Customer w/ ~Alzheimers/Dementia/NotADoctor

August 6, 2021 11:59 PM

UK question. I work in an unsupported essentially-solo public-facing position in a convenience store. I lost my closest family member around a year ago and the extended run-up involved vascular dementia. I have an older regular customer who is gradually succumbing to something similar (not a doctor). So far as I can tell, his support network consists entirely of a government-supplied care-assistant once a week/month, a young-ish neighbour who by good fortune alone is trustworthy to go purchase cigarettes and essentials with his card but can't/won't become more involved, plus somehow/logically myself - the part-time shop assistant in said nearby store. What do I do? He identifies me sometimes by name and sometimes by the name of his occasional helper. He asks me for help that I can't provide, despite my best efforts. I'm literally dying inside from the time I spent trying and failing to do the right thing to help my Mum. I want to help but I don't know what to do
posted by anonymous to Human Relations (8 answers total)

There are two things you can do.

Firstly, carry on being kind and helpful in the way you are now. This is the right thing to do and a familiar regular face is useful.

Secondly, report this to your local social services department as a “safeguarding concern” -

A. without knowing where you live I can’t provide the direct link but if you put your postcode in here. If two councils come up you want to go to the county council website.
B. Somewhere on the site there will be a link to report a concern - here is an example.
C. Complete the form for members of the the public. The category of concern you want is self neglect. It’s most helpful if you have the persons full name and address but even a partial address will help.
D. Describe the issues simply clearly and accurately, and identify what you are worried about - are you worried they aren’t eating properly, getting lost, at risk of financial exploitation?

This will trigger a safeguarding investigation - which means a social worker will visit the person, check with their GP, check with any care workers going into the house, and contact family if they can. If you put your details on the form (you don’t have to) they may contact you. You won’t know the results but it alerts social services to check up on someone.
posted by Gilgongo at 12:53 AM on August 7, 2021 [15 favorites]

This is a tricky and painful one. Thank you for helping, and caring about, this chap. I also have and have had family members with dementia, and I work on the edges of adult social care (not a SW, though family members are).

My first thought was a safeguarding referral too, but you haven't actually given any information which suggests the man is at risk. Do you think he is not eating / self-neglecting as Gilgongo suggests? You don't seem to think he is at risk of financial exploitation. It would be helpful to know what help he is asking you for. I have been in situations where family or family friends with dementia have asked me for things I can't provide (changes in living conditions / wanting to drive again / wanting to see dead family members / wanting more of my time) and it is incredibly upsetting but sometimes you have to accept that you can't help. He must already be on the SS radar if he has a carer coming in.

If you think he is lonely, you could try a referral to a befriending service (eg this one, though several other organisations run them). Whether they will accept referrals from people who are not family members may vary. If you have a local Men's Shed they may be able to help, though are often not set up to support really vulnerable people. Does he fall into any categories that might get him extra help? In my area this would apply to ex-Forces people but there may also be organisations for people from specific ethnic and religious groups.

Thanks again for caring about this man. My father has dementia and I would be pleased if someone were kind to him in shops - that can really make a difference to his mood. And I'm sorry about the echoes of your Mum's situation.

Feel free to get in touch via MeMail if you want to talk about this more.
posted by paduasoy at 1:21 AM on August 7, 2021 [2 favorites]

There may well be family who have "drifted" off but could be contacted to lay off some of the emotional burden. Living in NE England 35 years ago we were in the corner shop getting the Sunday paper when a distressed elderly gent came in looking for help for his brother. Shopkeeper was solo and busy, so we two random strangers went up the road to help. Brother had fallen the night before getting ready for bed, breaking an arm and Gent had waited all night to get help from someone he knew. They were both vehemently against calling an ambulance because "hospital" would be The End. Brother was severely dehydrated, so we made tea for everyone and tried to persuade Gent that a) more than a cuppa was needed b) some sort of medical help would be A Good Thing. Eventually he came round to that idea. The reviving power of that tea was miraculous. The first thing the paramedic did was cut the arm of the Brother's tweed jacket which was competent but not empathic. Turned out that the Brother had a son, a dentist, who lived in the posh suburb out West. What Gilgongo sounds great: [distant] family may not be aware of the issues.
Thank you so much for caring!
posted by BobTheScientist at 1:21 AM on August 7, 2021 [2 favorites]

I am a doctor but obviously not yours or this gentleman’s. Were I in your shoes, I would file the safeguarding concern as described above. He needs help and better services.
posted by ocherdraco at 5:45 AM on August 7, 2021 [1 favorite]

Is there an govt aging council? In my city in the US there is a Corporation for Aging that can assess people to be set up for more frequent home care services, do wellness checks, etc. There are also non profits that provide social services for the aging with hotlines you can call. I guess that's similar to what people are suggesting above.
posted by bearette at 6:14 AM on August 7, 2021

I will say though that if he has a government supplied occasional care worker that means he's already been assessed and is in contact with social services. Social services are mightily strapped for cash and it's often shocking for lay people to see what meagre care is provided.

