Yet More Hospital Life - Part 5 - The Ups and Downs of Life - or, Instruments of Torture: Hoists and Banana Boards

Yet More Hospital Life - Part 5 - The Ups and Downs of Life - or,  Instruments of Torture:  Hoists and Banana Boards

I've already said, how quickly you can get used to a completely new way of life, and we soon got accustomed to the longer journey between home and hospital, and made allowances for the more frequent traffic delays en route. Mum also got used being in hospital, and using bedpans instead of going to the bathroom.

Days turned into a week, and then two and three; Mum was terribly nervous of trying anything new, in case it jarred her ankle. She was also still in pain with her right knee, and so not very co-operative with the physiotherapists.

One morning, one of the bright, young physios brought along a beautifully smooth, shiny board.  The shape and colour of a banana, Mum was told this would help her to get out of bed, and spend some time sitting in the chair.

Mum looked suspiciously at the board, and then at the PT. "How I am going to do that?" she asked.

"Don't worry!" the physiotherapist assured her, "I'll help you....."

With that, she lowered the side of the hospital bed, and managed to slide one end of the banana board underneath Mum's behind.

"Right!" she said, enthusiastically.  "All you have to do now is relax, tilt yourself onto the board, let yourself  go, and slide down off the bed, and on to the chair!"

I could see Mum getting tense.  She didn't believe any of it; she was anxious she would go with such a rush and end up landing in the chair with a bump. There was also nothing to hold on to during the "ride." Even with the bed lowered, there was still a substantial difference in height from the bed to the chair seat.

The physiotherapist was not one to give up easily. "Come on," she said, "think how nice it will be, if you can sit in the chair for a while, instead of lying in bed all day!"

"Just a minute," said Mum, employing delaying tactics.  "If this will get me from the bed onto the chair, how will I get back up into bed again?"

She had a point.  It was one thing going from the higher bed to the lower chair; clearly, the banana board would not work in reverse.

"Oh, we'll get you back into bed!" The physio was reassuring.  "That won't be a problem."

Well, even I could see travelling by banana board was likely to make any patient feel out of control, and I thought it was reminiscent of slides in a salt mine near Berchtesgaden in Germany.

Nearly fifty years ago, I worked in Berchtesgaden as a fashion consultant for a company called Arwa, that made pantihose (tights in the UK), stockings and various sorts of fashionable hosiery. During my time with Arwa, I worked jolly hard, especially if there was an exhibition coming up and we had a new collection to prepare, with new colours and styles; but I did have time off, and one weekend found me taking a tour of the salt mine, not far out of  the town.  It was fun - and I was young and reasonably adventurous, although not especially keen on heights!  Some way into the tour, we were presented with the opportunity of taking a slide to get to a lower level in the mine. The slide was about 40 meters long, and formed by two long lengths of hardwood, I think probably oak, with a groove in the middle.  It was worn completely smooth by the thousands of miners - and now tourists - using  it over the years to get from an upper level in the mine to a lower one. We were told not to try to brake ourselves by putting a foot down on the way to the bottom; and with this instruction ringing in my ears, I climbed "aboard" the slide. With a few people in front, and a few more behind me, there was no turning back now! - and I reclined in the groove. Given a gentle push by the guide, we skimmed down to the lower level.  The only trouble was, as we got going, the rate of travel speeded up, and for someone not used to it, the slide was a nerve-racking experience.

A bit further on in the tour, another slide loomed: "This is a baby slide!" the guide laughed.  Yes, it was shorter, and I thought, "In for a penny, in for a pound!" and had another go.

If you had to ride the slides every day, I am sure you would get accustomed to them; but Mum, at 92, had an altogether different view of the banana board.

In the end, she tried it - once. As the physio got her positioned further onto the board, and she started to slide, Mum gave an ear-piercing scream as her weight propelled her downhill into the chair.  Mum sat there shaking,  and I covered her up with a rug and told her she had done very well.  That was the last time she agreed to slide on the board; getting her back into bed was another issue altogether.

Mum sat in the armchair for hours.  The material covering the seat was obviously something that could be cleaned and disinfected, so it felt cold and hard, and was not very comfortable.  I got a rug for Mum and covered her knees, someone else found a foot stool, and there she stayed.

At least it made a change for Mum, to be sitting up in a chair whilst she ate the dinner I brought her;  I made every encouraging remark I could think of, pointing out it was much better than being propped up in bed!

However, soon the time came when Mum had to get back into bed; and that involved using a hoist. Hoists are operated by two people, and I know nurses, carers, and everyone involved in their use, have to be well trained, but I do wonder if, before they are let loose on patients, they are also required to experience being hoisted themselves.  If not, they should be.  Even with the most helpful and reassuring operators around you, it's scary being fitted into a sling and then hooked up to the "crane," lifted out of a chair and swung over to the bed.  Being told to sit still and not move was not helpful; Mum wriggled and jiggled and tried to hang on to something, but there really wasn't anything to hang on to.

It might have taken only a few minutes, but in terms of stress and fear, it felt like a long time before Mum was safely deposited back on the bed.

