day care

I dropped Mum off at the Home, yesterday, around 9:30am and drove back to my house feeling like a parent who has dropped his kid off at the school gates. Would the other boys and girls accept my Mum?

At home, I suddenly had all this silence. It felt w-o-n-d-e-r-f-u-l. But I found it really hard to concentrate - my brain just needed to relax after all the stress of the last couple of weeks and I was suddenly very sleepy, so I didn't get very much work done in the end.

I picked Mum up at 7pm, after the evening meal was over. She was almost unrecognisable: her hair had been candy-flossed up into a white cloud around her head. She was in a sort of happy daze and kept talking about the lovely bubble-bath they'd given her. She stayed in the bath so long that she missed the Tai Chi class.

I've just dropped her off again this morning and heard that they're all going on a coach trip today.

response

Once again, I am humbled to record another individual who dealt with a comparable situation himself rather than seeking care from outside. My respect for you, Sir, is very great and your "do the right thing" message resonates with my guilty conscience about how I've decided to handle my Mother's future care.

My Mother's condition likely stems from a stroke she had about 12 years ago, where she temporarily lost the use of one side of her body. She quickly recovered at the time, but apparently this episode leaves her more vulnerable than others to further TIAs. The pathology of her diagnosis was mixed, with evidence of many small TIAs and some additional deterioration that could be Alzheimer's.

Yes, Care Homes over here are expensive too, typically £700-£800 per week for anything half-decent. This is twice my Mother's income from her pensions. In the UK, if the individual has assets of less than £21,500 the State will either contribute or pay in full to enable her to go into Care. Unfortunately, in my Mother's case the fact that she owns her own home places her well beyond that boundary, and I will be selling her apartment to fund the shortfall. If she lives long enough to outlast this asset, then the State will step in to top up her fees. Finance is not a worry, beyond the fantasy of my inheriting something from her estate one day. I've come to terms with that after some soul-searching (my soul was under a sofa cushion).

Yes, I have read a lot of horror stories about staff in Care Homes, not only ill-treating their charges, but also drugging them to keep them somnolent and co-operative. I haven't seen evidence of  this in any of the many homes I have visited these past few months. However, I have visited places which felt wrong in some way, that smelled, or where it seemed the residents were not encouraged to leave their rooms. Believe me, I am going to make sure that my Mother is happy where she ends up, or I'll take her home with me again.

I have thought a great deal about the idea of quitting my job and caring for her myself. As you say, a salary even a fraction of what would go to a Care Home would be attractive. One of my dreams is to settle in the countryside of France, enjoy the warmer Summers and grow my own food. Mum's assets and income joined with mine would make this possible, and I would have fewer worries and more time for her, but the care I gave her could not be 24-hour, and I lack basic Nursing skills. More to the point, I'm ashamed to say that my temperament isn't suited to looking after Mum. It really is with the best of will that I have searched for a place for her, out of my belief that she would benefit more from people who are more patient and less emotionally-linked to her failings. I am denying myself a good chance of realising my dreams because I feel that it's in my Mum's best interests.

Your scheme for Elder Elder Care is an intriguing one, and I'm curious if anyone has tried it. One thing I would say is that many of the Senior residents at my Mother's apartment building treat her contemptibly, I suspect because they see their future before them (the Warden there agrees that the ones most vile to Mum are those closest to her condition). However, I'm sure the number of kindly, charitable Seniors far outweigh the nasty contingent.

The place that I have been happiest looking at organises itself as a 'village' of people, encouraging as much interaction and shared responsibility as the residents are happy with. I've met some kind people there, and Mum is enthusiastic as well.

I hope for the best. This seems "the right thing" for Mum and not a shirking of responsibility, but I welcome opposing views and anyone who can pin-point any self-serving thinking on my part.

Good luck to you, too, Sir. It seems to me that you are far from a burden for the time being, and I hope I'm still capable of celebrating, myself, when you reach 110.

Greg

comment from a reader

I hope with his permission, I would like to quote in full a comment I got from a gentleman going by the name anthropositor. This was left after my "Driving Miss Crazy" post, and he has some valid points to make (apologies for places where the spelling has changed to UK English - Blogger didn't allow me to copy and paste this and I had to type it out myself):

"I was once a fairly affluent travelling man. My Mom had passed away. Periodically I visited my Father who was in his late sixties, and a particularly challenging fellow to deal with. He sporadically drank a LOT of vodka. I was putting off the time that I would have to deal with the situation. My siblings, for good reasons of their own, could not or would not deal with the situation.

