Before you start at a placement your agency or the family will have supplied you with a brief on what to expect. This will tell you the medical condition and health of your new client. It will also explain what help they need and how much care is involved.

With this in mind, you head off to your new placement. All is as you expected – for the first week or so – and then you find that things change.

How do things change?

Because you live with your client, you will be the first to see if they deteriorate in any way. Simply because as live-in carers we take care of people who are old, frail and unable to care for themselves, we will always see a downhill trend in their health.

Downhill trends may be very slow or happen quickly, depending on the general health and the condition of your client.

If you are taking care of a client with mental issues or Dementia you may see signs of less focus and more confusion. Where a few weeks before your client knew how to get from the bathroom to her bed, now she calls you to ask where she is going.

Confusion becomes more evident in many clients, sometimes leading to a panic attack where they are simply scared because they have no idea where they are and what they are supposed to be doing.

Physical signs may be that your client becomes more unsteady on their feet. Last week they easily walked around the garden, and this week you are walking behind them because they are wobbly and may fall over.

Co-ordination is another area where you may see a change. A week ago, your client could easily load food onto the spoon and feed herself. Now, you need to load food onto the spoon and guide her hand to her mouth.

What to do?

If you see that things are changing to the point where other equipment may be needed, then you should contact the District Nurse. This equipment may include a hoist to help your client out of bed first thing in the morning when they are very unsteady and a little befuddled about what you are asking.

Instead of using a stick to walk, your client may find it easier using a frame for extra support. There are different ways to raise chairs a little higher so that your client can get out of them with less difficulty.

The old family bed can be changed for a profiling bed which can go higher and lower as well as raise the head and feet. This will make getting in and out of bed a lot easier than from an older bed which possibly sags in the middle.

Who to talk to?

Apart from letting your agency and the family know your concerns (and you should do this) the best person to talk to is the District Nurse. It is she who can arrange for the Occupational Therapist to visit and assess the current situation. After this assessment, you will have a better idea of new equipment which is available and any other options open to you and your client.

To sum up

Because of the nature of the clientele a carer works with, there will always be changes, both mentally and physically. These may happen gradually or quickly depending on the health of your client. Even in the course of two weeks, you may see a deterioration.

It is important that you are proactive about any changes. Having things in place before things get too hard to handle will make life easier for both you and your client.

It is also important that you keep the family and next-of-kin informed about the changes you see in their loved one. Remember that the last time they visited (even if it was only a few weeks ago) their mom was far better. Now when they see her, she hardly knows them. They will wonder why you had not kept them in the loop. Keep them informed as often as you can. Send an email or make that phone call. They will appreciate that you are thinking of them.

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