After the Break (Part 4) - More Hospital Life

After the Break  (Part 4) - More Hospital Life

Catering

It took a while to get used to travelling the extra distance to the hospital Mum had been moved to; there was some resistance to our twice daily visits, and bringing in her food.

Armed with the permission I'd been granted by the first hospital, and taking into account Mum's age, the extended visits were sanctioned. I remember signing a disclaimer about providing Mum's meals, but eventually we could carry on as before.

By this time, it was getting on towards the end of November. The weather was getting worse; in rush hour traffic, with wind and rain, the journey could take an hour. Even so, our meals for Mum were still warm on arrival, and she would eat everything I had prepared for her. The food provided by the hospital catering did not have anything that Mum would eat; it was, as she put it, "All mucked about," with gravy often poured over the food; the sandwiches were also not to Mum's liking, as they included all sorts of "extras," such a spices and mayonnaise - none of which Mum touches. (I have to admit, I'm like this, too. I like plain bread and butter, and maybe a tomato, or a cucumber, as a filling.  The moment "a little bit of this, and a little bit of that..." are added, the whole thing has been ruined for me.  Mum and I are not, and never have been, what you could call adventurous with food!)

On one evening, I had made a large pan of Lancashire hot pot; wrapped up in the hot box, when I arrived on the ward, it was still piping hot, and smelled delicious. The aroma had the effect of the replicating the old Bisto kids' advert; as I walked down the main aisle of the ward, to Mum's bay, people looked up and, if they were mobile, followed me. They asked what I'd got in the hot box, and I explained it was Mum's dinner.

I know it's not easy catering for large numbers of people on a daily basis, on a limited budget; what I  also know, is that it is not difficult to make nutritious, delicious food quite cheaply; and the simpler the dish, the more people there are who are likely to enjoy it. Not everyone is into nouvelle cuisine and, talking to people around Mum's age, they are not overly fond of spicy  food, either.

Mum also likes bananas; I often left one by her bedside, to have as a snack when she felt like it. One day, the lady in the next bed called me over.

She said, "Your Mum's lucky, having you bring in the food she likes.  I've just been given this orange....."

She held it out for me; it was frozen, a solid ball of ice.

She asked, "How am I supposed to eat that?"

"And where on earth has it been stored?!" I wondered.

"I think I'd better be careful I don't drop it on my foot....."

Well, we had to laugh - but I fear other patients were quite envious of Mum and her custom-made menus.  When you're in hospital, you need to eat properly, to keep up your strength and help you get well enough to be discharged.

The nursing staff were, on the whole, very good.  They were all rushed off their feet, but somehow they kept smiling, kept going, and kept the patients cared for. There were a couple that were outstanding -  one was a lady from the Philippines, who was always patient, always smiling, and who had enough time to talk to everyone, yet still got everything done; the other was a male nurse from Liverpool, who made sure patients who needed help with eating and drinking, got food and fluids into them. He seemed to have eyes in the back of his head, and could keep tabs on anyone who might be in danger of trying to walk to the bathroom on their own, when they should wait for help.  He knew the street where Mum was born in Liverpool, and he would take time to reminisce with her.  It was lovely to know that when I left the hospital for a few hours, Mum was in pretty good hands.

"I'm Dead." (Or: "There's No Point Getting Up.....")

"I'm Dead."  (Or: "There's No Point Getting Up.....")

Scene:  Mum's Bedroom

Time:  One o'clock in the afternoon


A Carer arrives to get Mum up, after her morning nap.

Carer:
Hello Phyllis!  It's time to get up

Mum
Can't you see I'm dead?

Carer (brightly):
Come on, it's time to get up now

Mum stays quiet.

Carer
Alex is going to come in to help you get up.....

Mum
I'm dead

Alex enters
Come on, Mum, it's time to get up and go to the loo.  Then I'll make your lovely dinner.

Mum, still grumbling, reluctantly sits up, and allows herself to be helped on to the glider.

The Carer wheels Mum to the bathroom.

Alex
There you are, Mum.  Tell us when you're ready and then we'll take you to wash your hands.

Mum  (looking belligerently at Alex and the Carer)
You're going to have a big shock, because I'm dead!


Needless to say, Mum was very much alive for dinner; she ate the lot, and finished off the meal with 3  After Eight mints and a cup of tea.  At least she wasn't going to be dead hungry.

A Poetic Interlude

A Poetic Interlude

I had a dear friend, whom I had known since I first came back to England in the early 1970s. When she developed dementia, her family moved her into a care home, near to where they lived, and I had not seen her for a while.  When I visited her, I was shocked at the deterioration of her senses, her mind, her memory.  She still had the outward appearance of my friend, but did she know who I was?  and, more importantly, where was she?

I was inspired to write this poem......

Where Is My Friend?

Where is my friend? Hidden
Beneath the tortuous pathways
Of a confused mind.
Where is the steely Matron? - Full of wit
And flashes of wicked inspiration?

She's hiding now, in this frail frame of mind;
Just sitting there, crumpled in her chair.
(It doesn't even look comfortable).
She leans forward, conspiratorially. Oh, yes,
She has all the right vocabulary.

