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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