DEMENTIA CARE: PRESCRIPTION OUT OF STOCK.

What happens when something is out of stock? This isn’t always about pills. But it is almost always about prescriptions. When an item isn’t available, I’ll be told when the pharmacy phones to arrange the delivery.
   Or non-delivery.
   I was told an item was out of stock. They’d get a delivery to me some other time. The usual. Happens. When that delivery arrived, there was a receipt stapled to the bag telling me the item was not available.
   The item? A dietary supplement. This is added to milk, to provide a boost. The individual item is a sachet of powdered milkshake mix. And you get seven of those to a box and four boxes to the month if you have to take one milkshake a day.
   Not the case, here. Two a day. Eight boxes a month.
So. The item missing was a bulk delivery of 56 packets of food. This was strawberry powder, added to strawberry milk to create a double strawberry milkshake. By coincidence, the supermarket delivery of strawberry milk vanished into thin air, to be replaced by banana milk.
   Luckily, banana milk is acceptable. Doesn’t go great with strawberry powder. But there was no strawberry powder. So two failed deliveries led to a different food choice that was no choice – just handed out as a replacement.
   And the story was…out of stock. True for the supermarket, which would have quickly replenished stock. Not so true for the pharmacy. Yes, the milkshakes weren’t available. Technically, and only technically, they were out of stock.
   On to the next month, and another prescription. I could order the milkshakes, no problem. But they were gone. When the delivery phone call came through, I was told the entire line of milkshakes had been discontinued.
   I’d need to have a word with the dietician.
   Not as the weekend approached. I saved that one up for the next week. The prescription arrived, minus milkshakes. At least everything else was there. And so, to the phone. The milkshakes were gone. Oh no.
   The dietician would get back to me, to arrange the exact thing as a replacement. And the exact thing turned out to taste better than the earlier exact thing, according to the dietician. They do taste-tests in the office.
   I did a test once, with the frothy milkshake. It was okay. I don’t feel the need to test the new stuff. What to say about that? The new packets are stored horizontally in boxes rather than vertically. What does that mean?
   The box lid was rectangular before. Low. Now the new box has a square lid, and rises high. Luckily, the storage gadget on the kitchen counter still has the right shape of space to accommodate the new boxes.
   So. Nothing drastic. How is the frothy milkshake? Less frothy than the earlier version. More of a strawberry scent when you rip open the top of the sachet. It will do. As I type, I’ve mixed one up…but not handed it out.
   Waiting for the carers to come in and do their bit. Then, as they march out the door to the next place, I’ll see how the milkshake goes down. Literally. From the cup. Luckily, all of this was easy enough to arrange.
   What if it hadn’t been? Sometimes a change requires a walk around all the houses, all the departments, to get the thing done. And that is part of being a carer. Every tiny change can turn into a relentless slog through the mud to another field full of more mud.
   This problem was easy enough to see to a swift conclusion, once identified by the pharmacy. The dietician made sure that I had the essential phone number to call. And I made that call.
   There are harder calls to make. Stores. When calling stores, you are always prepared to call the other number for stores. There are at least two stores. And one of them sounds like the right place to call. But they don’t handle that item. The other place does that sort of work.
   One guy from stores arrived to remove a thing and I asked about another thing. He didn’t deal with that, but he could drop it off at a hospital for me. The system is only as good as its people. It is never better than its people. Often, you see that the people are far better than the system they are part of.
   There’s a third kind of stores-adjacent organisation I had to deal with. Just remembered that. Then there’s the unofficial place for stores. Here. A few times, care team members have asked if I have a spare this or a spare that.
   They know I have spares for almost every contingency. And so they borrow an item. I lend it knowing there’s no way to get it back, as it is consumable. But I act as stores, once in a wee while.
   I had no spares for the milkshakes. There was milk, and that’s the main thing. I do have spare milk. In the spare fridge. This is essential for someone on an all-milk diet. One fridge dies. The other goes on. Milk is split between the fridges.
   Glad I came here to write this blog. It is delivery day for the food. And, writing about milk…I realise I should be more organised in the distribution of the food. Last night I cleared the fridge of milk. Moved it to the other fridge, so the main fridge had space for the new milk coming in.
