NHS 111 Turns Up Trumps
Mum has often had occasions when her lower face, around her jaw line, swells up. In earlier days, it could be brought on if she had been sitting in a draught - however slight - or had forgotten to take her woolly hat with her when she went out, so we know she is susceptible to this problem.
Being 98, she also has very few teeth left. About 5 years ago, she had a domiciliary visit by a dentist, who arrived pulling a large amount of equipment behind her. She examined Mum, and announced the way forward would be to extract all the remaining teeth, plus taking out all the roots that were still in her jaw.
The dentist did not specify how long this work would take, and Mum was horrified. Apart from believing she still has all her own teeth (or most of them, at any rate!) she has always had a genuine fear of having to wear false teeth. That was one side of the problem; the other was the fact it would be an ordeal for Mum to have to endure all this work being done, at the age of 93. It did seem to me that Mum's age and mental state were not being taken into consideration.
Mum wasn't in pain - this was just a check-up - and she sent the dentist away.
A couple of weekends ago, on the Friday night Mum began to complain of pain in her face, and her left cheek was beginning to swell. I could see it was a bit red, and warm to the touch; inwardly I groaned, because the GP's surgery was closed, and I would not be able to get advice from her doctor.
I prepared a couple of soluble paracetamol tablets, and as soon as they had fizzed, Mum drank the water down; she rarely takes painkillers, so I knew something was definitely hurting her.
By the morning, Mum's face was definitely fatter on the left side. She hadn't been out, she hadn't been in a draught, so I wondered if it was a tooth problem; and then Mum announced she did indeed have toothache.
With the surgery closed, I thought I had better try ringing 111, and see if they could help.
I have heard some fearful reports about the service, but I was pleasantly surprised with the response we got. After a few pertinent questions (explaining Mum was 98, had dementia, was disabled, and so no, she didn't travel anywhere!) the helpful lady on the front line said she would refer everything to a doctor, and that someone would call us back within the hour.
It took less than that; a duty doctor rang me, and I explained the problems Mum was having. He thought it was possibly an abscess flaring up in a tooth, and that she would need antibiotics to combat it.
Because of her heart valve weakness, I know whenever Mum had had to have dental treatment in the past, the dentist always gave Mum a very large dose of antibiotics before starting work; the doctor now asked me, if Mum was allergic to anything, and was then able to prescribe amoxicillin as a suspension for her. He sent the prescription over to the local pharmacy, and told me the medicine would be ready within half an hour; and so it was.
I told him I was very impressed with how quickly he had sorted everything out for Mum, and I also mentioned how helpful and efficient the lady who had answered my call to 111 had been. He said he was really pleased to hear my comments, and I got the feeling that, when things don't go according to plan, people are quick to moan about the service, but when things go well, not many folk bother to say "Thank you."
We collected the medicine; Mum started on the course, and it worked wonders for stopping the infection.
It also galvanised me into action to get Mum registered for domiciliary care for any future dental problems. Over the years, the system had changed, and the clinic was no longer housed in the nearby health centre. By dint of sheer doggedness, eventually I managed to get through to the correct administrative office, where another helpful lady e-mailed over the forms I needed to complete. At least Mum will be registered, and if we need to call on their services in the future, I hope she will get a more understanding dentist than the one who come all those years ago!
In the meantime, on this occasion, in less than a couple of hours, Mum got the medication she needed; NHS 111 had turned up trumps.
Sunday 25 February 2018
Wednesday 21 February 2018
Mum Takes A Backward Step
Mum Takes A Backward Step
In the natural progression of illness, I suppose backward steps are inevitable, but it still hurts when they happen.
After all the efforts we made, nearly six years ago, to get Mum strong and confident to weight bear and push hard down with her hands on the bed/arms of the chair, etc., to help to lift herself up, over the past 5 months, Mum has gradually become less able to do this. It is a real struggle to get her to stand briefly, twiddle round and sit either on the glider, bed or back in her chair.
She tends to start the manoeuvre, and you can think she is going to follow through with the instruction to turn, but at the last moment, even though she might be standing up and almost there, instead of turning that extra small degree, she may suddenly try to sit down again; and this could well see her landing on the floor. It also means you have to be ready to "catch" her, and she is heavy; she may not be that tall, but she has some weight to her, and we cannot always be sure of holding on to her. It is a very nerve wracking situation. The carers are also concerned for their own safety - trying to support Mum means they may also suffer an injury.
I don't know if it is mainly because she has lost more strength in her legs, or that the dementia stops her from processing the information and the guidance we are giving Mum, but either way, it has become dangerous to carry on, and a decision has been taken that in future, unless she is clearly very alert and able, on most occasions Mum will have to be hoisted.
I do accept this. We have always had a hoist in place, and it has been used in the past, when Mum was unwell, or if she did not feel strong enough to try and get up under her own steam; but it still upsets me to know that very soon there won't be this choice for her, and it will be a permanent backward step.
