Advice needed - emergency dementia care

cornish mackem said:
Mental health , adult social care, maternity services , district nurses, gp , ooh gp and care line all have the ambulance service as their default when they can’t cope or don’t want to manage the complexity of working in multi disciplinary community services. That’s why so many of ambulance staff now work in Those services.
Most gp surgeries have paramedics down here. I know 1 that has 6 as they can’t recruit GPs or nurses. I’ve worked in primary care and home treatment teams now for 7 yrs and Only do the occasional shift in green .
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In my former NHS role I had regular involvements with most of those groups & know multiple nurse pracs & paramedics that I knew from the ward bases. Both Mental & General Health trained. Several had also stints with the Prison Service before returning.
 


Georgewhitt said:
Care lines are the ones that really irritate me.
They sell themselves as care, when in reality what they do is see an alarm activation, call the patient, and if they get no reply they call for an ambulance and register it as a "welfare call".
They are not "Care Lines" at all.
They should at least have a team of first responders to react to the alarms in the first instance, and then call for an ambulance if required.
The money they make from vulnerable people, then simply dialling 999 is obscene.
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They only add to the pressures on the service that they were created to take some of the workload presure off. But don't get me into that
 
Georgewhitt said:
There is very little "care" in what they do marra. They are purely a middle man between the patient and us, and earn a fooking fortune by dressing it up as "care".
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I did a bit of work looking at other providers when working at my first gp surgery. We had a young bloke with Huntingtons who liked a pint. He actually liked a lot of pints and would fall over in all kinds of places . Into peoples gardens on the way back from the pub was his favourite and if this stuff had started in the winter , he’d be dead now from being out all night under a bush. We got him something called a Pebell which works on mobile signal and GPS. He presses the button and all his contacts listed on it get a text with his location. Some even allow you to talk to him without the restrictions of being near the base station thing in your house. It’s only a couple of quid a month as opposed to about £20 after you buy the pendant thing.
I haven’t got shares in it before anybody asks
 
cornish mackem said:
I did a bit of work looking at other providers when working at my first gp surgery. We had a young bloke with Huntingtons who liked a pint. He actually liked a lot of pints and would fall over in all kinds of places . Into peoples gardens on the way back from the pub was his favourite and if this stuff had started in the winter , he’d be dead now from being out all night under a bush. We got him something called a Pebell which works on mobile signal and GPS. He presses the button and all his contacts listed on it get a text with his location. Some even allow you to talk to him without the restrictions of being near the base station thing in your house. It’s only a couple of quid a month as opposed to about £20 after you buy the pendant thing.
I haven’t got shares in it before anybody asks
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I think I'd have been wondering & asking how he was given that job dealing with people in that environment.
 
cornish mackem said:
This stuff is my job now and the reality is very different to what people get to what they should get. The demand on services outstrips supply by an unimaginable way.
The idea of a rapid response is a thing of dreams sadly.
The default answer we have to give is a rubbish one, “ admit them to hospital as a place of safety if nothing can be arranged “
Putting someone in ED who already doesn’t understand stuff must be terrible for them and let’s not forget how difficult for the already manic department to manage. We only take old and demented people to hospitals as a last resort ( actually, we only take anyone as a last resort) but needing a social admission is more common than you would think.
We in the south west have been at crisis point since pre pandemic so nobody can blame that on COVID.
There will be about 20 ambulances waiting outside Plymouths Derriford at the moment and possibly the same in Truro . All waiting to get their patients into the hospital and that hospital can only do that when 1 leaves .
Patient flow is being halted by lack of social care providers and its them very same people who stop hells bells dad being taken in.
It’s proper shit down here currently with no sign of an improvement

I’m not sure what the block booked bed set up is like in Devon but we couldn’t get someone in one today as an emergency in Cornwall . It might take 1/2 a day to talk to someone
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It's awful mate.
Worked in Older Person's Psychiatry for just over a decade and year on year you can see the criteria for getting accepted for carers from local authorities getting higher and higher as their budgets get smaller and smaller and the population ages. Social workers leaving in droves because they can't do the job to the standards they want because there isn't the funding to do what they want and when there is there aren't the care providers or the staff to fill the care package.

Meanwhile risks increase, people get more ill as they aren't taking meds because they forget but medication administration isn't a reason by itself for a care package locally. End result is patient loses out, more stress for patient and family and arguments between health and social, when in reality they all want the best for the individual at the centre of it all.

I've been so close to moving to Scandinavia because of my disillusionment with recent governments but I've not gone and keep telling myself things have to slowly get better with a change.
 
luvulongtime said:
aye 75 quid a week for 35 hours ffs that's what i got when me dad died and i had to stop work for 2 years to look after me mam until i managed to get her into a home, when covid happened everyone on benefits got extra 20 quid (to blow on cider and crack) those on carers allowance got fuck all
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Don't bite my head off, it was just a suggestion.
rudd said:
It's awful mate.
Worked in Older Person's Psychiatry for just over a decade and year on year you can see the criteria for getting accepted for carers from local authorities getting higher and higher as their budgets get smaller and smaller and the population ages. Social workers leaving in droves because they can't do the job to the standards they want because there isn't the funding to do what they want and when there is there aren't the care providers or the staff to fill the care package.

Meanwhile risks increase, people get more ill as they aren't taking meds because they forget but medication administration isn't a reason by itself for a care package locally. End result is patient loses out, more stress for patient and family and arguments between health and social, when in reality they all want the best for the individual at the centre of it all.

I've been so close to moving to Scandinavia because of my disillusionment with recent governments but I've not gone and keep telling myself things have to slowly get better with a change.
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How long will you give the "next government" to make a positive change before booking your ticket ?
 
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rudd said:
It's awful mate.
Worked in Older Person's Psychiatry for just over a decade and year on year you can see the criteria for getting accepted for carers from local authorities getting higher and higher as their budgets get smaller and smaller and the population ages. Social workers leaving in droves because they can't do the job to the standards they want because there isn't the funding to do what they want and when there is there aren't the care providers or the staff to fill the care package.

Meanwhile risks increase, people get more ill as they aren't taking meds because they forget but medication administration isn't a reason by itself for a care package locally. End result is patient loses out, more stress for patient and family and arguments between health and social, when in reality they all want the best for the individual at the centre of it all.

I've been so close to moving to Scandinavia because of my disillusionment with recent governments but I've not gone and keep telling myself things have to slowly get better with a change.
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Don’t hold your breath for change. It’s taken a generation to break it, it’s going to take a generation and a half to turn it around and that only if we really want too.
Meanwhile, NI rate cut.
I will say that our expectations are unrealistic in some cases of what we expect from a system even if we had enough staff. Some of the requests I see are very entitled. I had one the other day, I want someone from the council to come round and recommend a car and electric buggy that I can buy. The buggy has to be able to fit in the car.
There was some right huffs when I said that is what a salesman is for.
People want it on a plate in lots of cases and meanwhile people with real needs can’t get the help they need.
 

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