   Well, damn it, I have moved that milk too early. What if the other fridge broke down during the night? Need to keep a lid on that detail. One fridge has the temperature on a display on the outside. Both fridges contain portable thermometers. So I can check to see if they are okay, first thing in the morning.
   It was a thermometer check inside the old spare fridge that told me the old spare fridge had given up the ghost at some point in the night. The system worked. Luckily, I had milk in both fridges that day. Couldn’t trust the milk in the fridge that failed, of course. So it all went down the sink.
   Don’t know why I cleared one fridge of milk last night. Usually, I wait until the morning of delivery of the new stuff. Routine is routine, until it starts to drift. Well, it’s drifting back on course, now that I’ve written this blog.
   Routine also changes. Without milkshakes on the counter, I just poured regular milk. Made sure to use up that banana milk, so there’d be no awkward clash when the milkshake delivery resumed.
   And so, today, I returned to blender duty. Measure the milk in the drinking cup. There’s a handy scale down the side. Pour the milk into the blender. Add the powder. Shake a bit, just to destroy the large lumps. Blend. Pour some milk into the cup. Pulverise a few pills. Pour the pill powder into the drink. Add the rest of the milk. Pop the lid on and shake around to destroy any powdery pill clumps.
   Store in the fridge, until the carers arrive. This was the usual routine. And it went away. Now it has returned. No, it isn’t rocket science. But it takes a second to get back into the swing of it. I’m not reconstructing a golf game or returning to tennis. Just blending a whole load of stuff and getting ready for later on.
   As the frothy milkshake is now decidedly less frothy, it should be easier to drink. At some point, before, all that was left in the cup was froth. And that became tricky. Now, we’ll see.
   I don’t expect a violent refusal to drink the new flavour. The brand of milk is still the same, after all. And the idea of double strawberry is more appealing than strawberry milk plus the fairly neutral vanilla option that wasn’t appreciated, way back at the start.
   Is this all there is, to flavour? Strawberry? It’s a nice flavour. Banana is acceptable. Orange, on occasion. Vanilla, in the right mood. Chocolate is right out. And if the supermarket is out of stock on strawberry, the chocolate alternative is rejected. I have to hand that stuff back.
   Sure, I could keep it for myself if I felt in the mood. But I have so much coffee to drink, instead. Chocolate with coffee is one thing. Chocolate milk with coffee is definitely not a thing.
   Everything should now be in stock. But, as food is on the way…I am waiting for the delivery update telling me a few things aren’t there. As long as the strawberry milk is there, we are good for another week. If it isn’t there, I turn to the fridge for the spare supply. It would be funny to have the strawberry milkshakes today, but no strawberry milk to add to them. Except…it wouldn’t be funny at all. And that’s why I have a spare fridge.

DEMENTIA CARE: I PUT MY HAND TO THE DOOR.

Routine. You’d think routine, for a dementia carer, revolves around food. The selection and preparation of it. But there’s routine in everything. Why? Dementia is random, and so there can be no fixed routine.
   Your overall routine is to do what you do, and with a minimum of fuss. Call that a win. I get asked about Christmas and New Year. Now how did they go? Quietly. Nothing to report. In other words, no crisis, drama, fuss, apocalypse, or nonsense. A quiet time is a great thing.
   I minimise my risk. Whether that’s going to the bin or cooking a meal. The harshest event I faced recently was knocking a glass of coffee to the floor. I couldn’t save the coffee. But the glass was fine.
   If it hadn’t been okay, I’d have collected the fragments in a metal dustpan, and gloved up heavily to pick fragments out of the carpet. That’s not being prepared. Being prepared means having a spare coffee glass downstairs, ready to replace a broken one.
   I have two downstairs, just in case I am clumsy as fuck.
   Lately, I’ve revised my revision of the revised revisited revision of the rearranged revamped routine. Tired bedding went to the dump. That’s the only place for it.
   I stare at an item that I should have a spare for. Then I order that spare. Why didn’t I have a spare for that?
   This almost worked for me. The original was on the way out. And the spare died on me when I brought it in as a replacement. Some items face heavy use, and they won’t last.
   So I arranged another spare. Slightly different. And that isn’t satisfactory. Now it is the only thing that works. So it needs a spare. But…a different one. Not the same brand. And so, it is arranged.