There are, sometimes and in some places, voluntary organisations and churches that try to fill in the gaps. There are also established charities. If you have the bandwidth right now to research what's available, and you feel it would be helpful to him to try to put him in touch with such, a place to start would be the nearest local library. Librarians are knowledgable, often local and also, libraries are where voluntary organisations leave leaflets. But this is an area where you'd need both guidance and a lot of caution before you were confident in either recommending him to an org or an org to him: like, not just a random church that SAYS they support old people, but an organisation with a known history and track record. Please don't feel bad if you haven't got the bandwidth to research any of this. You are by no means the only person to be in contact with this man, some of whom do have legal, and paid for, responsibility for his wellbeing.

I'm sorry I don't know much at all about age-related uk charities and while there are directories (Charity Choice, elderly care and welfare) the info is probably too general to be useful for these circumstances. However in these days of Austerity Britain I have known of people in need getting real, practical, valuable, life-changing help from voluntary and/or church-based organisations. It's also my experience that personal face-to-face enquiries get a person much further, quicker, than online enquiries.

So I seriously recommend the Ask a Librarian strategy. If you feel able to go a bit further, sometimes Citizen's Advice Bureaus have regular drop-ins and they should have good advice of where a person such as your customer might get formal AND informal support.

To sum up what i'm saying, it's likely this man is already under the care of social services; and voluntary organisations, charities and churches are more likely to be able to give him additional support than the state.

Good luck, and take it easy, and look after yourself. You cannot fix the world. I don't know anyone who looked after a parent at the end of life who doesn't have a lot of residual guilt and regret. It's not because the wrong things were done: the fact that life is ending CANNOT BE FIXED. Try not to let feelings about your relative come back to haunt you through your encounter with this vulnerable customer. Not to be glib, but talk therapy can help, and I believe there's extra funding for it floating about at the moment due to all the trauma from Covid and lockdown; perhaps a gp can get something happening? I mean for you personally, because covid has meant proper trauma for some, and if a relative died during this, the trauma is very much compounded and hard to deal with.
posted by glasseyes at 7:25 AM on August 7, 2021 [2 favorites]

it is incredibly upsetting but sometimes you have to accept that you can't help. He must already be on the SS radar if he has a carer coming in.
I would like to emphasize this from paduasoy above.
posted by glasseyes at 7:35 AM on August 7, 2021

You are a kind and thoughtful person to be worrying about him. I am glad you are asking for help.

It may be that he misremembers your name because he has nobody to talk to regularly and so gets confused. My grandad called me by my mum's name pretty much every time I saw him from when I was a kid.

He probably needs a bit more mental stimulation and human interaction. It's great that you chat to him a little bit and engage with him. It could be that he just wants to pass the time of day with someone and see a friendly face -- are you OK just shooting the breeze about the weather and things like that for a few minutes?

I have been visiting three older people in my part of SE London since the second lockdown. One of them clearly has dementia that has been exarcerbated by having nobody to talk to all day long, and he wasn't remembering to eat regularly either. He had a fall recently and is now in hospital, which ironically and heartbreakingly is a great improvement because he is getting fed and having lots of attention -- but I fear for him when they discharge him back home.

Age Concern runs a telephone and in-person befriending service -- I would also check in with them.

You could also talk to your local librarians -- mine took on telephone befriending during the first lockdown, and they were dropping off books and shopping as well, so there's a chance this man is on someone's radar. There will be local community and church groups doing outreach and dropoff too, even if he isn't the same faith (or no faith) as them. The Irish community centre and the Islamic centre near me are providing hot meals, for example.

It's very likely that if you talk to a librarian they will be able to do something, even if it's just to get him someone to be a telephone befriender at first, and they can also find out who his GP is to make sure someone is aware that he is not coping.

One last caveat: He may have refused a higher level of care (in-home help) if offered it because it can be expensive; that's what my older friend did, even though he has the money for it. This chap may not be well enough to understand that he needs the care, but unfortunately social services will take him at his word and not do anything.
posted by Orkney Vole at 8:51 AM on August 7, 2021 [1 favorite]