DEMENTIA CARE: MAINTENANCE NEVER STOPS, TRUE.

Many systems tick along without needing much assistance. You can go so long before something breaks that you don’t recall a time when that something broke before. Twice within a week, two door handles flew off. I had to research the name of the bit that was causing the problem, so I’d know what to order in as a fix.
   My quick temporary fix was to swap downstairs doorhandles with upstairs ones that are used less often - and to leave those upstairs doors ajar. That way, the downstairs carers could still use the toilet without screaming for help inside an accidentally locked room.
   They’d have been fine. It is almost impossible to stay locked inside the toilet. The handle that pulls away, with no hope left, is on the outside. Inside, if the handle does pull away, ouch, it carries the spindle with it. And you can insert the spindle to turn the handle on your side, no problem.
   Spindle. One of the words I learned. The term I was looking for was grub screw. It is a type of bolt. These bolts go into the handle and rest flush with it so that you don’t tear your fingers apart on a raised thread. Looking at the failed handles, I learned that the grub screws had long stalks on them.
   A very old design. The stalk, whatever its official name is, provides a barrier that, when fixed in place, holds the handle to the spindle. With time, this very old design simply shears off through metal fatigue. We’re talking about a house that still has the original handles from the day the place was ready to inhabit.
   Design has moved on. Grub screws have a raised area instead of a long stalk. The fix is to remove the broken piece and fit a new one. I had to buy in. The internet offered many cheap solutions. And a few expensive ones that covered selections. I didn’t want selections.
   So I measured very precisely, and learned that I would get by on a 5 mm grub screw. I counted the doors. They’d all need fixing at some point, if these old bolts were starting to go within days of each other. Count the doors. Double the number of bolts required. Order a packet of those. Hope that my measuring was true.
   Did I need a selection box of grub screws of many different sizes and lengths? No. These specialised bolts are pretty much there for use in door handles. I have no other conceivable use for them. Thinking hard about that. No. There’s nothing in the house that could do with a fix involving a grub screw bolt. Just the door handles.
   Recognise the faulty or broken part. Arrange a replacement. Buy in. Wait. Then start changing all the old bits over. There were a few problems. In the door to my immediate left, part of the door handle mechanism is jammed. Even with the old grub screw removed, the handle won’t come off.
   I know why. It’s a spindle problem. And there’s very little I can do about that. I added the new grub screw anyway. With time, the new grub screws will work loose, and handles will fly off again. But the screws themselves shouldn’t be worn away or cracked.
   See a broken thing. Fix a broken thing. Or have someone come in and fix a broken thing. Replace a thing with a spare or buy a replacement. These old grub screws did their job decade after decade. I never game them much thought. Suddenly I had to give them thought.
   Replacing the door handles entirely was going to be a whole production. Identifying the tiny thing that needed fixing. That was a lot easier. I started with descriptions. Describe the thing in a door handle that holds the door handle on. Okay, hit the search engine. Right. These are grub screws. They are bolts. You need a bunch of these in a packet.
   They are cheap. What does the Amazon listing say? Item is often returned. Unsuitable. Reviews? This didn’t fit. Measure, measure, measure. The delivery came about an hour before the next shift of carers arrived. I resolved to remove my temporary fix of the toilet door and put in a long-lasting one.
   Building up a routine, I managed to work my way around most of the house before breaking away to deal with carers. See a problem. Fix a problem. The last big maintenance thing was the valve regulating the hot water, and a heating engineer dealt with that.
   Not long after, it was time for annual heating maintenance. That engineer told me the old valve was replaced by a new design of valve that doesn’t develop the same fault as often. Confidentially, there was a flaw in the old design. You go ages without fixing a thing and then must fix all the things.
   Maintenance never stops. True of any household. But there’s a focus on fixing things ahead of being fixed – having spares – in a house where you are caring for someone. I’m almost always ahead of the game. In the case of a gas heating problem, I can take steps, annually, to reduce the prospect of trouble. But that’s an area you generally leave to the professionals.
   Next. More professional stuff. Bathroom repairs. I managed a repair to the toilet downstairs without too much difficulty. Always on the lookout for trivial things. Stop them at the trivial stage. Tighten those taps. Or loosen them just a bit. Whatever you can do that you have to do, do that.
