Diary: ‘There are significant hoarding issues and a risk of things stalling’

Monday

I spend the first part of the morning making appointments and organising my diary for the rest of the week, before heading off to a local welfare association to collect clothing, bedding and towels for an older couple. During a visit last Friday, I found out that they are restricting how often they change their clothes and use the washing machine because of a lack of spares and concerns about bills.

I drop off the bulging bag of items and they seem both pleased and overwhelmed. It is positive for me to feel I have been able to achieve something for them so quickly, while the longer-term casework will continue. In the afternoon, I call into a nursing home to update the assessment for an older man with dementia who has been living there for just over three months. After a positive start, he has been more unsettled recently and his behaviour more difficult to manage. Staff seem to be doing their best to find ways of working with his preferred routine and I am hopeful it will reach an equilibrium again soon.

Tuesday

My plan to get in early is thwarted by a restless night worrying about a lack of available provision to support a complex young man with challenging needs. I start the day with a long phone call with an older woman I am joint working with an OT colleague. There are significant hoarding issues and after initial progress, it feels like there is a danger of the situation stalling. It is a difficult balance to engage creatively with her at her pace, while also mitigating the immediate risks.

I complete a nursing home review for an older man with learning disabilities where his friends had raised concerns. It seems to be more a breakdown in communication than inappropriate care, and I do my best to facilitate discussion and encourage ongoing contact. I end the day visiting a client where there are longstanding issues with the housing provider being obstructive, and I am once again frustrated by them creating unnecessary barriers and the impact it is having on both the client and his family.

Wednesday

My visits today seem to have a similar theme of single, older men and resolving issues with their money. I enjoy and take a lot of pride in supporting people to maintain their financial independence and get their affairs in order, which is just as well because unfortunately financial exploitation seems all too prevalent. Two clients in particular have previously had their good nature taken advantage of, and I am glad that both seem to be growing in confidence and measures are now in place to reduce the risk of this happening again.

I snatch a quick, late lunchbreak and am then thankful for an afternoon in the office to catch up on emails, letters and phone calls, although the housing provider from yesterday remains elusive and I suspect that the end of that tale is certainly not in sight.

Thursday

I have a welcome quiet hour to tie up some odds and ends before heading into supervision. As usual, I find it supportive and reflective and it helps to get my head in order. More money talk at my next visit but for an older woman this time. I had intended just to pop in to see how she was doing following recent intensive support to get her finances in order and clear various large debts, but the visit reveals another outstanding bill. This causes her considerable concern but some quick negotiation gets a plan in place.

After lunch I catch up with the student I am supporting in her final placement to review her cases and discuss her work plan for the coming week. She seems to be progressing well and despite the additional work involved, overall I am finding it motivating for me to see her develop. I then set off to see a client I have recently been allocated. Their care provider is changing which has led to some unsettlement and I complete a joint visit with one of the managers from the new service. It seems to allay the client’s immediate anxieties and I hope that the changeover goes smoothly without too many teething difficulties on either side.

Friday

I squeeze in a review first thing for an older man with high support needs and arrive just on time for a planning meeting to discuss the young chap whose situation has been the cause of earlier sleeplessness. There seems to be some positive commitment to bespoke service design, but I have had my hopes raised too many times before to feel overly optimistic and I am concerned about the impact on the client if options are presented which then fall through.

I complete a joint visit with a community psychiatric nurse to a chaotic older couple in the absence of their usual worker. Thankfully the situation seems more contained than anticipated and I don’t come away with a long list of urgent actions. I barely stop to eat before throwing myself in to a few hours of frantic calls, emails and case recording. It is my last day before a week’s annual leave and as usual, all sorts of situations seem to be arising. I am usually a stickler for leaving work on time and my determination pays off as with relief I reset my voicemail, activate my out-of-office email and head off as the clock chimes. Here is to some rest and relaxation!