Dementia difficulties

 

Social Work is a job where no 2 days are the same. However you definitely see a theme in terms of the types of cases we get.

Sometimes you can predict what will happen when you have barely begun because although people are individuals and have their own wishes, views and feelings certain aspects appear over and over again.

The geographic area that we cover means that a lot of the people we support are older people because of the locations we have. Other local teams get a lot more cases involving drugs and alcohol or additional needs. I see a lot of people on my caseload with either a Dementia diagnosis or suspected Dementia. When I had the opportunity to attend some training on Dementia this week I took it. It was split into 3 sessions, the first two were more what I am used to in terms of training. Here is the information, what are your views, how would you manage this situation etc. Whereas the third session was delivered by Palliative Care nurses and talked about End of Life and Dementia.

This was a topic I did not really have much awareness of and definitely not a lot of experience in. I have supported people who have Dementia who pass away but this session was talking about being there in the room and what you could do. It talks about signs that the end is almost here.

I found this quite triggering because of my own personal losses where I have either been present at the end or very near to it. It encouraged me to reflect on situations that I thought were long forgotten but also about how I felt in those situations and how the families of the people we support may be feeling.

Especially when someone has a diagnosis of Dementia because not only are they losing the person they love. They may have already grieved them once and learnt to love the new version of them who is now also slipping away. They could have held caring responsibilities for a long time and now they are also losing that part of their own identity. It is not as cut and dry as a loss of life.

It may also be that when the diagnosis is first received they do not know what to expect long term. Families don't always have the knowledge regarding Power of Attorney or Advanced statements. We may have to be the person to guide them through these things before the person deteriorates further. This can involve having some really tough conversations regarding how things will progress and thinking about that end stage a lot earlier than you might like.

The person themselves may have no idea what happens with Dementia so could struggle to put down their wishes and feelings for future planning because it is such an unknown entity. It is the same when it comes to moving people into care homes or Extra Care facilities because if you have never been to one you don't know what they are so how do we explain this to people in a way that allows them to make an informed decision.

There are a lot of extra bits that come into play when you are a Social Worker it is not just as simple as we help people. On occasion we are a shoulder to cry on for a struggling carer, we are a decision maker in cases where people lack capacity and in some people's eyes we hold all the power. We wear a lot of different hats regardless of our area of expertise and this is what makes the job trickier. We never know from one day to the next what hat we need to wear or sometimes from one minute to the next.