In the natural progression of illness, I suppose backward steps are inevitable, but it still hurts when they happen.
After all the efforts we made, nearly six years ago, to get Mum strong and confident to weight bear and push hard down with her hands on the bed/arms of the chair, etc., to help to lift herself up, over the past 5 months, Mum has gradually become less able to do this. It is a real struggle to get her to stand briefly, twiddle round and sit either on the glider, bed or back in her chair.
She tends to start the manoeuvre, and you can think she is going to follow through with the instruction to turn, but at the last moment, even though she might be standing up and almost there, instead of turning that extra small degree, she may suddenly try to sit down again; and this could well see her landing on the floor. It also means you have to be ready to "catch" her, and she is heavy; she may not be that tall, but she has some weight to her, and we cannot always be sure of holding on to her. It is a very nerve wracking situation. The carers are also concerned for their own safety - trying to support Mum means they may also suffer an injury.
I don't know if it is mainly because she has lost more strength in her legs, or that the dementia stops her from processing the information and the guidance we are giving Mum, but either way, it has become dangerous to carry on, and a decision has been taken that in future, unless she is clearly very alert and able, on most occasions Mum will have to be hoisted.
I do accept this. We have always had a hoist in place, and it has been used in the past, when Mum was unwell, or if she did not feel strong enough to try and get up under her own steam; but it still upsets me to know that very soon there won't be this choice for her, and it will be a permanent backward step.
Sunday 18 February 2018
The Dambusters, or, Mum's Minor (or Major!) Mishaps.
The Dambusters, or, Mum's Minor (or Major!) Mishaps
When Mum first came home in March 2012, she was very aware of when she needed to go to the bathroom, and could tell us. Once she was able to weight bear for a few seconds, and transfer onto the glider, we could get her to the loo in good time, and leave her in privacy, for however long she needed.
When she was done and wanted to wash her hands, Mum would call out, "I'm ready!" We then went in to wheel her across to the bath, where she could reach the taps and wash her hands properly.
Of course, this was a state that could not last forever. Over the past three years or so, it became clear Mum was losing the ability to know if she needed the loo or not; indeed, even if she was taken to the bathroom, sometimes she would call, "I'm ready!" and we would go in, thinking she still knew if she really was ready, and start wheeling her over to wash her hands - only to discover a long trail of water spreading across the floor on the way! Thank goodness for easily mopped floor tiles.
The carers and I took to sitting outside the bathroom door, so that we could hear what we euphemistically called "Handel's Water Music," as proof Mum really had spent a penny. There were times, when I was on my own and trying to get her comfortable before she settled down to have a nap, waiting outside the bathroom made me very anxious; if I heard audible evidence Mum had definitely used the loo, I would offer up a silent prayer of thanks, as it would mean a reasonably safe run back to the bedroom.
The other problem was when Mum thought she had opened her bowels, and reckoned she had finished; again, that also became a "hit and miss" affair. Caring for someone with dementia, when her understanding is slowly deteriorating, means you can end up feeling you have been transformed, albeit unwillingly, into a gastroenterologist, who has made a comprehensive study of the human gut and all its functions and foibles. I am not a prude, but it is hard when Mum's movements become a primary focus of my day.
We decided humour was the only way to deal with the problem. We came up with an idea centred on the film, The Dambusters, and Barnes Wallace, the inventor of the bouncing bombs; these were designed during WW2, to destroy three dams in Germany. From then on, whichever member of the family is on Loo Duty, a knowing look and "We've had a Barnes Wallace run," is sufficient to convey all the information required, and we are ready with gloves, cleaning and disinfecting equipment.
When Mum first came home in March 2012, she was very aware of when she needed to go to the bathroom, and could tell us. Once she was able to weight bear for a few seconds, and transfer onto the glider, we could get her to the loo in good time, and leave her in privacy, for however long she needed.
When she was done and wanted to wash her hands, Mum would call out, "I'm ready!" We then went in to wheel her across to the bath, where she could reach the taps and wash her hands properly.
Of course, this was a state that could not last forever. Over the past three years or so, it became clear Mum was losing the ability to know if she needed the loo or not; indeed, even if she was taken to the bathroom, sometimes she would call, "I'm ready!" and we would go in, thinking she still knew if she really was ready, and start wheeling her over to wash her hands - only to discover a long trail of water spreading across the floor on the way! Thank goodness for easily mopped floor tiles.
The carers and I took to sitting outside the bathroom door, so that we could hear what we euphemistically called "Handel's Water Music," as proof Mum really had spent a penny. There were times, when I was on my own and trying to get her comfortable before she settled down to have a nap, waiting outside the bathroom made me very anxious; if I heard audible evidence Mum had definitely used the loo, I would offer up a silent prayer of thanks, as it would mean a reasonably safe run back to the bedroom.