Clearly my Father was losing it. It was only a matter of time. Then I came back from a trip to find that he had had a stroke which had paralysed half his body.

This was twenty eight years ago. I looked into the care giving options, found them to be in excess of $2000 a month and elected to quit travelling to take care of him myself. I got him over his stroke and worked from home. Soon after his recovery I got married for the second time and got custody of my youngest Son.

Aside from the stroke, my Father continued to deteriorate behaviourally. It was indeed a challenging situation. My behaviour toward him was strained some of the time. I have some regrets about that. But ultimately, I did the right thing. No regrets.

Now I am about the age he was when I took over his full time care. He lived as well as could be expected for seven more years. For me this was an exceedingly difficult time, but I have never been sorry that I dealt with it the way I did.

I had a stroke two years ago which just made me stupid for a while. A pretty humbling experience. Fortunately my mental strength returned and then some. Your Mum is twelve years older than I am and her difficulties seem to be beyond simple stroke damage. Her situation is not likely to improve by much.

The costs of providing care for the aged are really extreme. You mentioned $100 per diem for day care. Full care would be double or more. And such care is often not exactly ideal. The young employees who work in such places often get as frustrated as you have been on occasion. When that happens, they are often not too inhibited with their irritation.

It strikes me that more should be done to set up situations in which lucid and capable old people do more caregiving for their less capable counterparts. They have some serious advantages in caregiving. They know that these things could ultimately happen to them, and maybe in the not too distant future. That alone makes them potentially much more understanding than youngsters are likely to be.

It is also true that many capable older folks need to supplement their income and would find elder care to be a good way to do it.

If someone in my neighbourhood made me an offer of say $1200 a month for continuous care around the clock for their loved one, I would certainly be considering the idea.

In the meantime, I will be doing my very best not to let myself become a senile hardship to my children. If I can remain lucid, ambulatory and capable until my one hundred and tenth birthday, I can't think of a better gift for my children or myself.

Good luck to you."

like a circle in a spiral

I'm chatting with a friend on MSN and I suddenly realise that I haven't been disturbed for over 30 minutes.

I poke my head out of the study door. The lights to the bathroom and Mum's bedroom are on. I knock on the bedroom door and go in. Mum is in bed, undressed and asleep. I can't leave her because then she'll be even more wakeful than usual during the night. I wake her and ask her to get dressed again. She is shocked to hear that it's not time to sleep, that she hasn't even had her dinner yet.

Over the next 10 minutes or so I can hear her making disapproving noises about having to dress. Eventually I call out to her to ask what's wrong.

"I can't get this skirt undone."

"Mum, I don't want you to get it undone. Please get dressed!"

She comes into the study, eventually, in a light blouse which will be too cold this evening. I ask her to put her jumper back on. I have to stand over her to get her to select it from the other clothing in her room. Eventually she picks the correct item. I leave her to put it on. The disapproving noises come back. I ask Mum what's wrong.

"Well, it's this jumper. It's too thick for me to sleep in."

baby

It's a cliché, I know, that the parent becomes the child.

I should have seen the last 9 months as my 'pregnancy', but I didn't. Perhaps there were classes I could have gone to, or maybe a Midwife should have been assigned to me.

I suddenly have a 79-year-old infant to look after: one who I can't leave alone, who constantly asks for attention, who cannot do anything without me standing over her and micro-managing every part of the task.

I tried to do some work this morning. Mum was coming up the stairs every 1 or 2 minutes, calling out to me about nonsense she creates in her head out of the scraps she can remember. I never got a chance to concentrate on more than a single sentence over the course of an hour. Eventually, I decided to set Mum a task to keep her occupied: to sort out her clothes and make a pile of the dirty ones. All the clothes Mum brought up with her are badly stained, and we've been out several times to buy fresh clothes (which are warmer and actually fit her). I told Mum that if she made a pile of her dirty clothes, I'd launder them for her.

This only made things worse for me. Mum wasn't up to the task. She kept coming back to me with all sorts of other things, and I'd remind her what she was supposed to be doing. I kept leaving my study to guide her back to her room and point to her suitcase and re-explain the task. A minute later she would be out once more. It's been 2 hours of this now, and I've given up responding.