   What else? I found a few receipts when I had a clearout. That takes me back to the pre-Covid days when people actually spent cash-money in shops. The item in question still works. It has a load of bits and pieces, and they haven’t lasted as long as the main unit.
   To prolong the life of this ancient blender, I’ve bought in spares. Blades. Rubber gaskets. They are the first to suffer. But I never replaced the conveniently-sized blender cup. Now’s the time. The original unit is trudging on to eternity, and may outlive the planet.
   But that cup blended its last frothy milkshake, and its time was up. The replacement package was made up of two cups. So I now have a new cup and a spare, automatically. They all fit, and everything is fine.
   Routine is about having spares for every fucking thing here. I looked around the kitchen. If that blender dies, there is a spare blender unit. It’s almost the same. The spare didn’t come with the same conveniently-sized blender cups. Different model. All the cups fit both units, though. And so…to my quest for the right size of spare bits and pieces.
   If something fails and you are screwed, what can you do? Improvise. Order a new thing. Wait for the thing. I can’t do that, rapidly, with a fridge/freezer. That’s why the kitchen has two fridge/freezers. This one-customer care home flies on two engines. The food supply must be kept cool. It is milk. And I have milk to spare, too.
   Should a fridge die overnight in summer heat, the care home flies on.
   It’s time to review fire extinguishers. They are regularly checked, it’s true. So are the fire alarms and the carbon monoxide alarms. The alarms I check every week, on Monday. That’s how I know it’s Monday.
   Carer routine means days of the week mean less to you. At the weekend, there’s almost no chance of being phoned by a clinic. That’s about it. The carers who come in are, mostly, on a four-day cycle. They don’t recognise days of the week, either.
   For them, they live by day one, day four, and the blur in the middle. My blur is daily. Since becoming a dementia carer, I’ve lived through one day of care many times. It’s a one-day week. There are fixed points. Monday. Fire alarms. Tuesday. Shopping. Saturday, order shopping in advance. Other days slide in and out.
   Only occasionally, do days of the week matter. Never get ill on a Friday. Avoid mechanical failures on the weekend. What did Christmas in July mean for me? It meant checking the winter salt supply. We’re covered.
   I restocked on batteries again. And I’m piling up used batteries that go to the place. I’ll take those into town with items for charity shops. Ditch unused medicine at the pharmacy. Town is a one-stop shop for many activities dealt with at the same time. No fucking about.
   You develop very specific routines. I put my hand to the door. Why? At night, when the care team leaves, I tidy a few things. Double-check. If a carer comes back in, she’ll come back within half a minute.
   That mini-routine of checking things reduces any chances of a collision. Then I go to the door and I put my hand there while I lock up. Maybe the carer is late coming back for something. She might rattle the door open and shout that she’s forgotten A THING.
   With my hand to the door, I save my face from the door as I go to lock up. I’ve never been caught out by this. But I am aware it could happen. Carers knock on entering, but not on re-entering. Now they are in a hurry, and need the pen, the coat, the car keys, the glasses, the head they left behind that wasn’t screwed on, so they tell me.
   That is why I put my hand to the door. In case they barrel in. I do that, having noticed their routine. Knock on a visit. But just run back in when remembering an item. No one has come close to bashing my face in with a door.
   This is how you view the world. Through routines. Yours. Theirs. No one’s. What happens if you don’t have a routine for an event? Make one up, in advance. That’s the hand to the door.
   Anticipate. Dodge a bullet. Twice in the past week I was asked about obscure things. I had instant solutions for both. Somehow, I’d anticipated these odd events. The first one was a straightforward purchase of supplies, just in case.
   And the second was off-the-wall. But I had a gadget for other purposes that we could apply here, and I helped the carers. The carers were done, and returned looking for help. That was a daytime thing, though, so I wasn’t near the door.
   No need to lock up. There’s an alarm on the door that tells me people have come in. As I was in the main caring room, doing a tidy, I could see what was happening in front of me. Could I help out? Did I have a thing to help out? No, I had just the thing, the exact thing, and it did the job.