The other problem was when Mum thought she had opened her bowels, and reckoned she had finished; again, that also became a "hit and miss" affair. Caring for someone with dementia, when her understanding is slowly deteriorating, means you can end up feeling you have been transformed, albeit unwillingly, into a gastroenterologist, who has made a comprehensive study of the human gut and all its functions and foibles. I am not a prude, but it is hard when Mum's movements become a primary focus of my day.
We decided humour was the only way to deal with the problem. We came up with an idea centred on the film, The Dambusters, and Barnes Wallace, the inventor of the bouncing bombs; these were designed during WW2, to destroy three dams in Germany. From then on, whichever member of the family is on Loo Duty, a knowing look and "We've had a Barnes Wallace run," is sufficient to convey all the information required, and we are ready with gloves, cleaning and disinfecting equipment.
Sunday 11 February 2018
Cat Companionship
Cat Companionship
We have always loved cats - and dogs too; we had dogs when we lived abroad - but cats, with their independent nature and "attitude," hold a special place in our hearts.
Over the past ten years or more, two cats in particular have shared our lives; both strays, they materialised on different occasions in the garden, and decided to stay. We made concerted efforts to find out if they belonged to anyone in the neighbourhood, but drew a blank; the old adage of "Dogs have owners; cats have staff," has been proved time and again.
Pushkin - nothing to do with Alexander Pushkin - she was named by Mum, because of her pushy nature - was semi-feral to begin with; she would come in, eat rapidly, and skedaddle out again afterwards. Ten years on, she now loves her comfort zones, and is quite the house cat. A little round barrel of a cat, she knows exactly where the warmest places in the house are. She can be found either curled up underneath the lounge radiator, or else stretched out on the bathroom floor, her body following precisely the line of the underfloor hot water pipes. Because the central heating is on so much, this area is warm nearly all the time. We discovered she also liked playing in water, and would dip her paws in puddles left after rain, and splash about, pouncing on flying droplets. She is a tortoiseshell, with a white bib and white paws, and an exceptionally thick double coat; although it took a long time (about four years, at the last reckoning!) she will now allow herself to be picked up and stroked and brushed. She is quite aloof, and not a jumping cat in any way; I have never heard Pushkin miaow, but when she wants to be "fussed," she will come and sit at your feet, and give you "the look." We always get the message, and pick her up for a gentle stroking session. What she lacks in a voice, she more than makes up for with her high decibel purr! When she's had enough, she will suddenly jump down, and go off to one of her other favoured spots.
Blackie also seemed to come from nowhere. I got back from shopping one morning, dumped the bags in the lounge and went out on the patio and, in my usual dulcet tones, sang out, "I'm home!" It was then I saw an enormous black cat, stretched out on the garden seat. He was huge, and completely black; even his whiskers were black and the only bit of colour to be seen were his green eyes. He raised his head and stared at me for a moment, unblinking, before resting his head back on his paws.
Unlike Pushkin, Blackie is definitely a cat who demands attention. He has the full range of "cat conversation," and it really is a case of, "I want to be fussed; do it NOW!" Even so, it took a long time for him to become really happy and confident with us. Because he is such a long cat, sitting with me on the sofa means his head and front paws are on my knee, whilst the rest of him overflows onto the middle seat. For months after he had adopted us, when I stroked him I could tell he was still alert and ready to be away in a moment, if he became unhappy with something. When he wanted to be off, I let him out immediately; no-one is a prisoner in this house! Then he'd be back, and the whole cycle would start again - until one night, he was lying on my knee as usual and, even though he had settled down, I could feel his body was quite tense. I talked to him and carried on stroking him until, quite suddenly, he gave a huge sigh, and I felt him relax. It was as if he had finally accepted he had found a good home, where he could stay without fear. It has been like that ever since.
Blackie quickly settled in to the routine of house; he still does his "rounds," spending equal time with everyone, to enjoy being fussed and receive the appreciation due to him. In spite of his size, in many ways he can be quite reticent - for example, he is easily put off from eating his food, which is why Pushkin is so aptly named. She can hear the opening of a sachet of cat food at 100 paces, and if Blackie is trying to eat his dinner, in seconds Pushkin will arrive beside him, at his bowl. Although she may be small, she soon pushes Blackie out of the way; he retreats, and she eats his dinner. We now feed Blackie alone and make sure he can eat in peace, before Pushkin has her turn.
Because he is now getting on a bit - we think he must be at least 12 years old, if not more - he finds climbing up on the sofa a bit of a struggle; jumping on Mum's bed is like ascending Everest, which he cannot manage anymore, so we lift him up and place him beside her. It makes Mum so happy, having Blackie with her.
He snuggles down on her knees, and I ask: "Isn't he heavy for you?"
"Oh, no," Mum says, stroking his head. "He's fine. He's lovely and warm"
Mum just loves it when he spends time with her; as the dementia has progressed, he seems to know when to go in and bother with her, and quite often spends the night on "guard duty," stretched out by her bedroom door.