And, of course, this has worked rather well. After not getting any response from me, Mum has settled down and is now relatively quiet. 

If only I could get her toilet-trained.

breakfast

When I wake up, Mum is already wandering the house and all the lights are on. Same as any morning this week. I go downstairs to let her dog into the garden, and then I pour two bowls of cereal and add the soya milk we use. Mum is sitting at the table, ready, and asks for some juice. I pour the last of the pineapple juice into a glass.

I start eating my cereal. Mum is sitting there waiting for something. In between mouthfuls I ask, "What's wrong? Why aren't you eating?"

"I need some milk, don't I?"

"It's on your cereal, Mum."

"On my cereal?..... On the cereal?"

"Yes, Mum."

And so she quickly tips her pineapple juice onto her cereal and my voice reaches an octave I haven't heard since my balls dropped.

day care

Wednesday's trip was achieved by my taking a holiday from work (a day I might accrue rights to sometime before Easter). Yesterday I tried again to work from home, but Mum was impossible again, and I felt close to tears as she settled back into her 4-minute-interruption routine. I spoke to my HR Representative, who encouraged me to take off all the time I needed up to Christmas and offered to find another person to fill my role at work. I didn't want to take up this offer because the role is uniquely based in my home city and on an interesting project. 

I did however say that I'd like to take today as holiday, too, because I didn't feel comfortable in my decision having only taken Mum to see one Home. This is self-sabotage, perhaps, viewing other places after finding one that Mum likes, but my conscience and I are on somewhat estranged terms and communicate through my gut these days rather than thought. I set to locating some nearby homes for comparison and lined up a couple to investigate today.

We set out around 11 am and drove for 20 minutes to a neighbouring small country town. Here we visited a lovely stone house which had been tastefully extended. The lobby led on to several lounges of varying sizes, filled with armchairs and chatty older people enjoying a sherry. We met the Manager, who took us on a tour of the hotel-style dining room and then sat with us in a typical suite, which was comprised of a sitting area, a bedroom and a wet-room. Although this Home didn't advertise as having an EMI/Dementia capability, the Manager told me that in her opinion Mum would fit in excellently into the demographic.

She told us that the only available room had just recently been taken, so there was no guarantee when they would be able to house Mum, but then she offered to take Mum in as a day-care resident for £50 per day, with a view to giving her the next vacancy. This would mean me dropping Mum off in the mornings and picking her up in the evenings. Mum would be fed both lunch and dinner, have an opportunity to bathe in a special bath with a chair hoist, and get her hair styled on-site. This would leave me free to work and would be an excellent opportunity for Mum to sample life at this Home. I actually teared-up with relief at hearing this.

I like the place a great deal: the facilities were more like those of a good hotel than a Care Home, and the staff warm and funny. Several residents told us, without prompting, how much they liked the place. My only reservation is that this Home is convenient for me but would leave Mum out of reasonable visiting-range for her other relatives. However, I think I'm going to take up the day-care option for now.

We didn't visit the second place I'd found. There didn't seem a point any more.

go west

Almost all my Mother's relatives live in the north-west of the UK, about a 2 hour drive west from here. Meanwhile, I harbour ambitions to travel at some point, once Mum is settled somewhere and being looked after. There is therefore an argument for finding a Home for Mum that is within reach for the other relatives rather than being on my doorstep.

Today I took Mum west, to see one of the Homes I visited a couple of weekends back. At that time, I had been looking for a place which had independent apartments or bungalows to replicate my Mother's present living arrangement while providing support if and when it was needed. Now I realised that she needs a LOT more care than that. She should not be left alone and is very dependent and frequently disoriented. With her mobility severely impaired, I realised that the bungalow option was especially no longer appropriate. So I took Mum to see the more modern of the two places I had been happy with last time, with a view to getting her assessed by them. I suspected now that one of their 'households' would be better for Mum.