   What can’t I prepare for? A light aircraft, hitting the building. Even then, if I survived the impact, I’d go to the fire-drill. Hit the streets within a minute. Phone for help after evacuating. And then call the Social Work department to arrange emergency accommodation that could cope with various aspects of dementia care.
   That’s as far as I could plan. I think it’s as far as anyone could plan.
   So do I have any recommendations for you? Have more towels than you need. When a towel gets into a knife-fight with the washing machine, and comes out half-dead, you send that towel to Towel Heaven. And the whole operation doesn’t skip a beat.
   That’s it. Have more ready and waiting. More than you need. For you will need more. And you’ll need that extra item on the wrong day of the week at an awkward time of night. It’ll be right there, waiting for you.
   Being a carer means never having to reach for a household item that has just run out. If a toothpaste tube is fresh-opened, there’s a second waiting. I switched to metal dishes so I can never break a dish when I drop it. Or…it would be damned hard to break a metal dish. Let’s go with that.
   Also…metal dishes are fucking great. Why don’t I switch to metal cups? They aren’t so great. I have tools to fix things on both floors. Saves time hunting around for tools in a crisis. There’s no spare microwave. If that breaks, I have other cooking gadgets in abundance.
   I made space for two fridges. But there is only room for one microwave in the kitchen. I don’t believe in cooking gadgets outside the kitchen. That just feels wrong.
   You have spares for everything…except when you don’t. If I ever need a spare appendix, I’ll let you know. In the meantime, at night, when locking up, I put my hand to the door. Why? I don’t have a spare jaw.

DEMENTIA CARE: A BIG FAN OF A BIG FAN.

Heat came and went. Then heat returned. I’d arranged a new fan. Big. Powerful. It would help, in the warm times. But how would it help? It’s been a nuisance to place…in the right place. The trouble with a damn good fan is that it will cool you down.
   Okay for you, for me, true. But for someone with limited mobility and almost no concentration, the fan becomes a problem. It’ll make the cared-for too cold. And it’ll dry you out. I can, and do, make adjustments. Eternal vigilance is the answer.
   But there’s a nervous atmosphere to leaving someone in a room with a fan working away. Let’s talk about the hot and the cold of it all.
   What is it like, in summer, in the house of an elderly person? From what the carers tell me about the service in general, really old people feel the cold far more. They reach for the heating in July. Using winter thermostat settings that haven’t been changed since some other century, since you were about to ask.
   On chilly September days, the carers tell me this place is quite cold. So it is. No heating. Extra layers instead. Save your heating money for the winter war. As the weeks grow colder in October, I fire up the atomic pile and prepare for a potential Ice Age.
   I should add that this is Scotland. Air-conditioning in summer? That’s called opening a window.
   I make sure the heating is very definitely off during the summer. If the cared-for needs warming up on a chill summer’s day, there are extra blankets that do the job just fine. This is the rule of chilly days in late spring, the whole of summer, and early autumn.
   No heat required. Just extra layers. Warmer clothing. More of it. Thicker blankets. More of them.
   And the flip-side? No cooling required, except now and again. The heat problem is unpredictable. As with all other matters, Scottish miserliness applies here. There is no justification for adding air-conditioning. On financial grounds, the financial grounds are shaky. There are drinks for cooling you down on that one roasting day of the year in Scotland.
   Air-conditioning? Our weather isn’t built for it. And our houses aren’t built for it. Hell, our windows aren’t built to take it. So we go for the cheaper approach, as our wallets aren’t built for it.
   I choose a fan that stands on a base, and occupies that one part of the room where no one will trip up over the equipment. Leaving someone alone in a room with a fan, there are a million considerations. I won’t list them all here. That would be rude. Here are a few…
   Every item of equipment is a tripping hazard. This includes all items of mobility equipment, as you’ll learn to your cost about five minutes after adding mobility equipment to your floorspace.
   A fan is a tripping hazard. It’s also a tipping hazard. You can’t place the fan in a zone that trips you up. But then you can’t put it within reach of the person who is stuck in the chair. What they can’t trip up over…they might still grab and tip.
   Then you’ll have a damaged fan, an increased tripping hazard to yourself as you walk in the room to find out what made that noise, a risk of electrical fault and fire, and so on.
