One of the tragedies surrounding the death of Joan Dorling is the lack of appropriate residential care for people with dementia.
Dick Skellington's daily diary of Dorling's ordeal at the hands of the NHS also charted the struggle her daughter, Linda Clark, had finding a place for her 83-year-old mother in a care home. Clark never wanted her mother to go to a specialist NHS ward, but there was no other option.
Day 12
We all agree to get her [Joan] out of there by the end of the week.
Day 16
We visit two care homes, the first is too like Princess Marina Hospital and second is suitable, possibly. Ashdown would put Joan on a one month probation. They said they might be able to cope with her disruptive behaviour. The costs are near £500 a week. It is small and discrete, not like a care home. I think this might be as good as any for Joan to be situated.
Day 22
We visit Westgate nursing home. It is full and has a waiting list. It was very open in a rural situation. We both thought it rather good.
Day 24
We spend the morning visiting care and nursing homes. Two in Northampton are full and have long waiting lists, another does not take severely demented patients. We visit Duncote Hall. It is set in lovely countryside and eight miles north of Joan's home. A former stately home that has been refurbished. They expect to have a vacancy within a month. They will do an assessment just before Easter and if it is positive Joan can move once we get a vacancy.
Day 28
Linda spends much of the day phoning homes. Most are full, the rest either do not take behavioural problems of do not have dementia units.
Day 30
We have identified a home in Oxfordshire perhaps with a bed at Wardington Hall. We will go and see it tomorrow. They have a person centred approach and are reluctant to administer antipsychotic drugs. They employ lots of staff and they engage every hour with residents. It sounds good but is 20 miles from Stoney and very, very expensive, probably about £900 a week! We hope the state may decide she [Joan} is worthy of continuous care provision. Linda cries all the way home.
Day 31
We drive to Wardington. It is set in lovely surrounding. Wardington ring Linda. The manager is understanding. She has two vacancies, a share and a single. She said they prefer challenges but want to see Linda before they do an assessment. The earliest is probably next Tuesday. Means taking [more] time off work but it is so important we get Joan out of Jennings Ward.
Day 35
Joan has passed the assessment. Just the paperwork to sort out now...
Even when Linda finally found a suitable care home for her mother, Dick's diary conveys how bureaucracy seems to conspire against them.
Day 37 [the day after Dorlings's fall]
The first problem comes early. D who is handling the application for continuous care phones Linda at 1030. There is a problem. Joan's doctor's practice is in Buckinghamshire. Joan lives in Northamptonshire. They have only just realised that although the prospect of Northamptonshire county council funding Joan's immediate care is strong under the continuous care scheme the entire project now has to go to Buckinghamshire county council. The lady will come and to the assessment next Tuesday. She does not accept the Northamptonshire verdict on Joan, so Joan has to stay longer in Jennings. Worse, the two counties appear to interpret the care package eligibility rules in different ways, with Buckinghamshire earning a rather mean reputation for allocations. Linda is distraught. D presses heroically for common sense and reason to prevail but the Buckinghamshire forces dig in. Worse. They say it may take three weeks to resolve, and Joan can not leave Jennings until it is sorted. M intervenes. Reasonably she asks Linda to pay up front for the first month's care. This will mean Joan can leave after the assessment, next Wednesday morning in an ambulance. Later we get another phone call... The ambulance can not cross into Oxfordshire. Joan is being discriminated against by a system that can not cope with people who live on county boundaries. The solution? An expensive one for Northamptonshire. Joan will be able to leave in a taxi and go the 24 miles to Wardington. With a carer. And possibly with one of us.
It is as if the Gods have devised systems that can not deliver what is most required: care for the person most in need.
I think I will blog this episode in Joan's life. Let us face it the blog is there for people to testify to those unwanted truths in our society.
Day 42
M from Wardington rings to say Stony Health Centre will not help her process Joan's care plan so Linda has to call Stony as power of attorney. D from Bucks CC rings to say she wants a side of A4 statement from Linda about Joan in the last 12 months. She says continuous care may be difficult to achieve.
The following day, Dorling is finally diagnosed with a broken neck and six days later she is dead.
Skellington's diary highlights how if there were more places available in local residential care homes for people like Dorling living with dementia, it is probable that her premature death could have been avoided. So the NHS does not appear to be the only villain in this tragic tale. How culpable is the social care system?