   But the bathroom needs a fix to an extractor fan. And the shower demands a replacement part that I don’t keep in stock. That’ll be for the bathroom repair guy to deal with.
   Things in the house that need moved to one side and back again, tightened, loosened, cleaned, moved right across a room to a new position, checked, or even replaced…you can’t let any of those items slide. I switched to my spare electric toothbrush. The regular one was done. Yes, I can go to a manual backup. But once I’ve owned an electric toothbrush for an age, it’s time to bring a new one in – just in advance of the day of replacement.
   Maintenance really is all about spares. Have them. Arrange them. Hold the fort together while a delivery arrives. Yes, there are gaps in your routine. I never thought to have replacement grub screws on standby. That’s right. I couldn’t name them to start with. Well, now I know. And I have a few spares there, just in case. Fix the thing early if you can. Use the best type of fix. I had all sorts of tools for fixing the old washing machine. My fixes kept it going until the new washing machine arrived. Job done.
   I’ve talked about fixes before. And I’ll do so again. Sometimes maintenance is about fixing a problem and not a device. Just glancing around the main caring room, I found it difficult to read the time on the clock. It’s about angle, position, the nature of the clock itself.
   Not a clock to replace. It’s one of those picture deals. Photos around it. These provide memories. Talking points for the carers. Also, it still works. It’s fine when I’m in the other half of the room, nearer the bed. But when I sit on a stool next to the chair, to dish out meals, the time spent can be important. I need the time at a glance.
   Why don’t I wear a watch? It would catch on so many things, as a carer. I have time on my phone, in a pouch at my hip. But my hands are full. Time at a glance. Maintenance meant buying a calendar style clock with bold numbers, easy to read across the room with a shift of the eyes.
   This is why maintenance never stops. You solve problems. The room looks super-organised. Yes, it is. And that’s based on all the problems I had to fix over many years as a carer. I have a toolbox upstairs and another downstairs, so that I don’t need to change floors to reach for tools. That has saved me from all sorts of trouble, so many times.
   Obviously, as a wintry spring howls around the walls, there’s garden maintenance. But I tend to think of that as gardening. The weed war started just the other day. I won the first battle. And I’ll win all the rest of those battles, too. I hate seeing a weed, annoying me by its mere existence. And I get that feeling when something unbreakable suddenly unaccountably breaks.
   But for those moments, there are spares. Or spares on the internet. And I get by. Writing this blog post is now done using spares. I could no longer preview the post before publishing. So I had to switch to a spare browser, where that is still possible. Carer blog. So. Carer-related maintenance of a sort.

 

DEMENTIA CARE: WAITING FOR AN ENGINEER.

I’d have blogged a week ago, but I was waiting for an engineer. With one thing to talk about, lined up for this talk, this written talk, I was forced to wait. Yes, I could’ve written anyway and left the end of the story dangling off a cliff for another month. Wasn’t worth the drama.
   This is the story of hot water. Not the heating. Just the heating of the water. Unexpected frost rolled in for a few days, and so the Scottish weather was cauld. The sun came out, true, but there was no warmth in that. Heating? It heated.
   With elderly care there are two problems. One is heating the house in winter. Please heat the house in winter. The other problem is heating the house in summer. Please don’t heat the house in summer.
   The water began to act unpredictably. Slow to heat up. It turned lukewarm. There was a sudden burst of heat. Back to lukewarm. This wasn’t the end of the world. If you are a bath person, yes, okay, I see your point. It is the end of the world. Luckily, I am a shower person and the shower is on its own electric circuit. Nothing to do with the gas. That’s the whole point of the shower system. If your hot water goes, you still have hot water.
   As for elderly care, you must be careful with warm water and super-sensitive skin. Lukewarm water with a burst of heat to it is adequate. Failing that, there is always the one-cup kettle that does you sub-boiling water in 30 seconds flat. Throw a few cups into the basin and mix with cool water and you are good to go.
   In other words, yes, you’ll get by until the heating engineer arrives.
