An elderly person with dementia may find himself in a real mess, even if everyone wishes him well.
Home, ambulance, hospital, home, ambulance, hospital, rehabilitation ward, new home, rehabilitation ward.
That’s an elderly person from Helsinki I hope so adventures since spring. Close to hope Anne Uskali describes moving from one place to another using the jargon of nurses: the revolving door effect.
So the elderly person is sent home from the hospital and has to be returned to the hospital with almost the same door opening.
The health care crisis is partly caused by people getting the wrong kind of help or at the wrong time, or having to deal with the same thing multiple times. Finland is full of elderly people in the same situation as Toivo.
In this story, Toivo appears under a changed name due to his fragile health. He has agreed to do the case, and HS has familiarized himself with the documents concerning him. Anne Uskali appears in the story under her own name.
Toivo was supposed to sleep here in his new home, but he woke up frequently at night and went wandering.
Hope has had amnesia for a long time. His life was still independent and good for years. For example, he actively practiced sports and liked going to the movies with his loved ones.
However, last year, Toivo’s memory and exercise ability were already so weak that he started needing help several times a day.
The relatives also promised to give it. Uskali moved a few hundred meters away from Toivo for this. According to him, the bureaucracy related to the elderly person’s ability to function and its assessment has been confusing.
I hope the security system was in use.
The decision was made for Uskali that he could not officially become a caregiver, because Toivo did not need enough daily help yet. Around the same time, the city’s home care estimated that Toivo would need a lot of daily help, three visits a day.
This was annoying, but it did not affect the desire of loved ones to help. A reasonable division of labor was born: home care took place twice a day, Uskali or someone else from the family every evening.
“We were good together. We watched the evening news and drank coffee,” Uskali describes.
In addition, he helped in similar matters as home care and took care of dishes, laundry and paying bills, for example.
I hope so the home had two floors, but when his mobility deteriorated, his life was arranged on the ground floor.
One night in May, Toivo didn’t remember in the middle of the night that he should no longer climb upstairs alone. He fell and was badly injured.
In the morning, home care found Toivo in a pool of blood on the floor. He was taken to the emergency room by ambulance and it was recorded that he had pain in the pelvic area.
Even in the small kitchen, everything is carefully arranged.
In the emergency room, for some reason, only the head was photographed and a small cerebral hemorrhage was observed. Toivo was sent home, where relatives took care of him the next night.
The very next day, home care found him lying on the floor again. This time, a hip fracture was detected in the emergency room.
Fortunately, the ambulance rally stayed here and Toivo Malmi hospital. Instead, the strangest stages of his adventures were yet to come.
With ore after the month spent, Toivo was temporarily transferred to the rehabilitation department in Koskela. It was supposed to be there for a maximum of three months.
Everyone thought that returning to the old home was too big a risk because of the two floors.
Toivo moved in Koskela with the help of a rollator, unsteadily, slowly and with the steps of a mouse. If he fell, he couldn’t get up by himself.
The local memory barely worked at all. Instead, there were enough great stories.
In his own opinion, Toivo had just been to Sweden. Sometimes he asked for pocket money so that he could go to the villages in the evening like in his youth in North Karelia.
A memory test performed by professionals confirmed that the memory had deteriorated.
Close ones wished Toivo a place for round-the-clock care. Toivo himself did not oppose the idea.
Uskali was told that before this he should try living at home so that all home care services are available. That means, in practice, a third visit a day and an alarm system installed on the door.
“We reluctantly agreed. I wanted it to succeed, but I was afraid for Toivo,” describes Uskali.
He decided to do everything he could to ensure that Toivo would be happy and safe in his new home.
Uskalia was also surprised by the fact that Toivo’s memory medication had been reduced before the home trial and the new medication had only been tested days before discharge.
To old so he was not allowed to return home, but his relatives managed to find a rented apartment on the same level near Uskali and Toivo’s old home.
The mirror cabinet in the toilet has its contents marked. Toivo could have held on to the handles.
Uskali arranged Toivo’s furniture as well as important photos and memorabilia so that the place would look as familiar as possible. Aids and technology were acquired. The cabinets were marked with their contents in large letters.
Then everyday life began. Uskali was supposed to doze off on Toivo’s sofa the first night, but he soon realized that it wouldn’t be enough.
“He didn’t realize where he was or recognize his own things. He was confused and a little distressed.”
For example, Toivo woke up several times during the night to look for the toilet, but did not recognize the purpose of the regular toilet bowl in the apartment.
Then he not only peed in the wrong places but also slipped and fell several times in his own urine. It was only up to luck and Uskal’s vigilance that we were spared from further injuries. For example, Toivo could not press the safety bracelet himself.
After two days of home care, it was concluded that the experiment could not be continued safely. Toivo was taken back to Koskela.
Uskal was told that now it has been tried and he can start applying for a permanent nursing home.
Daring antagonize. Proportioned to Toivo’s pension, the experiment turned out to be a completely unreasonable expense of thousands of euros, including moving and rent costs.
What annoys Uskali even more is that the experience was disgusting and painful for Toivo. In his opinion, for example, home care professionals have acted humanely and well, but Toivo has had to suffer completely unnecessarily due to bureaucracy and poor information transfer.
“The right hand does not know what the left is doing. That’s what precious old age is all about, in a puddle of pee. So a pool of blood wasn’t enough.”
At the end of the list written for home care, you are asked to check if there is pee on the floors that you could slip on.
Lead Doctor: Perhaps sincerely thinking of his best interests
Helsinki the hospital’s chief physician Laura Pikkarainen do not know Toivo’s case and could not directly comment on the affairs of an individual person.
“Here, they must have tried to think of the best for this person. Getting discharged from the hospital requires intense presence, especially for an elderly person, in order to succeed.”
About five percent of those discharged from Helsinki city hospitals return within two weeks. The number is lower and therefore better than a few years ago.
In Pikkarainen’s opinion, zero percent would be a sign that some patients are being kept in the hospital longer than their own interests require, just to be safe. Rehabilitation at home usually progresses faster due to daily exercise.
The information should transfer smoothly, because both the Helsinki and Uusimaa Hospital District (Hus) and the city’s social and health services are in the same information system. It is still possible that not all relevant information is passed on to the right people.
In Helsinki, in recent years, ambulances have had to be sent to elderly people in home care less often than before. Even in Helsinki, there is currently a mobile nurse whose purpose is to bring urgent care to the elderly. Then the elderly person does not have to be transported to the emergency department each time.
Quickie says that healthcare exists specifically for the weakest and sickest. It is clear that ambulance rides are also needed in this age group.
“But it’s a distraction and a burden on the elderly if they are taken to the emergency room even when it would be possible to act the other way around.”
In Pikkarainen’s opinion, this is most clearly a problem when it comes to an elderly person who has already been found to need a place in round-the-clock care. There are too few places, waiting times are long, and some are taken to the emergency room because there is no other option available quickly.
However, Pikkarainen says that the bureaucracy does not always require trying all the arts of home care before entering a nursing home. The assessment of whether an elderly person needs a place in a nursing home can be perfectly started in a hospital or rehabilitation department.
“Here, perhaps, it is sincerely hoped that it would be possible to be at home.”
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