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| Mum in the garden with Blackie on the bench beside her (where else would he be?!) and Pushkin, probably looking round for some more food! |
Thursday 8 February 2018
Mum in Hibernation Mode
Mum In Hibernation Mode
Is it the winter, with the shorter days? So many people feel the effects of the seasons, and winter can be especially trying. I accept happily the changing seasons, but towards the end of November, with the nights getting ever longer, I find myself looking forward to December 21, and the winter solstice, after which the days turn and start to lengthen, and I can feel spring will soon be here.
Since September, when Mum was whisked off to hospital, and we discovered her iron levels were low, we have noticed Mum has been having more days where she sleeps through various mealtimes. It used not to worry me unduly - we can all miss a meal, with no ill-effects, but it is happening to Mum more frequently.
There is no set pattern. On a normal day, she will be up and doing and awake at breakfast, have a nap afterwards, and be up and ready for her dinner at lunch time. After another nap, she is usually read to get up again at about 7.30, and have some supper, before bedtime at 10.00 -10.30. On "sleepy" days, she can be awake at breakfast, and back to bed as usual - and then stay completely fast asleep for hours afterwards; or else she can have lunch, and then sleep right through until 10.30 p.m., when the carers come again for the bed call. When that happens, if Mum wakes up, they will put a clean pad on for her, and settle her back in bed. I put the back of the bed up into the sitting position, and Mum will cheerfully tuck in to tea and cake in bed. We have also experienced her not waking up in the morning, even though the carers have taken her to the bathroom, washed and dressed her in clean clothes, and then got her back in to bed, and she has slept soundly and peacefully for another 6 hours, finally getting up at 2.00 p.m., with the arrival the carers at lunchtime.
This is happening more regularly, and she quite often misses a meal and a cup of tea. It is a strange phenomenon; it's as though her brain has "switched off" for that time, and only comes back to life after a much longer rest period. Today, for example, she was awake enough at breakfast, but falling asleep again at 10.00 a.m. - she kept going long enough to finish her tea, but it was a real effort for her.
We all accept that Mum is getting weaker - there are times when she really can't stand up, or do the "twiddle" from the chair to glider, or bed to chair, and has to be hoisted. The carers we have now, are very good, very understanding and gentle with her, so she doesn't complain about it - at least, not very much! On the other hand, her upper body strength is still pretty good; she can press hard down on the arms of her chair, and lift herself up to sit more comfortably.
She also seems to get be getting more tired; to cheer her up, and give her something to look forward to, Mum knows I have booked for us all to go for Tea at the Ritz in July. I never make too many plans, but with a bit of faith and hope, perhaps with the coming of the spring she might find a new release of energy, and take a couple more "forward" steps again.
Is it the winter, with the shorter days? So many people feel the effects of the seasons, and winter can be especially trying. I accept happily the changing seasons, but towards the end of November, with the nights getting ever longer, I find myself looking forward to December 21, and the winter solstice, after which the days turn and start to lengthen, and I can feel spring will soon be here.
Since September, when Mum was whisked off to hospital, and we discovered her iron levels were low, we have noticed Mum has been having more days where she sleeps through various mealtimes. It used not to worry me unduly - we can all miss a meal, with no ill-effects, but it is happening to Mum more frequently.
There is no set pattern. On a normal day, she will be up and doing and awake at breakfast, have a nap afterwards, and be up and ready for her dinner at lunch time. After another nap, she is usually read to get up again at about 7.30, and have some supper, before bedtime at 10.00 -10.30. On "sleepy" days, she can be awake at breakfast, and back to bed as usual - and then stay completely fast asleep for hours afterwards; or else she can have lunch, and then sleep right through until 10.30 p.m., when the carers come again for the bed call. When that happens, if Mum wakes up, they will put a clean pad on for her, and settle her back in bed. I put the back of the bed up into the sitting position, and Mum will cheerfully tuck in to tea and cake in bed. We have also experienced her not waking up in the morning, even though the carers have taken her to the bathroom, washed and dressed her in clean clothes, and then got her back in to bed, and she has slept soundly and peacefully for another 6 hours, finally getting up at 2.00 p.m., with the arrival the carers at lunchtime.
This is happening more regularly, and she quite often misses a meal and a cup of tea. It is a strange phenomenon; it's as though her brain has "switched off" for that time, and only comes back to life after a much longer rest period. Today, for example, she was awake enough at breakfast, but falling asleep again at 10.00 a.m. - she kept going long enough to finish her tea, but it was a real effort for her.
We all accept that Mum is getting weaker - there are times when she really can't stand up, or do the "twiddle" from the chair to glider, or bed to chair, and has to be hoisted. The carers we have now, are very good, very understanding and gentle with her, so she doesn't complain about it - at least, not very much! On the other hand, her upper body strength is still pretty good; she can press hard down on the arms of her chair, and lift herself up to sit more comfortably.
