In this week’s blog post from the Coronavirus and dementia in care homes (CoDeC) study, we get to know Nigel and how the pandemic has affected his activities of daily living.
Nigel is living with dementia and during the lockdown was living alone in a sheltered housing complex in Yorkshire. He and I had agreed to stay in touch over the telephone whilst the service Nigel had been attending for two years had closed due to the lockdown restrictions (Nigel attended a social farm as a service user and I worked there).
Throughout lockdown I was calling him every week for a 20-30 minute wellbeing call. He was also receiving phone calls from his family and other services he was part of. During this time it was fairly difficult to understand what impact the Covid lockdown was having on Nigel although there were considerable changes in his lifestyle. For example, Nigel’s family were not able to visit him as they were shielding another family member, and his own COPD made him vulnerable. He would also tell me he didn’t like to mix with the other residents in the sheltered housing as they were significantly older than he was and mostly women. Therefore he had abruptly lost contact with all the social groups he’d been a part of before lockdown: frequent contact with his family in person (Sunday dinners etc); the weekly social farm; monthly local DEEP group; a weekly befriending service. So, from a lot of frequent and regular contact with family and services, Nigel was suddenly impoverished without any in person social contact.
Nigel was going out during lockdown to the shops and back, but that appeared to be the extent of his activity for three months. When lockdown started to open up at the end of May/early June, Nigel visited his sister Brenda and she noticed a change in his physical appearance, but it was only when Brenda was able to start to visit him again in his own home that she discovered the degree to which he had been affected by the whole situation. After having problems with alcohol for many years, Nigel had been drinking only alcohol-free lager for the past three years and this had contributed significantly to his ability to live independently. Unfortunately during lockdown he had accidentally bought a low-calorie lager which was packaged in a similar way and mistakenly believed it to be alcohol free. It is unclear how long this had been happening, but by early July it was clear that Nigel was also confused about his medication and the combination of missing medications and drinking alcohol turned into a toxic mix for him and he began suffering emotionally with high levels of anxiety and paranoia.
Various other events lead to Nigel being admitted to hospital and then into residential care for rehabilitation. It is not yet clear whether Nigel will be able to live independently again, but the signs are currently hopeful. It is likely however that there will be a permanent deterioration in his dementia. The succession of issues Nigel faced during lockdown might have been avoided if he had remained in contact with people ‘in person’.
There are likely to have been signals that he was struggling or unwell and then help could have been sought at that point. For Nigel, the lockdown was pretty disastrous. Routines and social contact and meaningful activity which were vital for him and had been built up over years, were all suddenly removed, leaving him pretty much without support structures and isolated. I’ll leave you with a quote from Nigel who was often very vocal about what he wanted at the social farm:
“[We] do what Sandra (the farmer) needs us to do. Its good as it keeps us active and and we’re not sitting on our arse all day….Its something to do for a day”.
For me this quote underlines Nigel’s need for activity, occupation and social contact- all things that were removed from his life as a consequence of the lockdown, which had a serious and lasting impact.
Blog by Justin Mazzotta with support from Nigel’s sister Brenda.