Thursday, 27 April 2017

Keeping up Mum's fluid intake

Keeping Up Mum's Fluid Intake

Diary note from 1 February 2017

Mum is sipping her tea.

We are doing the usual "rounds" with her, to get her to drink:

"One for Blackie; one for Pushkin; one for Tiddlywinks; one for Wendy's cat, Artist (actually Artemis, but Mum can't pronounce or remember that, so Artist it is); one for Al's pussy cat, Apollo.

Then it's "One for Wendy; one for Al.... etc...."

In between each name and each sip, with her right hand, Mum takes a fresh tissue out of the box to wipe her face. She then puts the tissue under the table and passes it to her left hand, after which she reaches out and puts the tissue in the plastic bag hanging on the door handle.

She is then ready to lift the cup again for the next mouthful.

This slows the drinking down considerably, and the bag is always bulging with tissues.

We try to persuade her to keep just one or two tissues on the table in front of her, that she can re-use at least a couple of times.  On this occasion, she had a collection of several tissues on the table in front of her, and is hanging on to them in between sips of tea.

Half way through one "round" of names, in an effort to distract her, we make a suggestion.

"Now, put both hands round your cup, and hold on to it for a few mouthfuls of tea."

Without batting an eyelid, Mum looks at us and says, "I can't!

"Why not?" we ask.

"I can't pick up the cup like that. I've got tissues in my hand!"

Thursday, 20 April 2017

Surgical Indecision

Back in the day when Mum was still able to consider things fairly rationally, certainly before the millennium, she was in constant pain, to a greater or lesser degree, particularly with her left hip.

She was referred by her Doctor to see an orthopaedic Consultant; she attended all the appointments made for her, and listened very nicely to what was recommended. She would then say "I'll have to think about it....." and another appointment would be made for her.  Invariably, when she returned for the next consultation, Mum would say, "Yes, yes, indeed I will take your good advice.... but there are a couple of things I'd like to get sorted out first, before undergoing surgery."  It all sounded terribly reasonable at the time.

I would pick Mum up from her home in Southsea, and drive her to all the appointments at RN Hospital Haslar in Gosport, but over the years, she never seemed to get any nearer to making a decision to get herself out of pain.

She was clearly frightened of an operation. Her fear wasn't assuaged when the Consultant gave her statistics of having a hip replacement. He told her, "95% of patients do very well. 3% have no improvement, and 2% will have a very poor result."

For Mum, this translated as disaster. She was sensible enough to know that all surgery carries a risk, and that the Consultant had to explain what could happen, but in spite of meeting many other patients in the waiting room at Haslar who had already had a hip replacement, and being told how great it was that they were now pain free and able to walk properly again, Mum could focus only on the 2% disaster scenario. The "glass half-empty" was in full control in  Mum's head.

In the end, as the Consultant had predicted, Mum's hip stopped hurting her; the bones settled in the socket, and she lost a bit of height. However, before that happened, and whilst she was still in pain with her left hip, she started to throw most of her weight onto her right leg; after a while, her right knee began to protest, and cause her even more problems.

She was offered a Zimmer frame and shown how to use it, but preferred to rely instead on a low four legged stool, that she would lean on heavily, then pick up and plonk down a few inches away, before taking a step forward. Her GP always tried to encourage her to use the right walking aids, and explained that using the stool also put put a terrible strain on her back.

The problem was, with Mum sounding so lucid, and definite in her decisions, no-one could argue with her, and we watched with bated breath as Mum made painfully slow progress around the house, clinging stubbornly to the low stool.

One evening, the accident we had all been dreading, happened; Mum took a step forward, got her foot tangled up one of the legs of the stool, and went over onto the floor. One look at her lower leg was enough to show it was serious;  the ambulance was there within minutes, and Mum was taken off to hospital, with a broken ankle.  At 92, we really feared the worst.





Subtle Changes

Subtle Changes

It's only when you look back that you realise how much things have changed. To being with, the downhill trend is almost imperceptible, but then, in a relatively short space of time, it becomes clear that there have been several steps "down," but only a couple of steps back up again.

Since the beginning of 2017, we have had to work at lot harder to get Mum to drink her tea. We have tried a straw (not very easy with tea leaves at the bottom of the cup, until we we swapped loose leaf tea for tea bags), a tommy tippee mug, and finally feeding her the tea on a spoon.

We have to keep reminding her that when her GP has prescribed antibiotics for her, the medicine is always in a suspension, and she takes every dose off a spoon. She manages to get it all down and swallowed in one mouthful, and drinking tea off a spoon is no different. She needs prompting to open her mouth, to keep sitting up straight so the liquid doesn't spill out from the side of her mouth, and then to swallow.  There have been a couple of times when Mum has taken tea off the spoon and then given me big smile and taken a breath in to speak: result - spluttering, coughing and then a sneeze or two until she gets the tea back up.

In fact, when all is going well, using the spoon to help Mum to drink can be quicker than any other method. We start off with a round of the names of all the pussy cats that we know - "one for Blackie, one for Pushkin, on for Tiddlywinks, etc..", followed by the names of our family; each round can be done in less than ten minutes, and maybe 6 or 7 rounds will see every last drop of tea "down the hatch,"so if we allow an hour, that will also give time to have little rests and maybe a bite or two of coconut sponge cake, in between drinks.

There has also been an increase in the wetting of clothes, which necessitates a change of at least Mum's nightie.  If her jumper and cardigan are still dry, that is a bonus.

Back in 2012. when Mum first came home to live with us, it was just one change of clothes in the morning; it was rare for her to have an "accident," or take the pad off, which resulted in her being completely soaking wet (or worse). The bedsheets were changed once a week, on a Friday; an extra set of bedlinen during the week, was required only on rare occasions.

Over time - and especially since about the middle of 2015 - it has gradually got worse, and sheets are now need changing more frequently. We give a silent cheer when the inco sheets have done their job, and the bottom sheet has remained dry.






More of Mum's logic... You couldn't make it up!

More of Mum's Logic... You Couldn't Make It Up!

Scene:

Mum is busy brushing her teeth. Alex waits patiently for her to finish, and makes conversation.

Alex:
Now, when you've finished brushing your teeth, I'll bring you your lovely breakfast.

Mum:
I don't want any breakfast.

Alex:
Why not?!

Mum:
Because I'll be dead,

Alex:
Well, you certainly will be dead if you don't have your cornflakes and a nice cup of tea.

Mum:
I'm on my way out.

Alex:
Well, if you're on your way out, why are you brushing your teeth, then?

Mum:
Well, it's nice to have clean teeth when you're dead.......