A day in the life of a dementia home carer

What really happens on a day visit?

Katie Smith* became an at home carer in 2003 after caring for her dad at the end of his life.  She works for a local provider that supplies specialist dementia care.

Every visit that Katie does is different, depending on the needs and wishes of her clients. Here she describes her visit to John*, who was diagnosed with Alzheimer’s five years ago. Katie spends around two to four hours a week with him.

 “A typical home care visit starts with me greeting my client, John*, and assessing where he is today, whether he recognises me or whether it’s time to introduce myself again. This is all done very gently and subtly, so that it doesn’t distress him and he doesn’t feel pressured or awkward. My visits are to give Margaret*, his wife, a bit of respite and support. She withdraws gradually to another room, when she knows he’s relaxed and focussed on me.  I already know from my visits before and my detailed notes that he loves to watch the birds in the garden and likes two sugars in his tea, so that’s what we settle down to do first. He can’t quite recall my name, so I pretend I can’t quite remember his and we reintroduce ourselves but, today is a good memory day, he knows he’s seen me before and that we both like custard creams.

After chatting for a bit about how rude the blue tits are, not waiting their turn on the bird table, we decide that the garden could do with a bit of weeding. Margaret has left the key out so I can find the tools in the shed. John is a bit wobbly on his feet, so I guide him gently outside and he digs about in the raised wooden bed that Margaret has set up for him. He delights in finding worms and creepy crawlies and is very happy just turning over the soil for a while. Lunch is an egg sandwich, which I put on a bright orange plate so he can see the white bread easily. Margaret has popped out for a walk and to do some shopping. John wants to know where she is. I tell John she’s shopping and he laughs, rolling his eyes and saying she’s always shopping! He’s a bit agitated though that she’s gone so I suggest we watch a bit of television. There’s a re-run of Blue Planet and John loves David Attenborough. It holds his attention for 15 minutes or so, then he dozes for a bit, and I do some tidying, I check his medications and I’ll help him take them later on. When he wakes up, he’s a bit distressed because he can’t remember who I am and why I’m there. I never try and ‘remind’ him of who I am. I simply apologise for alarming him, introduce myself again, as if for the first time, and tell him I’ve just popped in to help his wife, who will be back soon and offer him another cup of tea. He takes a bit to settle, but distraction is the key. I tell him that my windscreen wipers on my car are on the blink and, as an ex-mechanic, he’s keen to advise me and we chat about that. Margaret comes home and we sort his medication together. I say goodbye and tell him I’ll see him again soon. ”

*names have been changed.