poetry on ward 3

It's Mum's last full day in Hospital today. When I arrive, she smiles at me and asks: "Didn't you know I was in here?"

She doesn't remember my other visits. I take comfort from the thought that at least she knows she is in a Hospital today.

She is shaking again, though she tells me that she is warm. I know that tremors can be a sign of advancing dementia, but I suspect she is just nervous. My presence here is frightening because she knows that I will find her out, that I know her well enough to notice that something is wrong. For years she has been hiding a growing problem, with varying degrees of success, but she suspects that it's obvious now, that the task of hiding it is beyond her capabilities.

I try to get her to sit up, to face me, but she remains curled up on her left side, staring fixedly at the Nurses' Station just beyond the entrance to the ward. Whenever I say anything, her gaze flickers to me and then back. Her face is set in an anxious grimace. It's like she's waiting for something or someone to arrive. Not me.

The Consultant visits us, a young Canadian, and he is rewarded with her rapt attention. I take the opportunity to ask about her condition, about the tremors. There are no definitive answers. He is content for her to move on tomorrow.

I stroke her hand. She seems to like that. Soon her eyelids are drooping and she is asleep.

There are 3 other ladies in the room, having a conversation about favourite remembered poetry. The one who seems the most far gone into dementia keeps stating over and over that she loves "the one with the host of golden daffodils". The other two attempt to recall the words. When they progress to talking of their own favourites, the first lady brings them back to Wordsworth's "Daffodils".

After a few minutes of this, I get up quietly and visit the Nurses' Station to ask if I might access the internet. I google the poem, print it, and take it back to the ladies. They are thrilled to have someone do something for them. The first lady is unable to read, so I offer to recite it to the room. By the time I'm finished, all three are in tears.

I wish Mum had seen this. I know she would have been proud.

I was proud of myself. Not just for doing something nice for the ladies, but for keeping my voice steady whilst reading a line I had forgotten: "A poet could not but be gay..."

update

Mum was expected to be in hospital only a few days. She is still there.

On days when I haven't been able to visit, I've rung the ward where Mum is convalescing. The usual routine is that I ask the Staff Nurse how Mum is doing. The Nurse fails to recognise Mum's name. The Hospital staff are calling her by her first name, which Mum has never used and to which she doesn't respond. No matter how many times I correct this, they haven't altered their information in 2 weeks.

Then, when I ask again, the Nurse puts the phone down before I finish and goes to speak to Mum, who of course says that everything is fine, which the Nurse reports back to me. I then have to inform the Nurse that Mum has dementia and is hardly a reliable source, and that I was asking about the progress of her recovery and not her mood.

When I called a few days ago, the news I got back was alarming:

"Oh yes, we've had someone in to assess your Mother for Nursing Care and we're attempting to place her in a Home."
"Excuse me?"
"We've assessed her as unable to walk, so we need to find her a Home."
"She's IN a Care Home ALREADY."
"Ah......... er......"

The phone was handed to someone else, who repeated the above statements. She explained that my Mother's Care Home is listed in their records as a "Residential Home". I took the opportunity to correct this misperception and informed them that the Home is more than adequately equipped to deal with Mum and that there is a dedicated Nursing floor in the building, should nursing be required. I got the distinct impression that I was being humoured at this point.

I rang the Care Home in a state of panic. They reassured me that Mum could not be taken off their hands without their own assessment taking place first. The member of staff, who sees Mum regularly, told me that Mum is often uncooperative with people she doesn't know and that, in her opinion, Mum was probably unwilling to trust the strangers who were attempting to get her to walk. She said that she had seen Mum refuse unfamiliar Care Workers in the Home.

Just as my blood pressure was returning to normal, however, the member of staff said: "We'll make our own assessment and decide then whether she can come back onto the household."

I was perplexed because Mum being unable to walk isn't a new situation. She was in a wheelchair for a few months back in 2008, around the time of her 80th birthday. After that, the local GP gave her some cortisone shots to her knees and Mum was able to walk with relative ease almost immediately. When Mum's knees started to trouble her again this year, I requested that the shots be repeated, but this wasn't done. I couldn't understand why this same situation was now threatening a change of environment. The member of staff informed me that fees for the Nursing floor were substantially higher, upwards of £900 per week. My heart sank. The fees for Mum are currently £625 per week and her income is £400. Taking on a shortfall of £500 per week would mean that we would run through Mum's capital quickly.