The Home is still in the process of opening, so the Manager and her Deputy were being pulled in all directions by consultants with powerpoint presentations. Nevertheless, the Manager took us round a household which hadn't yet been opened: 8 bedrooms set around the perimeter of a vast communal area which was part lounge and part kitchen/diner. All the walls had handrails around them (useful for Mum who wobbles unsteadily along on tip-toes). The rooms were a decent size with a bed, two chairs and a coffee-table in a window alcove, dressing table, LCD TV, a generous amount of drawer and closet space and an en-suite wet-room. The lights in the wet-room go on as you enter, and a pressure pad in the mattress means that if you get up from your bed in the night the bathroom lights up. The Manager explained that the pressure pad system could also be used to alert staff if someone was prone to falling out of bed, but in Mum's case could be set so that it only triggered an alert if Mum was out of bed for more than 10 minutes or so. Out in the kitchen area, it was explained that staff would be around day and night, that meals would be served at regular times in the dining area but that Mum could ask for anything at any time and it would be made for her. If she wanted eggs at 2 am then staff would make eggs.

Mum looked delighted with everything, but then she puts the smiley act on for all strangers, so I found it difficult to gauge her reaction. I think, in fairness, that she was responding to the kind people who we met rather than the facilities (perhaps she's social while I'm more materialistic, or maybe I just feel forced into that role in this case). However, the staff were all very warm and friendly. The Events Manager even ran downstairs to the hair salon to fetch Mum a comb when Mum expressed embarrassment about her windblown appearance.

Next we sat down with the Deputy Manager, who answered my questions and talked us through setting up a "Life Plan" for Mum. This will be a continuously-updated document stating Mum's memories, relationships, life events and her wishes and needs. There was too much to fill while we were there, so I was recommended to take it away to complete and mail it back to the Home. We sat in the café on the ground floor and had a pleasant lunch while I filled in areas of the Life Plan and Mum listened in to other conversations, as is her habit. As we left, Mum was already talking about "when I move in". I think we have a winner.

living la vida loca

The architecture of my home isn't ideal for Mum. There are steps, stairs, a narrow bathroom, no shower, there are bare floorboards and the place is a bit draughty. My heating has been on 24/7 since she arrived but she's still feeling the cold. I have put an electric blanket under her bedclothes in place of the hot water bottle I forgot to pack for her.

I'm trying to work from home this week, which is proving very difficult. Mum's memory retention is between 2 to 4 minutes, so she will tend to come wandering upstairs 4 minutes after I've sent her down. Concentrating on a difficult technical document is pretty hard when distracted like that, and I'm scared of losing this job. It's been hard to hold onto my temper even though I know it's not Mum's fault. I've put notices on all the doors telling her that I'm working and not to be disturbed, I've put a notice on the loo asking her to flush it, I've a notice on my bedroom door telling her that I have an alarm that will wake me up at the correct time and that she shouldn't come into the room before that. None of these work.

She doesn't even know where she is. This morning, at breakfast, Mum suddenly announced: "I'm just trying to work out how I can get back to my apartment without anyone seeing me in my nightie." It turned out that she thought my kitchen was part of her apartment block.

Mum has never once flushed the toilet here without prompting - she has simply lost that bit of her brain I suspect. Every time she visits the room (every 5 minutes while I'm working, no exaggeration) I call out "Can you flush the loo, please?" when I hear her coming out again. "I DID flush it, didn't you hear it?" she'll reply. Sometimes I rush out and get her to look and see that she hasn't, but even then she'll tut and sigh as if I'm making it all up in my head.

Small things like that shouldn't get to me, but I'm still losing a lot of sleep to disturbances at night, and I'm terrified by how disruptive I'm finding Mum's presence here.

On the plus side, I'm eating more healthily than ever. Having a "child" stay with you makes you plan meals a LOT better, I find. And I simply haven't any time to myself to swallow my usual quantities of chocolate.

driving miss crazy

We had an okay journey in one sense - the traffic wasn't bad, and the lashing rain miraculously ceased whenever we made a pit-stop.

I had to drive with the window open at one point because I was so tired that I started to drift across lanes and even the adrenaline of nearly crashing into someone didn't seem to help keep me alert. Mum didn't let up about how cold she was feeling, sitting there in her multiple layers while I drove on wearing just a t-shirt, desperately trying to keep my eyes open until we reached a service station. I couldn't get her to understand that a few more minutes of cold might be better than major injury or death.