She also seems to get be getting more tired; to cheer her up, and give her something to look forward to, Mum knows I have booked for us all to go for Tea at the Ritz in July. I never make too many plans, but with a bit of faith and hope, perhaps with the coming of the spring she might find a new release of energy, and take a couple more "forward" steps again.
Tuesday 6 February 2018
Tea at the Ritz - At Ninety-six!
TEA AT THE RITZ AT NINETY-SIX
Wendy and I had been away for 48 hours in Germany, on a working trip for me; everything had gone well, and we were on our way home. Sitting in Frankfurt airport, waiting for our flight to be called, we started talking about Mum's/Grandma's 96th birthday, that was coming up in a few weeks' time. I had already started to write a little poem for her, but it needed polishing and more appropriate words inserted in a couple of lines, that would suit and please Mum best.
I got out the rather crumpled piece paper with the verses I'd been working on (when inspiration strikes, I will write on anything - tissue box lids, serviettes, even - on one occasion - a paying-in slip, whilst I waited in a queue at the Bank!) and read it to Wendy. It's good to read poetry aloud; it helps you to feel the rhythm and make sure it scans and makes sense. We were working very quietly, but soon realised some people were listening and taking in every word. We explained what we were doing, and it became like a poetry workshop, in the most unexpected place.
By the time we had to stop and board the plane, we had just about got the poem to flow as we wanted, and when we got home, it was incorporated into a special card we made for Mum. Sitting in the Palm Court, enjoying Tea at the Ritz on her special day, this is the poem we read out to her:
Tea at the Ritz at Ninety-six
It's Tea at the Ritz when you're ninety-six
A special family outing;
It's been booked and planned with attention and care
And for weeks the days we've been counting.
The waiters are charming, and make such a fuss
You'd think the Palm Court was made just for us -
There's champagne and tea with cream scones and cakes,
All delivered with flair on fine china plates.
As the pianist plays "Happy Birthday to You,"
A cake with a candle aflame
Is presented with love and our wishes to you
"Many Happy Returns! Again and again!"
Wendy and I had been away for 48 hours in Germany, on a working trip for me; everything had gone well, and we were on our way home. Sitting in Frankfurt airport, waiting for our flight to be called, we started talking about Mum's/Grandma's 96th birthday, that was coming up in a few weeks' time. I had already started to write a little poem for her, but it needed polishing and more appropriate words inserted in a couple of lines, that would suit and please Mum best.
I got out the rather crumpled piece paper with the verses I'd been working on (when inspiration strikes, I will write on anything - tissue box lids, serviettes, even - on one occasion - a paying-in slip, whilst I waited in a queue at the Bank!) and read it to Wendy. It's good to read poetry aloud; it helps you to feel the rhythm and make sure it scans and makes sense. We were working very quietly, but soon realised some people were listening and taking in every word. We explained what we were doing, and it became like a poetry workshop, in the most unexpected place.
By the time we had to stop and board the plane, we had just about got the poem to flow as we wanted, and when we got home, it was incorporated into a special card we made for Mum. Sitting in the Palm Court, enjoying Tea at the Ritz on her special day, this is the poem we read out to her:
Tea at the Ritz at Ninety-six
It's Tea at the Ritz when you're ninety-six
A special family outing;
It's been booked and planned with attention and care
And for weeks the days we've been counting.
The waiters are charming, and make such a fuss
You'd think the Palm Court was made just for us -
There's champagne and tea with cream scones and cakes,
All delivered with flair on fine china plates.
As the pianist plays "Happy Birthday to You,"
A cake with a candle aflame
Is presented with love and our wishes to you
"Many Happy Returns! Again and again!"
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| Mum and Granddaughter Wendy Celebrating Mum's 96th Birthday with Tea at the Ritz |
Sunday 4 February 2018
Overriding Mum's Bad Mood
Overriding Mum's Bad Mood
Mum woke in the early evening from her afternoon nap in a very bad mood. The carers were helping her to transfer to the glider, and Mum had a real "go" at one of them.
"Get out! I don't like you!" she yelled. Compared to some of the screaming fits Mum can get into, this was mild.
The younger carer took it in her stride, and retreated for a while, leaving the older carer to deal with Mum. It worked well, and soon Mum was back in the bedroom, and sitting in her chair.
There was an interesting wildlife programme on t.v., where the animals had been fitted with lightweight cameras and filmed each other, with fascinating - and sometimes hilarious - results. Mum wasn't following it very closely, she was more engaged in taking handfuls of tissues out of the box, and arranging them in an oblong pile on the table. Tissues are really expensive, particularly at the rate Mum gets through them - at one point, she was disposing of 6 and a half boxes a day, so we told her not to take such a wedge, but just take out one at a time from the box.
This did not go down well. "I buy them!" she insisted, "you can't tell me what to do!"