I experienced a lot of paranoid thoughts at this point. I thought that the Home was probably seeking to maximise profits by taking the opportunity of Mum's assessment to charge more, even though she has been in the same condition in the past with no question of changing her care. Then I started to worry that this was all MY fault, because I had informed the Home of the reason for Mum's infection - the inadequate hydration regime. I felt that we were being persecuted now for daring to criticise.

I despaired and sank into helpless inactivity.

Today, the acting Manager of the Care Home telephoned me to inform me of the Nursing assessment, unsure if I had been informed. I questioned her vigorously on her reasons for treating Mum differently this time and she was obviously surprised to hear that Mum has been in precisely this state before without anyone changing her status. She told me that since 2 other residents on the household were now also in need of nursing care, Mum's change of status would be too much for the team to handle and that Mum would have to return to the Home on the Nursing floor.

"So the other 2 people get to stay in their familiar surroundings and Mum is penalised?"
"Not penalised... but moved."

I went into a long explanation of our finances and she eventually reassured me that the increase in fees would be met by a Local Authority subsidy of £108, although I was not at all convinced that £625 + £108 = £900. It turns out that newcomers to the Home are being charged £795 per week and that Mum benefits from a discount for having been there from the start. The £108 is based upon the discrepancy between £795 and £900. The Manager assured me that we would not notice a hike in our payments if Mum was assessed as requiring a move to the Nursing floor.

After much grizzling from me, we eventually agreed on Mum coming back to her familiar surroundings for 2 weeks, giving her a chance to feel at home and possibly receive cortisone shots to her knees. After this 2 weeks, the assessment will be made about her future.

I'm visiting the Hospital and the Care Home tomorrow.

Hallowe'en Fright

The phone rang a little after midnight. It was from the Care Home. Mum was on her way to Hospital. They told me that she had been throwing up, had suddenly gone very pale and clammy to the touch. They would call again if there was more news.

I arrived at the Hospital in the afternoon. It was alarming to walk in and see Mum looking so altered. She was canted over to one side in bed and looked dishevelled and shrunken. Her left hand was shaking as she pawed distractedly at the cannula fitted to the back of her right. "Hello Mum", I said and she gaped blankly before peering out of the door past me, looking down the corridor to the activity around the administration desk on the unit. After a few more attempts to get her attention I asked her outright if she knew who I was. "You...are...Greg", she said, eventually. She couldn't have looked less interested.

I went to find a chair so I could sit beside her bed. On my return, I noticed that Mum's arm was still shaking and I wondered if she was nervous, so I reached out to hold her hand. As her hand rested in mine, I felt the coldness below and realised that the bedclothes were soaking wet and soiled. The window was open and Mum was sitting in a draught in her own filth - she wasn't shaking, she was shivering!

I closed the window and called a Nurse into the room. As he went to get someone else to replace the bedlinen, I noticed that Mum's IV drip was empty and that her oxygen mask had slipped. How long had she been like this? How long would she have been left like this until someone had noticed? I began to panic about the future and how I would cope when Mum was more seriously ill.

The Nurse came back in to check on Mum's vital signs. They were low, and he fiddled with the oxygen supply before replacing the mask on Mum's face. I was ushered out of the room while they changed Mum's sheets and gave her a couple of blankets.

The Staff Nurse gave me a rapid summary of Mum's condition and their treatment plan, but his accent was strong and he peppered his talk with so much jargon that I ended up deciding to ask someone else. The other Nurse, who'd brought the clean sheets, was much better - warm and chatty - and both Mum and I warmed up chatting to her whilst she brushed Mum's hair.

She told me that Mum's illness stemmed from an infection in her bowels, brought about by impacted waste which was, in turn, due to constipation. The reason for the constipation was dehydration. She said that anyone brought in from a Care Home was always dehydrated - they just don't push sufficient liquids in these places. She told me that the Hospital had given Mum a couple of enemas to stimulate a bowel movement and had performed an endoscopy to inspect her inflamed innards. She thought Mum would be here a few days yet.

By the time I had to leave, Mum was doing much better and I didn't feel quite so conflicted about leaving her as I had before. I believe my visit helped the staff see that Mum wasn't some unwanted husk. Someone cared how she was doing.

A close friend just told me: "it's a good thing you were there for her today". And for once I feel able to accept that I have done something good for Mum.