At the service area, Mum suggested that I had a nap, but then her short-term memory interfered with our attempt and she'd start asking me questions or tutting and sighing every 4 minutes, just as I was relaxing into a doze. I'm ashamed to say that after many repetitions of this I shouted at her, and after the 20th time I squirted my water bottle in her direction. This is emotional abuse and I'm guilty of it. I feel so wretched, such a little man. My only defence is that I was weakened by having only 3 hours sleep in the past 72 hours. Mum called me a "swine" but quietened down, and after another 20 minutes or so I got out of the car and loaded up my system with sugar. I bought her some chocolate gingers and apologised profusely, but it's never going to leave me that I did that. I'll never forgive myself and it's one of those moments that cheapens your soul in an instant and irrevocably.

determination

Yesterday, I had pretty much decided that I wouldn't be able to cope with Mum if I took her home with me. I couldn't even face the prospect of the long journey, stopping at every service station on the motorway for Mum to visit the toilet. But last night, it came to me that I couldn't leave her here in this condition alone. Also, practically, if I didn't take her up with me now then I'd only have to come down again... and soon. Suddenly, my worries about how I'd cope with my job while caring for Mum melted away and I even had an impish thought about taking her into the office with me so that I could 'spread the joy'.

We had a horrid cyclic conversation about what would be done about Mum's dog. One minute she'd be happy to hand her over to me or another relative. The next she would tell me that she'll die if separated from the dog. I got the feeling that this wasn't going to get resolved, so I suggested that we went to bed. I hadn't slept more than 3 hours the night before, and that was after a day's work and a 7 hour drive, so I was e-x-h-a-u-s-t-e-d.

Mum walked into my bedroom at 1 am.

Mum came in at 2 am, wanting to talk to me about being invited to join the local Rotarians.

Mum turned the light on in my room at 3 am.

At 5 am, Mum poked her head in the room and asked if I was about to use the shower.

After that I was so full of fury that I couldn't sleep. Mum has kept me from sleeping the whole night and, because I am back at work tomorrow, I have no option but to drive up North today. I would never drive in this condition, but I'm going to. If I die on the road, I'm taking her with me.

whimsy

We're walking out of a multi-storey car park, heading for a restaurant we've been to several times before. Mum suddenly stops in her tracks and gasps:

"Oh..... Look at THAT!"

I look ahead, wondering what has her so amazed.

"Thick. White. Fog!" she finally says, awe-struck.

Across the road, the side of a building is painted white.

local

Mum rejected the first Home out of hand, saying that it was "too close" but not able to explain why that was a bad thing. I suspect that she doesn't want to meet any of her current neighbours after being 'sent away'. We drove on, with Mum wincing and sucking air through her teeth to let me know how much she needed the toilet again.

I drove to our old town, where there's a brand new Care Facility (I'd use that word instead of 'home') that came recommended by Mum's Social Worker. It certainly looked pristine and impressive, with sunlight flooding down 3 stories from a glass roof into a central atrium. The rooms were well-specified and en-suite and there were hand-rails around all the walls. Mum was smiling and nodding and seeming agreeable, but I had concerns that the place was a prison - so many doors that needed swiped cards or keys to get through and the House Manager walking around with a necklace of about 20 sets of keys and cards. Also, the other residents looked very far gone in their Dementia, lolling and drooling and calling out incoherently. I kept looking at Mum's face to check if she was alarmed, but her attention was on our guide and I'm not sure she took in anything that wasn't pointed out to her. And of course, all she was thinking about was going to the loo. I found her a WC and she went inside. As she came out she announced that she needed the toilet and that she thought there was one there... pointing across the hallway. This while stood in the threshold of the toilet she was leaving. Curious.

I drove Mum on to the next recommended Care Home. We had been advised that this one had no current vacancy, but I wanted to get a sense of what constitutes a "good Home". This time, the Home was an older property - a Victorian double-fronted house set back from a busy road. Once inside, however, I understood why the Social Worker had recommended the place. The Owner and her staff were so warm and friendly and full of humour. As a converted family home, the corridors were not designed for Zimmer frames and there were ramps and a stair-lift in place to overcome obstacles for the infirm. We inched our way past single and shared bedrooms (not en-suite) and into a lounge at the back of the house. Here, I was encouraged to see a group of residents actually interacting and seemingly retaining their wits. The Owner told us that a couple of the residents had recently celebrated their 104th birthdays, which I took as a good sign. I was charmed by the Owner and felt that this was a person I'd be happy to care for my Mother. Where the modern Home had the facilities I'd wish for, this place had heart.

During our 45 minutes there, Mum didn't ask to use the toilet once. Curious.

going going gone

I asked Mum what we should have for breakfast as I looked into bare cupboards. She blithely told me that she was going to have cereal, then looked dumbstruck that there was none there. I suggested that we eat a cooked breakfast in the local café.