I am always wary when Mum gets into a strop with anyone, in case it spills over to the rest of us, after which she might start refusing to eat or drink. On those occasions, I always try to tempt Mum into having something - if only a few sips of tea - but that can also backfire. When she is in a really mutinous mood, she will sit with her lips clamped shut and reject any suggestions we might make. On other occasions, she might momentarily agree to have a mouthful of tea, and take a sip, but then refuse to swallow it, and spit it straight out again.
I have been known to remonstrate with her: "Ma, why on earth are you spitting out a perfectly nice drink of tea?!"
"My mother taught me to do it."
"No, she didn't - my Grandma did not approve of anyone spitting!"
"Yes, she did!"
Or:
"You've put something in it!"
"Of course I haven't. It's just a lovely cup of tea, with fresh full cream milk in it."
"I'm not drinking it. You've put something in it."
Which is the point at which I give up.
If there is time to leave Mum alone for a while, it may be long enough for her to forget what it was that upset her, and she will click back into what we call "normal mode." In that case, she will eat and drink something.
I do worry, because I am aware of the importance of keeping up her fluid intake. This evening, I decided to take a very positive approach, and try to override any remaining grumpiness.
I made Mum's tea, and a slice of her favourite coconut sponge cake. I didn't ask the question if she would like some supper; I simply produced it, and strode purposefully into the bedroom.
"Hi, Ma!" I said, "I've made you a lovely cup of tea! Look!" I held out the mug of tea for her to see it.
"Is that strong enough for you?"
"Oh, yes, that's lovely." (Her approval didn't mean she would actually drink it).
"Good!" I put the mug down in its usual place, always well away from Mum, while it was still hot.
"And I've got you a lovely slice of coconut sponge cake - your favourite! And what an interesting programme you've got on the t.v! Just look at all those animals, with tiny cameras - they're filming each other!"
I kept talking non-stop, so that Mum couldn't get a negative word in edgeways, and carried on like that, in a very firm, positive tone, for what felt like ages, but probably only fifteen minutes or so. I laid a cover on the table, put down the bowl with the cake, and started feeding Mum.
Whilst she was eating, I kept up a running commentary about the programme, and by the time we got to a section on meerkats, Mum was in a different frame of mind. The final "Winterwatch" programme followed, and Mum became quite engaged by it; she also finished every last crumb of cake and every last drop of tea.
Sometimes you just have to get in there, and be determined and positive things will turn out well. It doesn't always work, but if Mum can be distracted from her bad mood, the odds are in your favour!
Mum woke in the early evening from her afternoon nap in a very bad mood. The carers were helping her to transfer to the glider, and Mum had a real "go" at one of them.
"Get out! I don't like you!" she yelled. Compared to some of the screaming fits Mum can get into, this was mild.
The younger carer took it in her stride, and retreated for a while, leaving the older carer to deal with Mum. It worked well, and soon Mum was back in the bedroom, and sitting in her chair.
There was an interesting wildlife programme on t.v., where the animals had been fitted with lightweight cameras and filmed each other, with fascinating - and sometimes hilarious - results. Mum wasn't following it very closely, she was more engaged in taking handfuls of tissues out of the box, and arranging them in an oblong pile on the table. Tissues are really expensive, particularly at the rate Mum gets through them - at one point, she was disposing of 6 and a half boxes a day, so we told her not to take such a wedge, but just take out one at a time from the box.
This did not go down well. "I buy them!" she insisted, "you can't tell me what to do!"
I am always wary when Mum gets into a strop with anyone, in case it spills over to the rest of us, after which she might start refusing to eat or drink. On those occasions, I always try to tempt Mum into having something - if only a few sips of tea - but that can also backfire. When she is in a really mutinous mood, she will sit with her lips clamped shut and reject any suggestions we might make. On other occasions, she might momentarily agree to have a mouthful of tea, and take a sip, but then refuse to swallow it, and spit it straight out again.
I have been known to remonstrate with her: "Ma, why on earth are you spitting out a perfectly nice drink of tea?!"
"My mother taught me to do it."
"No, she didn't - my Grandma did not approve of anyone spitting!"
"Yes, she did!"
Or:
"You've put something in it!"
"Of course I haven't. It's just a lovely cup of tea, with fresh full cream milk in it."
"I'm not drinking it. You've put something in it."
Which is the point at which I give up.
If there is time to leave Mum alone for a while, it may be long enough for her to forget what it was that upset her, and she will click back into what we call "normal mode." In that case, she will eat and drink something.
I do worry, because I am aware of the importance of keeping up her fluid intake. This evening, I decided to take a very positive approach, and try to override any remaining grumpiness.
I made Mum's tea, and a slice of her favourite coconut sponge cake. I didn't ask the question if she would like some supper; I simply produced it, and strode purposefully into the bedroom.
"Hi, Ma!" I said, "I've made you a lovely cup of tea! Look!" I held out the mug of tea for her to see it.