   I haven’t had to call a heating engineer in so long that the experience has changed. Or has it? I was warned by the automated recording that my call may be handled by Artificial Intelligence. Okay. How is that going to work? I’m not sure. Either the person on the other end of the phone was a school-leaver nervous in the job and sticking to the script like glue…or someone created an Artificially Intelligent voice sounding like that.
   Was the guy wooden? I’m not saying he was wooden, but if you nudged him he’d rock back and forth like a painted horse. Was the guy an Artificially Intelligent Scotsman? (Here, we usually call those POLITICIANS.) I couldn’t very well ask him.
   Are you for real?
   The thing is, he pretty much sounded artificial. One of the giveaways is mispronouncing Scottish things. So I was 99% sure he wasn’t real. Though one of the carers who comes in…she mispronounces Scottish things. There are entire sections of the map with place-names that would fit inside The Lord of the Rings and no one would notice. None now live, who remember how to pronounce it.
   You have to treat these artificial chat bots as real people. They are responding to you, after all. So any gap in the conversation is a gap you have to fill with detail so you can prompt the next response, working your way down the list of problems until you reach the confirmation of an engineer being sent out.
   Before all that, you’ve already spoken to a real person who asks about the problem and they put you through to the robot: presumably already set up to deal with the thing you told the living human being. The difference between the real person and the robot one is still a difference. Give it a year and I’ll have a robot of my own, phoning the problem in to the robot on the other end of the line.
   The upshot was…an engineer. Twelve hours later, thanks to priority service, the engineer arrived. It was the valve. I would notice this in summer, as the hot water wouldn’t work but my heating would suddenly come on. With a new valve in place, hot water would return to being consistent.
   He didn’t have a valve with him. But he could order one for the next week. We’d get by. Thank you, electric shower and thank you to the one-cup kettle. Also, thank you to the lukewarm water we could still receive. And so, almost a week went by…
   We survived. Then the next engineer turned up, waved a box at me, and went to fix the problem. He reappeared almost instantly, declaring that the wrong part was ordered. Well. I didn’t have anything to say to that. Fortunately for everyone concerned he had one in the van. He went to the van. There, he retrieved another very similar box.
   The carers were coming in as he worked away, so I used the one-cup kettle for the basin. We were all fine. By the time he left, consistent warm water was restored.
   But that isn’t the story. I thought about the loss of heating itself with the frost all around us. The worst thing is to notice that in the morning. And you’ll realise quickly. Telephone the hotline. Talk to a real person. Transfer to a robot. Book the appointment. And then…
   Wait…
   And wait.
   Now the heating thing is different. You should get priority for elderly care and it is worth mentioning to the human you speak to initially. Sometimes the engineers are just slammed. They’ll get to you when they get to you. And I have plenty of throws and duvets and warmer clothes for emergencies.
   But I don’t fancy waiting half a day for a fix with frost on the ground. If the worst came to the worst, I could move furniture around to create a space in front of the ornament.
   The ornament is a fireplace. It works. But it was only ever meant to be ornamental. As it wasn’t used, and remains unplugged, I rearranged the furniture to get the best use out of the room. It is the main caring room, aside from the kitchen.
   The heating itself hasn’t had a breakdown since…I think a circuit board went. That or the pump. It’s rare. They take care of these things during annual maintenance. But you don’t want to be caught short. Not going into winter, in the midst of winter, or heading out the other side of winter into a spring that’s never quite sure what it is.
   And I remember, one time, when it was clear that the spare part wouldn’t be ready until the next day. So the engineer left loads of tiny electrical heaters to protect the main room. And there were throws, duvets, and heavy clothing to see us through.
   You can always heat the kitchen using the oven, wasteful as that is, in an emergency.
   The thinking was…I really don’t want to be caught short for twelve hours or until the next day. This is unlikely to happen, but look at what just happened there. And that was for the water. Not for the main heating. With that in mind, I ordered what looks like a portable electrical radiator. Just to see what that’s like.
   It works. You can’t dry clothes on it for safety reasons, but it works. I delayed writing this until the engineer came and went. Okay, he came and went to the van and came back again and then went away. I had a spare radiator before he arrived. With the radiator checked out, I’ve ordered a second one. But there’s no need to wait to blog about the arrival.