It took us 2 hours to get out of the door. I had to dress Mum myself, because she couldn't process instructions like "now put on your blouse" and would just stand there. Her skin hangs off her arms and legs in turkey folds, the muscles within have melted into something the consistency of a soufflé.

At the café, we found a table but Mum needed the toilet, so I guided her to the doorway to the toilets. As soon as we'd sat down again, she wanted the toilet again. We couldn't order and then leave our table and she couldn't make it to the toilet alone, so I suggested that she hold on. We ate quickly and then I took her to the toilets. 

At the doorway, Mum just stood frozen on the spot.

I asked her what was wrong. 

"Well, I can't go there, can I? There's no toilet for me to sit on!"

She was looking at through the first door into the small corridor which led to the toilet door, thinking I was leading her to an empty room. This was only 15 minutes after her last (successful) visit to the toilet in a café that she's been going to extremely often over the last 7 years.

By the time we got outside to the car, Mum needed the toilet again. I had planned to visit some Care Homes with her, but this wasn't working out well. I took her back to her apartment building and let her go there.

I know Mum hasn't got a bladder infection, because I spoke to her Doctor on Wednesday and he had just done a urine test and checked her blood.

horror show

I drove in darkness through heavy rain and buffeted by frightening gusts of wind that made me feel the car was going to be scooped off the motorway. I arrived at midnight after a 7 hour journey.

Mum was asleep sitting up in her chair in the living room. The flat was as hot as hell and stank terribly. Mum looked hell, too. Her face was haggard and had a blue-whiteness to it. She looked scary-thin. I saw that her ankles had swollen massively, like Hobbit feet, from weeks of not ever being raised. I roused her, said hello, and set to exhorting her to sleep in her bed tonight. She finally acquiesced, but then she could hardly walk, even supported on my arm.

I let the dog outside and she immediately began shitting everywhere. I could see stains on the carpet in various places inside indicating that being outside was a rare treat for this dog these days.

It took me an hour-and-a-half to get Mum into bed. First we had to find her silk pillow and she couldn't find a nightie anywhere. I kept telling her to wash her face and clean her teeth, but she'd just stand in the doorway, transfixed, with her jaw flapping silently. The bathroom smelled worst of all: a mixture of mould, rotten food and possibly sewage. There were several frozen meal plastic trays in the bathroom, half-consumed, and dirty underwear stuck in corners. There was no toothpaste to be found, so I gave Mum my tube. 

Mum couldn't undress without my aid - couldn't remove her skirt. How long had she been wearing it? How long since she'd showered? She couldn't give me a credible answer. I left her to get into bed, but she came back to the guest room naked. I found a slip for her to wear, made her drink something and filled her hot water bottle.

I was exhausted, but my night wasn't over. Mum came into my room at 3am and at 5am, talking crazy irrelevant nonsense.

a bit more about me

Anyone who has checked out the excellent blog "Alzheimer's Moments" will understand why I feel so guilty. Here's a man who has crossed a continent to go and live with his Mom and support her himself rather than see her institutionalised. His tone is usually one of gentle amusement, fascination or wistful sadness where mine is usually one of gloom, despair or sheer terror. I respect and admire the Author and I find his posts to be 'chicken soup for the soul' (well, I'm vegetarian, so probably more like 'leek and potato'.... except that I don't like soup either..... hmmm).

Anyway, once again I'm feeling the need to expose a bit more of my personal circumstances in mitigation for my being such a poor excuse for a Son. This is not meant to exonerate me, but I hope it will help the reader understand where I'm coming from, and where some of my decisions originate.

I've referred to a new job role recently. The fact is that I've been away from work for the past 5-and-a-half years after a breakdown and consequent Chronic Fatigue problems. I have suffered on-and-off from Depression since probably 1992 (it was first diagnosed in '95) but it was a condition managed by medication until a work crisis broke me in 2002. At that time I spent 18-20 hours per day asleep and I couldn't hope to manage my own affairs. My brain is still scrambled, and I'm sure some of my decisions may strike those around me as odd. I still struggle to cope with my own day-to-day problems, and find dealing with Mum's often overwhelming (as is no doubt obvious).