"Is that strong enough for you?"
"Oh, yes, that's lovely." (Her approval didn't mean she would actually drink it).
"Good!" I put the mug down in its usual place, always well away from Mum, while it was still hot.
"And I've got you a lovely slice of coconut sponge cake - your favourite! And what an interesting programme you've got on the t.v! Just look at all those animals, with tiny cameras - they're filming each other!"
I kept talking non-stop, so that Mum couldn't get a negative word in edgeways, and carried on like that, in a very firm, positive tone, for what felt like ages, but probably only fifteen minutes or so. I laid a cover on the table, put down the bowl with the cake, and started feeding Mum.
Sometimes you just have to get in there, and be determined and positive things will turn out well. It doesn't always work, but if Mum can be distracted from her bad mood, the odds are in your favour!
A Psychiatrist Calls
A Psychiatrist Calls
Six months after Mum came home, one of the local hospitals contacted us, to arrange a home visit by a psychiatrist, to check Mum's mental health, and level of dementia.
We all wanted to know how Mum was, so an appointment was made, and a few days later the doctor arrived to examine her.
He was very pleasant, and Mum was all smiles, and chatting away, about her life abroad - the doctor was also from overseas, so Mum felt they had something in common.
As their conversation progressed, Mum came out with a few outlandish remarks - she was going to marry a Frenchman, and was really looking forward to the wedding, which still had to be arranged; she was also working for Treasury. It was true that she had worked for Treasury, albeit a very long time ago, when she lived in Africa; she had been retired for years! When it was pointed out to her that she was nearly 93, and so probably wouldn't still be employed, she was quite insistent:
"Oh, yes! They have phoned me up, and they want me to carry on, because I make them so much money!"
Then came the clincher: "And I'm going to be working in Australia for Treasury, too!"
All these comments were noted down. Then the doctor asked Mum, if she would mind answering a short questionnaire?
"Yes, I can do that!" Mum was confident.
"Please count back from 100 - in sevens."
Now, the doctor clearly didn't realise that all her working life, Mum's career had involved figures; without any hesitation, Mum started off: 100; 93; 86; 79; 72; 65........ when she got half way, he twigged it was absolutely no problem for Mum to reel off numbers all day long.
He progressed to other questions - the day of the week - she got that right; the date..... Mum was a number or two out. She also got confused drawing hands on a clock to show the time, but for me, the piece de resistance came when the doctor posed a question about the Royal Family.
He asked, "Who is the head of the Monarchy?"
The problem was, English was not the doctor's first language. Until then, Mum had coped pretty well understanding his earlier questions, but with this one, he placed the emphasis very firmly on the second syllable of the word "Monarchy," and pronounced it to rhyme with Malarkey.
We all wanted an accurate assessment about the state of Mum's mental health, but I could see she was never going to work her way back from what sounded like Malarkey, to the word Monarchy. I said to the Doctor, "Excuse me, but I think you probably meant to say....Monarchy?"
On hearing the correct pronunciation, Mum came straight back: "It's the Queen!" So that was one more question she got right.
Finally, the test was complete, the scores added up, and the doctor gave us his opinion. Mum certainly had dementia, and he would recommend she start on Memantine, as it could help her, perhaps by slowing the progression of the disease.
The next hurdle was to persuade Mum that taking another pill was a good idea. She has never been one for taking medicine, but I said I would put it to her, and see what she felt about it.
I knew it was no good telling Mum she had dementia. As far as she was concerned, her mental acuity was perfect, and her memory equally strong, so I told the doctor I would suggest she take it more as a preventative measure, to stop anything happening in the future.
I did really well with this approach, and Mum agreed to try it; the doctor listened what I told her, and began writing out the prescription. He explained the dosage had to be built up slowly, over four weeks, with a gradual increase until the full 20mg dose was reached. If she had any worries about side effects, she could call him.
Mum was nodding her head and said she would try it, but suddenly, as if the previous conversation hadn't occurred, Mum asked: "What are these pills for?"
The doctor then began to tell her, in great detail, that Memantine was for her dementia. I understood he wanted to be completely frank with her, but he nearly talked her out of taking it at all.
"I do not have dementia!" Mum was insistent.
The doctor looked at me, and I looked at him. I decided to have one last try to see if Mum would still agree to try it.
"You don't have to carry on with it, if you don't want to," I said. "It's up to you, Ma. But if I knew I could take a pill that would help me in the future, in case something went wrong, I would definitely take it."
"Oh," she said. "So, it's not for now?"
"I think you should try it. If you don't like it, you aren't forced to take it, Ma......"
"Alright then, I'll try it. But only for a month, mind."
I looked at the doctor, and he looked at me.
"That's fine," he said.
Before he left, he said there would be a follow-up appointment, to see how Mum was getting on. It meant she would be taking a total of three pills a day: Amlodipine (a low dose) to keep her blood pressure at a good level; Anastrozole for the breast cancer she had been diagnosed with, 18 months previously; and Memantine. I hoped that, if Mum didn't experience any side effects, after one month she would be accustomed to taking it, and simply carry on.
