Older Mind Matters

Harry, Joan and the heroes, part 4

I've had email asking how Harry and Joan are getting on.

Harry is still in the respite bed, but getting quite agitated about how much his care is costing and about what would be best for both him and Joan in the future. He has visited sheltered housing with care and put his name down ‘to keep his options open’. A Social Services assessor has told him that he doesn’t qualify for residential care, so he expects to return home soon.

Joan has had her plaster cast removed, and is walking short distances with supervision. Harry is able to visit her with family or friends since she moved to a hospital much nearer to him.

Heroes include family, friends and neighbours, some quite elderly and with their own health problems, who are visiting regularly and trying to keep the couple’s spirits up.

The main lesson at the moment is the remarkable lack of integration in services. Harry has a number of health problems and none of the people involved in his care seemed to have tracked him down. If he hadn’t phoned up several people himself, when things didn’t happen as they should, treatment could have gone badly wrong. His aftercare, spanning primary and secondary care in several specialties, lacked coordination. Perhaps that would once have been done in an out-patient clinic, but no longer. Perhaps some general practitioners would co-ordinate post-discharge care, but others probably wouldn’t. The danger is that no-one takes charge and nothing gets done.

Integration is also lacking in thinking about Harry and Joan as a unit. What happens to one of the couple, seems disconnected from what happens to the other: a social services care coordinator (a hero against the odds) is trying hard to pull things together.

2 comments (Add your own)

1. David Jolley wrote:
It is good that we are able to keep following the story.

There is a sense here that calm has begun to return and both Harry and Joan are regaining abilities and confidence in themselves. Harry at least is showing that he has views which people value. I wonder what Joan and he are saying when he visits her in the local hospital.

They are fortunate too, in having family members who are able to be with them and help rescue them from the worst of hazards which can arise when several individuals and agencies take the tiller in succession or in parallel. The strange tensions included in the scenario wherein Harry rails against the personal cost of being in a means-tested facility, while ‘the social worker’ rules that his needs are insufficient to qualify for a residential placement, will puzzle a man from Mars or a visitor from most European (civilised) countries.

It is great to learn that a social services care coordinator has a vision which sees Harry and Joan as a unit. This will surely be how Harry and Joan and their family will want it.
Perhaps a step-wise return home is going to be possible and the best option. If so it will need to be supported by a plan which includes extra care at home supplemented maybe by day care and/or other respite arrangements, with a view to anticipating and minimising the impact of future difficulties. Within this the only way that things can be held together is through a strong and proactive Primary Care steer once they are home.
Really in the turbulence of other places, it would be good if this steer could still be available in support of representations from Harry and Joan and the family. I wonder if a patient-held record including some notes on ‘preferences in the event of’ might be useful

Sat, April 7, 2012 @ 8:39 AM

2. David Jolley wrote:
This is an important story. Is there more to be told?

Sat, May 26, 2012 @ 12:33 PM

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