page about her current medications. Obviously not, which explains why sometimes I need to say "that's for your records" when a medical professional goes to hand me back the sheet of paper. If she was a dippy demented old lady and had gone to Wild Dog with those packs without argument she would have been fed pills like a battery hen until she was over medicated. I wonder how often that happens?
So yesterday, Tuesday, I took her to Wild Dog a little after 1000, about the usual time I take her for day respite. We were escorted to her room where we waited for nursing staff. I told them the blister packs were incorrect and she will self medicate as at home, putting pills in labelled containers for each day. Too difficult for the two nurses to handle; a more senior one called, officious, "Must be in a blister pack" she says. I point out that were she to take the pills in the packs made up by the chemist then she will be over medicated. She needed to consult with management; I heatedly stated that if this was not sorted quickly then we were going home. Management person arrives, takes a higher stance "Leave it with us, we will contact the doctor to correct the schedule and organise for the medications to return to the chemist". I am slightly pacified. I tell them I will return about 1600 to change the pump; no one shows much interest; I can do it any time it suits me. They leave us, I help her unpack a little, then take her up to the day respite room for lunch.
I went home, prepared an Apo syringe leaving it in the fridge, had some lunch then down the street for a coffee and checked with the chemist. I asked to speak to the chemist involved in this saga and he passed me to another who was now handling the matter (did I detect some animosity?). She, a chemist I had not seen before, told me that no FAX had been received from doctor. Well, I thought still early days, or hours.
Back home to collect the made up Apo syringe, spares and accessories packed into the ANSSR back pack and off to Wild Dog by 1600. The Day Respite people said she was feeling weary so had returned to her room. The Day Respite manager wished to speak to me about her attending Day Respite each day she was there. I said yes to provide her with company and activities; also discussed and agreed to discounted fees during her residence. The doctor rang me to verify her meds schedule; can't those ranked by society above engineers and technicians understand a simple spread sheet? Here am I, a retired aged buffoon, explaining to a doctor who will send a formal message to the chemist who will neatly package pills in a form acceptable to Wild Dog so that my wife can swallow them at times defined by ourselves? Is this comedy or actual farce?
I found her there sitting quietly. Sweating like a pig. Although the A/C control was set at 18C the window of the room was open. I was soon sweating as well, on this warm humid afternoon. If at home the air conditioner set to 21C would have kept her reasonably dry. I drew the curtains and closed the door while I changed the Apo pump and syringe. No staff disturbed us.
Later, after 1700 as I was leaving the Management Person saw me, called me into her office to speak with a senior RN. They had contacted the doctor and the chemist who said at that late hour nothing could be done since their pill packaging person had left for the day. It seems Wild Dog management were in a bit of a quandary. The RN said she assumed I thought she was being pedantic about the medications; I said "Yes, you are". She asked whether my PWP usually self medicates and whether under the circumstances, if specimen bottles were provided, we could make up the medication batches to tide us over until the blister pack fiasco (my word) can be resolved. I said yes, pointing out that we had come prepared for this situation with batches of meds for 1000, 1400, 1800 and 2200, which my PWP had been taking since arriving at 1000 this morning.
So I went with the RN back to the room, some labelled specimen jars were given to us. The RN left us to conduct our sordid activities unobserved, asking that either she or a senior shift nurse be called to collect the container of meds and blister packs when we were finished. I complied with her wishes and left for home.
A day of learning experiences. My Potential Problem Analysis skills (the unwashed refer to such as pessimism) need to remember this day for I was too optimistic in only allowing for only one day's allowance of pills. I should have allowed for maybe 3 days supply.
From home I rang her several times but she was unable to reach her mobile where I had positioned it on the charger. She rang me about 2000. The staff experienced difficulty assisting her onto the loo, an attempt with a lifter failed because the previous resident of the room had used fittings which obstructed the lifter.
When I see her later today I will lie that I enjoyed a good night's sleep.
In hindsight, the Wild Dog staff do a good job, being flexible enough for the patient's welfare needs to be met. I suppose I shouldn't ask for more than that.
But any more days like yesterday will nullify any benefits of respite for either of us.
Today is one of bureaucratic anticipation.
posted by Kilpike | 8:44 am
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