With hindsight, and six years on, we can't be sure if the drug has helped Mum or not. Maybe if she had started taking it earlier, a more noticeable benefit would have been achieved; but at 98, we don't really know if it has made a positive difference. I guess it's a case of the road not travelled.
Six months after Mum came home, one of the local hospitals contacted us, to arrange a home visit by a psychiatrist, to check Mum's mental health, and level of dementia.
We all wanted to know how Mum was, so an appointment was made, and a few days later the doctor arrived to examine her.
He was very pleasant, and Mum was all smiles, and chatting away, about her life abroad - the doctor was also from overseas, so Mum felt they had something in common.
As their conversation progressed, Mum came out with a few outlandish remarks - she was going to marry a Frenchman, and was really looking forward to the wedding, which still had to be arranged; she was also working for Treasury. It was true that she had worked for Treasury, albeit a very long time ago, when she lived in Africa; she had been retired for years! When it was pointed out to her that she was nearly 93, and so probably wouldn't still be employed, she was quite insistent:
"Oh, yes! They have phoned me up, and they want me to carry on, because I make them so much money!"
Then came the clincher: "And I'm going to be working in Australia for Treasury, too!"
All these comments were noted down. Then the doctor asked Mum, if she would mind answering a short questionnaire?
"Yes, I can do that!" Mum was confident.
"Please count back from 100 - in sevens."
Now, the doctor clearly didn't realise that all her working life, Mum's career had involved figures; without any hesitation, Mum started off: 100; 93; 86; 79; 72; 65........ when she got half way, he twigged it was absolutely no problem for Mum to reel off numbers all day long.
He progressed to other questions - the day of the week - she got that right; the date..... Mum was a number or two out. She also got confused drawing hands on a clock to show the time, but for me, the piece de resistance came when the doctor posed a question about the Royal Family.
He asked, "Who is the head of the Monarchy?"
The problem was, English was not the doctor's first language. Until then, Mum had coped pretty well understanding his earlier questions, but with this one, he placed the emphasis very firmly on the second syllable of the word "Monarchy," and pronounced it to rhyme with Malarkey.
We all wanted an accurate assessment about the state of Mum's mental health, but I could see she was never going to work her way back from what sounded like Malarkey, to the word Monarchy. I said to the Doctor, "Excuse me, but I think you probably meant to say....Monarchy?"
On hearing the correct pronunciation, Mum came straight back: "It's the Queen!" So that was one more question she got right.
Finally, the test was complete, the scores added up, and the doctor gave us his opinion. Mum certainly had dementia, and he would recommend she start on Memantine, as it could help her, perhaps by slowing the progression of the disease.
The next hurdle was to persuade Mum that taking another pill was a good idea. She has never been one for taking medicine, but I said I would put it to her, and see what she felt about it.
I knew it was no good telling Mum she had dementia. As far as she was concerned, her mental acuity was perfect, and her memory equally strong, so I told the doctor I would suggest she take it more as a preventative measure, to stop anything happening in the future.
I did really well with this approach, and Mum agreed to try it; the doctor listened what I told her, and began writing out the prescription. He explained the dosage had to be built up slowly, over four weeks, with a gradual increase until the full 20mg dose was reached. If she had any worries about side effects, she could call him.
Mum was nodding her head and said she would try it, but suddenly, as if the previous conversation hadn't occurred, Mum asked: "What are these pills for?"
The doctor then began to tell her, in great detail, that Memantine was for her dementia. I understood he wanted to be completely frank with her, but he nearly talked her out of taking it at all.
"I do not have dementia!" Mum was insistent.
The doctor looked at me, and I looked at him. I decided to have one last try to see if Mum would still agree to try it.
"You don't have to carry on with it, if you don't want to," I said. "It's up to you, Ma. But if I knew I could take a pill that would help me in the future, in case something went wrong, I would definitely take it."
"Oh," she said. "So, it's not for now?"
"I think you should try it. If you don't like it, you aren't forced to take it, Ma......"
"Alright then, I'll try it. But only for a month, mind."
I looked at the doctor, and he looked at me.
"That's fine," he said.
Before he left, he said there would be a follow-up appointment, to see how Mum was getting on. It meant she would be taking a total of three pills a day: Amlodipine (a low dose) to keep her blood pressure at a good level; Anastrozole for the breast cancer she had been diagnosed with, 18 months previously; and Memantine. I hoped that, if Mum didn't experience any side effects, after one month she would be accustomed to taking it, and simply carry on.
With hindsight, and six years on, we can't be sure if the drug has helped Mum or not. Maybe if she had started taking it earlier, a more noticeable benefit would have been achieved; but at 98, we don't really know if it has made a positive difference. I guess it's a case of the road not travelled.
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