   Okay. Now the fan is within reach of the socket. No, no, no, you don’t plug a fan into an extension cord. You are trying to limit the cabling on the floor.
   Where was I? You bought the big fan. It’s in the room. No one will trip up over it. And no one in a chair will reach out to grab the unit. Did you find a socket in reach? Yes. Okay. Now you are in business. Using two sockets.
   The primary socket places the fan nearer the person. And the alternative socket is much further away. Which to use?
   Depends on the heat in the room. If the heat is gradually building, you’ll need to use the alternative socket on the other side of the room. Keep the fan at a distance. Let it do its work in circulating the air. Not a big deal. At full blast, it affects the room, but doesn’t turn the cared-for to ice.
   But if the heat is building quickly or turns very warm after a slow build-up, you are on the primary socket space, with the fan much closer to the person you are trying to keep cool. Let the air circulate. Avoid creating a solid fixed cone of air.
   If the fan moves from side to side, use that function: never let the fan dwell on the person being cooled. The machine should do its job of moving from side to side.
   It’s out of the question to point the fan directly at the cared-for, switch it on, and return after twenty minutes to find a mummified husk in the chair. Fans dry you out.
   With the fan close, the strength of the machine can be turned down. The air is circulating nearby. You aren’t keeping ice in its solid form here. Just cooling a person.
   Some people find the sound of a fan soothing. Bless them, the fools. Yes, the fan has variable speed settings. This means it is quiet, noisy, or loud. For a woman with no real concentration, the fan isn’t interrupting anything else. Sad, but true.
   What about falling asleep? If she falls asleep in the chair, she falls asleep. No, no, no, the fan isn’t left on overnight to cover the bed. The only cooling machine that stays on overnight is the fridge-freezer.
   Even in the depths of winter, there’s nothing heating the house all night long through to the morning. Why the hell would you cool even a single room with a fan from dusk until dawn?
   Items stay powered overnight. Electricity is available. It powers the community alert box, the inflatable ripple mattress, the fridges and their connected freezers, the fire alarms, a gas and electricity monitor. That monitor powers down to some minimalist mode after a while…
   During winter, the heating is done for the night and there’s a retreat to warm blankets. There’d have to be mammoths roaming the streets to force the heating on all night long in winter.
   In summer, the sting of heat in the day fades as the sky very slowly darkens…and the fan stops. Consider everything when buying anything as a carer.
   I’ve considered where the fan sits and when. And I decide when to use it and for how long. I check in, periodically, to make sure all is well. If I need to check more carefully, I fire off the temperature gun and take a few readings on behalf of the cared-for…and for myself by way of comparison.
   Always revisit tripping hazards. Check active machines. Hell, check the ones you switched off. Double-check the ones you just bought. And triple-check the ones you bought a while back, to see if they are still useful.
   I have a harsh rule. If a cable is worn or frayed, it is done. Apply this rule, and you’ll live longer. There are no electrical cables leading into the bathroom. Something else that’ll help you live longer.
   But then, this is Scotland, and there are no electrical outlets in the toilets or bathrooms.

I took a break before finishing this blog post. Just wanted to see how the weather panned out. There were warm days that built heat gradually in the main room. The fan was off at first. Then, after firing off the temperature gun, I switched the fan on at the alternative socket, with the fan moving side to side.
   Easy circulation of air, from across the room. Blasting away. Another check-in, and another shooting with the temperature gun. All is well. This is working. Just go with that, for now.
   The day passes. Heat builds. Time to move the fan closer, using the primary socket. The air is still moving side to side. Aiming for the target. And the target is not the person. The person is off to the side.
   I’d cut the strength of the blast. Periodic check-up. Temperature gun. Shoot myself as well. We’re all good. I leave her to it. There are, after all, many other aspects of caring. And they go on in other rooms. Laundry is laundering. Pills arrive and I must sort them carefully.
   The cooling machine has a whole system of its own, set up by me. And it is on. Working away.
   Except…not today. A bump in the weather rolled in from the ocean, and we’re into one of those chill, wet, blustery, autumn days that will happen at any old time in June, July, and August. Rehearsals for September and October.
   Today, writing about keeping someone cool, I’ve arranged warmer clothes and thicker blankets. Well, there’s the Scottish summer for you.