This week’s writer is a social worker in a local
authority’s old age psychiatry team.

MONDAY I spend the day attempting to fax a
referral to the disability team for an occupational therapist to
carry out a bath assessment. The disability team insist I send them
my comprehensive assessment along with a completed referral form.
As there are no computers in the office I have to fax it. The fax
line is my direct line and every time I try to send the first page
the telephone rings. I try to photocopy my assessment, but the
photocopier is broken. I give up and decide to put it in the

TUESDAY A carers organisation calls and informs
me a carer I referred to them five months ago is now receiving a
three-hour sitting service so she can leave her husband, who has
Alzheimer’s, at home. In the afternoon I visit a woman who
has advanced dementia. She has been on the phone for most of the
morning confused about who she is and why she called me. When I get
to her house she is anxious and asks me if I can help go through
her pile of post. Some of the letters date to February 1999. Most
are from catalogue companies. As the pile of post diminishes she
relaxes. She asks if we can drive to the beach. Back at the office,
I make a referral to the Age Concern befriending service for

WEDNESDAY Carry out a joint visit this morning
with Care & Repair, the charity for older and disabled people.
This is a follow-up visit from last week. The client’s home
has no smoke alarm, the back kitchen window is smashed and the
front door lock broken. This is an important visit as the client
drinks heavily most evenings and usually falls asleep in his
armchair in front of his fire, holding a bottle of whisky.

THURSDAY I reassess a client who lives in a
residential home. He keeps wandering off on his own on to a busy
road and at night goes into other residents’ rooms and
attempts to get into their beds, believing they are his own. The
home manager involves his GP and community practice nurse in case
there are any underlying reasons for this recent behaviour. The
client has early dementia and is becoming increasingly disoriented.
He’ll have to move to a more secure home with a higher ratio
of staff to give him more attention.

FRIDAY Visit a family who live on a farm. I
park my car on the road as it is likely to get stuck on the muddy
track leading to the house. The main carer, the family’s
daughter, was admitted to hospital on Wednesday with breast cancer.
The two grown-up sons at home are unable to care for their father
and the mother needs nursing care. Explain to the father, who has
Alzheimer’s, the risks if he stays at home. He has no insight
into his capabilities and is offended when I advise a short stay in
a residential home. After much persuasion he agrees and I pack a
bag of clothes for him.

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