My company kept me on their books on a very low retainer all this time until last month, when I was given an ultimatum to return to work or face state benefits. It couldn't have come at a worse time given that this was precisely when Mum's condition took a steep downward turn. Just when I need time to spend time with her, investigate Care Homes or come up with an alternative solution, I'm chained to a desk trying to re-integrate with a company that outwardly talks about flexibility but is actually intractable.

It was pointed out to me this afternoon that the company might think that I've invented this whole situation with Mum to excuse further absenteeism. The idea is profoundly shocking, but it could explain some of the feedback I've been getting. I just don't think that way myself, so I'm reeling right now. It might be a good idea for me to gather some documentation together just in case I need to present proof to them.

comedy II: a visit to the Doctor

I don't call these posts "comedy" because I'm laughing (see "comedy"), but because there's a farcical aspect to the incidents.

Here's what I know about Mum's visit to the Doctor on Wednesday:

I had telephoned the Surgery to make the appointment for Mum. I booked transport for her. I told the Warden all about it and asked him to intercept Mum if it looked like she was going out to the shops. I rang Mum 30 minutes before the appointment to remind her about it. I checked that Mum had indeed left at the correct time.

So far so organised.

At the Surgery, Mum was asked to take a seat in the waiting room, but when her Doctor came to get her she was nowhere to be found. It took them 20 minutes to find her in another part of the building in a corner somewhere. Mum didn't recall what the appointment was about (the fungal infection that was making her foot hurt) but asked the Doctor to inspect her swollen ankle (again). The Doctor thought the swelling looked mild, but suggested a blood test and asked for a urine sample to check for a return of the bladder infection (bladder infections can cause confusion). The Doctor pointed to the toilet but by the time Mum had come out she had mislaid the sample cup and forgotten what she had gone in to do. She wandered out to the waiting room and told the Driver that it was time to go. Meantime, the Nurses were trying to find her to take her blood sample. She could not be found. 

Mum returned to the flats, introducing the Driver to everyone she met as her Doctor, come to visit her.

The Warden called me to say that he was concerned that Mum couldn't produce any pills or cream prescribed for the infection, so I telephoned and spoke to the Doctor concerned who told me all of the above. Once he knew about the reason for her visit, he decided to call on Mum at home. Blood and urine were taken and everything checked out.

every time we say hello

It's happening again. 

I only made up my mind to go down and visit Mum yesterday and she has already called me up 3 times this afternoon, asking me where I am and when I'm going to arrive. She thinks it's today I'm coming. She evidently thinks my land line reaches me wherever I am, too.

Each time she rang I explained that it was at the weekend that I would be coming down and that I work during the week. 

Each time she reacted as if to say "Of course! I knew that!"

And then she would call again.

Each time I asked her what day it was today. Each time she had no idea. I would tell her to look at her clock, but she would read out the date every time I asked her for the day.

I'd forgotten how hard this is. I'm feeling exhausted even before the long drive down.

guantanamom

The Social Worker has just telephoned again, and we had another good chat about options for Mum. We discussed various styles of Care Homes and Private in-home Care. She is contractually prevented from recommending specific service providers, but she was able to give me a range of options to look at while I'm visiting this coming weekend.

I found one thing she said a particularly interesting insight: that Mum's disorientation is like that of a tortured prisoner. Think about it: she is depriving herself of food and water, her sleep patterns are disturbed and she is suffering from an infection. Meantime, we're all circling around her threatening to make big changes in her life on her behalf that must seem scary.

It's a perspective that I'm going to have to keep in mind, especially when I catch Mum telling me exactly what she thinks I want to hear.

feet

I had a call from the Warden first thing this morning. Yesterday, Mum's Chiropodist/Podiatrist had been concerned to find another growth between Mum's toes, and had immediately called for a Doctor's appointment, which has been arranged today. It looks like Mum may need some help washing herself.

Anyway, the Warden pointed out that this was inevitably going to mean a prescription of anti-biotics again (can I cope with that again?). I'm not a devout man, but it seems almost too perfect that I was planning to spend time with Mum anyway - I'll ask the Warden to regulate her pills until Friday when I come down for the visit.

The Warden expressed surprise that the Doctor hadn't inspected her feet when Mum went on Monday about her swollen ankles, but I suddenly worked it out: Mum would have got to the Surgery and not remembered why she was going. They'd have had a very general chat about nothing in particular. That would explain why Mum was very vague about his advice when I rang her afterwards. How stupid of me not to see that coming. From now on, I should ask to speak to the Doctor directly when I make an appointment for Mum.