Sunday, 27 August 2017

Having Run-Ins With Authority (2)

Having Run-Ins with Authority (2)

As the days of the New Year passed by, talks with the health-care professionals as to where Mum would go next, became a great deal more pressing. We kept being told that we must make a decision: was Mum coming home to live with us, or were we going to put her into a care home?

 I knew it would impossible for us to take Mum home in her current state - she needed more time, in a rehabilitation setting, with more help that was not available in her current situation.  We knew that there must be options, but they would have to be found, recommended and fought for; Mum wasn't fit enough to come straight home, and we were not going to be bamboozled into rushing into something that could turn out to be a disaster.

During this time, we took advice from very helpful people in the Patients Advisory Liaison Service (PALS), and one of the orthopaedic surgeons gave me another good piece of advice.  He said, "I know you want to have your Mum living with  you; and from her follow-up appointments, I can see why you are worried about her being discharged straight from hospital to home."  He then told me, "You must say, if she comes home now, you cannot guarantee her safety....."

That turned out to be a gem. One morning, whilst I was with Mum, helping her to brush her teeth and giving her breakfast with full cream milk, the Ward Manager came over to see me.

"I have to tell you," she said, "we have arranged a full meeting this morning, regarding your Mother's future care. All the health professionals who have dealt with your Mother will be present, to discuss what we are going to do."

It was very much on a "take it or leave it" attitude.  We had no choice in the matter; the meeting would go ahead in a couple of hours, whether the rest of the family could be there or not.

I quickly rang round, and rallied everyone - in the end, three of us were ranged against a panel of health care professionals who definitely considered they knew better than anyone, what should happen to Mum.

I am not that good at coping in situations like these.  Hours later, there are always things I remember I should have said, and things I wish I had thought about at the time, and had omitted to put forward.  Happily, one member of the family is able to sit calmly and quietly during meetings, not saying very much at all,  just listening, taking everything in; later, like a tiger, he pounces, leaving the opponent with not much choice but to agree to all he suggests.

The meeting commenced. Reports flowed back and forth and the main objective was to move Mum on - in the circumstances, it was felt, a care home would be best.  We were adamant this was not our wish, but before coming home to live with us, we felt Mum needed to spend some time in a "half-way" situation. We had heard about a particular hospital, where patients could stay for a maximum of six weeks, and which concentrated on helping them to achieve their full potential; this would also give us the time we needed to get things organised at home.

The young social worker who was present made a great show of rustling her folders, files and paper work; she piped up that it was impossible to find a bed in this hospital; in addition, it was in a different area, and there would be no funding available..... There was a general nodding of heads; clearly the panel felt that that would be that, we would accept what the Social Worker said, and go away.

This was the moment when our family struck back; they had reckoned without the tiger.  Very quietly, so everyone had to pay attention and listen, he looked straight at the Social Worker and said, "Well, then, you are going have to try and achieve what we are asking. This is the week you are going to have to earn your salary.....!"

After that, the meeting broke up very quickly.  If some of the people present had been able to harrumph at the suggestion of Mum moving to rehab, they most certainly would have done; we hardly merited a "Goodbye" from anyone.  I saw Mum on the ward, and promised I would be back later, as usual, with her dinner. Mum of course remained in blissful ignorance about the meeting that had just taken place, where strangers, who knew little about her, and nothing of her past history, had been trying to organise her life - and ours! - for her. I went home, the rest of the family went to their work; we felt we had already done a full day's work!  It had been quite a morning, and we awaited developments with trepidation.

Over the next few days, every time I went on the ward,  I sensed a certain froidure in the air emanating from the Ward Managers; this persisted until a week or so after the meeting, when the Social Worker returned for a visit to Mum, with a progress report.

She was positively beaming.  "I have some good news!" she said, "I've managed to get your mother a bed in the rehab hospital! They are organising an admission date, and will let us know soon, exactly when it is."

"That's an excellent result," I said.  I let go of the feeling that if we hadn't been prepared to stand up and fight for what we knew was best for Mum, no-one in authority would have made the effort!









Tuesday, 8 August 2017

Having A Run-In With Authority (1)

Having A Run-In With Authority (1)

With Christmas behind us, and the New Year also duly celebrated with Mum in hospital, 2012 was clearly going to present some major obstacles to be overcome.

We realised Mum could not go back to her old home - there were too many stairs and it was too far away for it to be practical for one of us to be there with her all the time.

Equally, because of work commitments, it was going to take longer than I guess anyone wanted, to achieve a smooth move; we were not going to be rushed.

Physiotherapy continued, but because of Mum's fear and reluctance to make an effort, progress was slow.  She was fitted with a moon boot, but found it very painful to wear. Her left hip had stopped hurting her so much, but her right knee could still cause her gyp, and she kept saying that at 92, she couldn't do so much; however, after all these protests, on another day she would suddenly be convinced she would soon be able to get back to walking five miles a day!

Mum certainly used to be a great walker.  Before her accident, she would often walk from her maisonette in Southsea to the hospital - and that really was a long way! I'm not sure if she just wanted to save the bus fare, or simply enjoyed a day in the fresh air. She would take rests on the way, get talking to people and then tell me she had got their address, and wanted me to write to them.  (As I've mentioned before, this is how my Christmas card list got longer and longer, every year!)

I kept encouraging her to believe that if she could only conquer her initial fears, she would indeed be up and walking again. I was careful not to be too specific or ambitious about distances, but I reckoned the more we could convince her to try and have confidence to weight bear, the greater the chance we would have of success.

Although progress was slow, she did seem to be getting the idea; that is, until one morning, whilst I was with Mum after helping her to finish her breakfast, the Doctor came on the ward round, closely followed by his entourage of Ward Manager and senior nursing staff.

He arrived at Mum's bed; she did her usual "Good morning! And where are you from?" routine - Mum always asks where people come from. He hardly looked at her, and just kept his eyes down, reading through her notes.  (This of course was before the "Hello, my name is......." campaign that took off in 2013, and encourages health care professionals to introduce themselves properly to patients).  At last he spoke to her, and asked her how she was feeling.

"I'm fine, thank you," said Mum, very brightly and hopefully, "and I'm looking forward to getting out of hospital, and walking again."

The Doctor perused Mum's notes for another moment or two, and then delivered his prognosis:

"You will never walk again." He was almost smiling as he said it, and as his words sank in, I saw the look on Mum's face.  She was so crushed, and I thought, "How can you say that to someone?"

Without stopping to think, I came out with, "How dare you say that?  Only God decides what will happen to us, and whether my mother will walk or not.  Who do you think you are?  God?"

It was a fortunate that Mum's bed was the last one in the six-bed room on the round.  The Ward Manager's face was a picture: shock, horror, disbelief that this crazy woman had dared to confront the Doctor with such a rebuke.  The nursing staff swiftly closed ranks around the Doctor and hustled him off to the next room, without so much as a backward glance at me, or at Mum, who was still looking stricken.

She said, "I will walk, won't I?"

"Of course you will," I assured her. I could not know at that time whether that would be true or not, but what on earth is the point of causing distress to a lady of 92? Hope springs eternal, and should not be extinguished.

Years later, when Mum was attending an appointment at another hospital, we came across this Doctor again.  He was charm personified, and I thought perhaps he had decided to change his manner, and the way he interacted with patients;  then I realised he had not recognised Mum, and had not got a clue who I was.  Just as well, really!