   Two should be enough for emergencies. I may order in a third…purely based on the notion that I have room in storage for a third one. After that, I would run out of room. It is awkward buying them in as spring arrives. But this is Scotland, and spring arrives on the stage like a shy ballerina who doesn’t know if that’s her chosen calling. She sees the company dotted around the seats, as this is a rehearsal. And then she runs away.
   The heating stays on through most of March, so I’d better have spare heating now. Depending on how awful April is, the heating may be on through a fair chunk of April. Anyway. If I buy the portable radiators in now, we are all set for trouble in the next winter. And that’s the main thing.
   Our heating is so reliable that the only thing it can do is work reliably or fail horribly at the worst possible time. And I don’t really think I was prepared for failure in the depths of winter. If we have to go half a day, another day, before an engineer gets to us…we should have more of a plan than dusting off a disused fireplace. Those things smell of dust when you fire them up, telling you how long ago it was that you briefly used them.
   I remember laughter when the offer of insurance was made. No, it is just an ornament. It’s been switched on to see if the bloody thing works. That is just as true of the new portable radiator. But I won’t be moving furniture around to activate it. I’ll be moving it around the furniture instead, which is far more preferable.

 

DEMENTIA CARE: SWAMPED BY TINY DETAILS AGAIN.

Maybe it is just the time of year. Nothing slows down like February. My best efforts place me in front of a keyboard. But I end up keyboarding other things, and not this blog post. I can go deep into the month before making it to this place for blogging purposes.
   I am here, seeing to tiny details. They are the details that’ll overwhelm you. Not the big things. The big thing staggers into view, or earshot, and you just fucking deal with it.
   Tiny details. Death by a thousand foil cuts. I don’t take foil cuts any longer. The pill-popper gadget protects my thumbs from the assassin’s blade. Or from the ludicrously sharp layer of metal that holds pills in place.
   I jump on a tiny detail. The pill crusher. It is electric. There’s a spare. Also electric. And there’s a spare for that. Manual. But I see a detail, and I pounce. You throw the pills into the plastic cup thingy that screws onto the engine.
   You fire up the engine and crush the pills. Then the pills, powdered, fall like snowflakes into the drink. I pour more drink in and swirl the mixture around. The real trick is to do this without creating lumps in the milk. The mug is plastic, and capped, so the drink won’t spill. You can’t have lumps in there, clogging the exit. Over the course of a year, the nature of the pills might change once or twice.
   We are taking about the same pills in the same dosage. But the texture is altered. Then you might have an easier time of it crushing the pills. (The same is true of blending powdered milkshakes into the milk. A change in manufacturer made blending more easy.)
   The tiny detail is in the daily grind: literally. I overlooked particles of medicine left in the crusher receptacles. I use the pill holder and the other holder from the spare, creating a conveyor-belt of crushing.
   Putting fresh pills in this morning, I saw the residue had built up. So I removed the pills, thumped the holder on the counter, and poured the loose dust down the drain. In that way, seeing to small details, paying attention to small things, I avoided creating a tiny overdose.
   But it reminds me that I need to keep finding better ways to handle things. Stay on top of the small detail at every turn. Supermarket sponges, for bathing, were good. Then they became tiny, and no use for carer purposes.
   So when it was time to replace the sponges, as I do regularly, I’d run out of decent sponges. I ran away from the supermarket to join the internet, and bought a load of sponges in. The detail here was from the carers.
   They like to use two sponges, preferably different colours, and of different sizes. Basically, this boils down to one sponge for the face and one sponge not for the face. I mixed and matched sponge offers, deals, quality of material, type, size, colour, discounts, and within the week all of the sponge problems were solved.
   Going from room to room as a carer, you check the electrics. And I noticed that extension cords, which are useful if looked after, were all different. They’d been added gradually, over time. Electrical requirements change.
   Is it ideal to have a hospital-style bed plugged into an extension cord? No. But the cord provides a different degree of safety. It takes the cable under the bed to a locale where the carers don’t walk. This removes a tripping hazard.
   Yes, it is far easier to plug the bed into the nearest socket. But that socket is placed at the worst location. It’s where one carer goes to and fro, making many adjustments, and there’s no way to avoid tripping over the wire, there.
   I really started looking at the extension cords. Uniformly different. Some had surge protection. Others had no such luxury. Length of cable was wildly out of any kind of tune. Number of sockets available. Also random.
   Tiny details. What to do? I replaced them all. Everything was upgraded to surge protection, with an added safety switch, and individual switches. Coloured ones, for at-a-glance reference. This is all trivial. But when you ask yourself, of the oldest-looking cable, how long has that been here? What is the maximum load? I guess it said on the cable label, but the cable label dried up and blew away in the wind.
   Time for change. At one swift drop of the sword, I cut the old cables away. Don’t cut electrical cables with a sword. That’s a hot tip. Which is what your sword will end up with, if you go cutting live wires.
   Everything is shiny and new again. And restructured. Extension cords are not in danger of overload. The bed might be on an extension, but the electric mattress isn’t. Separate feed. Luckily, it is long enough to take the same quiet path away from the carers. Has its own socket, right there on the wall. Secure as can be.
   I upgraded nail clippers. I guess this all goes back to the start, and taking control of someone’s life. You can’t take control of someone’s life when you take control of someone’s life. Leave things for them to do.
   But do take over.
   I was forced to reorganise the pills. Then I was forced to reorganise them all over again. I took charge of ordering prescriptions. Something I’d helped with, unofficially. That’s how this starts. You are an unofficial carer for a time.
   In my case, two years. After two years, I was a fairly official unofficial carer. Just signed on the dotted line and made it legal. The thing I think back on is the towels. All white. Clean. Easy to see when they get dirty, you’d hope.
   But are these white towels cycling through. Or is someone’s dementia addling the process? I took over. All I did was arrange for new towels. Different colours. At a glance, on a daily basis, whether you lived in the house as a carer or not…you could walk in and use your memory of the towels to match up to the routine of cleaning them.
   That’s the way it went. I varied the routine of this thing, that thing, off the back of tiny detail. Towel colour. A system that worked. Just vary the details. Adapt to each system and mini-system or micro-system in the house.
   A colourful remnant of the early days? The breakfast tray. I’ve only just retired that, and replaced it with something sturdier. Safer. Oh, the original tray was safe enough. But wearing out, I knew it had to go. Replacing nail clippers, a few towels, electrical extensions, well, I just added the tray to the list of recent alterations.
   I need to replace that thing soon.
   When is soon?
   If not now, when? Within the month? Yes. Within the month. And that plan saw the end of the old sponges. There were no handy sponges in the pile of replacements. So I changed a detail or two, and now I have spares for spares.
   Soon enough, it’ll be time to restock plasters, bandages, dressings, and other handy items for use in a sudden mini-crisis. At least I can use those as well. The anti-spill drinking mugs are not for me. I freshened those up recently.
   Running a household is one thing. And running a household as a carer for a client of one…that’s many things. The same things, only more so. Everything in life, but with a little bit extra. I cleared out a few light bulbs that clearly only fit lamps that are no longer here.
   This does not make me sound as though I am on top of the detail. Hidden truth: no one is on top of the detail. We are on top of as much of the detail as we can spot, on any given day. Night changes everything. You come in for the start of morning routine and you see a thing. It can wreck your day. So you jump on that immediately. And hope there’s a spare.
   Details extend to the street. It’s the calendar on the fridge, and the fridge magnets moving around, telling me which bin goes out that week. I walk to the street and check to my left for the bin that always goes out super-early, just to confirm I haven’t messed things up.
   But the detail is there for me, at the bins. All I need do is check the level of the bin. If the recyclable bottles are at the brim, then I’m pretty certain that’s the bin that goes out. A failed bin collection would ruin me for a week. But there’s a hotline to call. And you’d leave the bin out for another day, knowing the service has been delayed for some reason. They’ll get to you.
   Blogging is not a priority. But the tiny detail nagged at me. Two weeks in, fixing a million things, blogging can wait. And it could. In another two weeks. The blogging cycle starts again. I’ll have demolished a cardboard mountain by then, I hope.