All the right words, from the time when
Her thoughts were razor-sharp, cutting edge.
She says, "I have....." (and now she's counting,
Counting slowly, deliberately, a child again,
Using all her fingers and toes....)

Triumphantly, the answer comes:
"I have eight sons, you know!"
I hear her call me - call me by another name.
She announces loudly to a passing nurse:
"Of course it's her!" She's insistent.

Then puzzlement flits across her face,
Coupled with a sudden, frightening
Uncertainty - so painful to see.
Is she thinking, "Where is my friend?"
Like me?

After Surgery

After Surgery

With much trepidation and reluctance, Mum signed the consent form for surgery on her ankle,

Things then  moved quickly; the operation was scheduled for the next day.  As Mum was convinced she wouldn't survive, we all rallied round to cheer her up and give her some positive thoughts.  Great grandson Al was very good news; more than anyone, he kept her happy, and managed to distract her for much of the time.

It is a horribly anxious time when someone you love is taken to theatre for an operation; Mum might not have been facing major heart surgery, but even so.......

After she had been wheeled off to the theatre, we sat by Mum's bed on the ward, and waited. After an hour or more, I asked a nurse if we could find out how things were going; she told me I could go down to the theatre reception area, and they would update me.

Happily, the news was good.  They said Mum was doing just fine; the epidural had been effective, and she had been awake during the procedure. It would still be a little while before she was back on the ward, but at least she was on her way.

After that, it seemed time passed more quickly, and soon Mum was back in bed on the ward - complaining volubly about the freezing spray she had had to endure on her back, before the operation began. The doctor who accompanied her back to the ward squeezed her hand and said, "I know how cold it is....but it really was necessary, and you coped very well!"

It was clear Mum just needed to rest, and sleep. She was safely tucked up in bed, and that gave the rest of the family the chance to get home and relax, and catch up on some sleep as well.  Being nervous, anxious, worried .....  it is an exhausting state to be in.

Early the next morning, I was back at the hospital;  Mum was awake and quite chipper. The nursing staff said she had had a good night, and had had a bed bath, so I was able to help Mum to wash her face and clean her teeth, and get her started on eating her cornflakes.

During the course of the morning, the surgeon arrived on his rounds. After being so against letting him operate, now Mum was all smiles and extremely flirty! and thanked him profusely for taking such good care of her.

Out of Mum's earshot, he explained the full extent of what they had been able to do.  He had inserted a metal plate and half a dozen screws on one side of Mum's left ankle, to hold everything together - looking at the X-rays, I saw a distinct resemblance to a bit of Meccano kit!

He said that although everything had gone well, Mum's bones were like cheese, and very crumbly, and she would need a lot of physiotherapy to help get her up and about again.

Even if Mum's ability to walk was going to be restricted in the future, at least I felt we were making some progress, and I knew we would all encourage her to follow a physiotherapy programme.

Mum stayed in hospital for a few more days; one of us continued to go twice a day, continuing the routine of an early morning visit, to make sure she ate her breakfast and took her medication, and a second visit in the early evening, to bring her dinner.  There was certainly nothing wrong with Mum's appetite!

One evening, after I had got back from the hospital, and had just begun to think it was time I got to bed, there was a phone call from the Sister on the ward.  Mum was fine, but they were moving her to another hospital, five miles further away.

"We'll do everything for Phyllis," the woman said, "you don't need to worry about anything."

By now it was about 11.30 at night.

"Just a minute," I said. "My Mum is 92 - it's very late at night, it's November, and it's very cold. Of course I shall go round and make sure she is alright, and settled on the new ward."

After another exchange or two, when I was told it was completely unnecessary for me to go, I finally managed to end the call - and end the idea of getting a good night's sleep, after a long day!

It was really hard to get ready to go out again, but it proved to be just as well that I did go to the new hospital.

When I arrived, I had to find out which ward Mum had been sent to; I was determined to check on her, and I would not take "no" for answer.  I said I just wanted to reassure Mum that all was well;  that she knew that I knew where she was; and that I would be back, first thing in the morning.

With much humming and ha-ing, I was finally allowed on the ward to see Mum.  She was sitting in bed, wide awake, very upset, and shivering with cold. She also did not know if her personal items had come with her.

I was mightily unimpressed.  I told one of the nurses, "My Mum has lived abroad for most of her life, in hot countries.  She is not used to being moved out of doors in the middle of the night, when it is so cold, here in England. She needs extra blankets, and, whilst you're at it, have you got a hot water bottle for her?"

I didn't care if I ruffled feathers; my main concern was Mum, and she was so pleased to see me, and hear me asking for help and extra bedding.  Presently, more blankets were provided, and I got Mum well wrapped up, snug and warm, and settled her down for the night. She was very happy when I found her personal bits and pieces in the locker by her bed.  I promised her I would be back in the morning, as usual.

Then, at last, I could go home and get some rest.

After the Break (Part 3 - Surgical Decision)

After the Break (Part 3 - Surgical Decision)

Mum had been in hospital a few days, and had further checks and x-rays; it became clear her broken ankle wasn't going to heal without surgery. 

A charming young orthopaedic surgeon came to explain the problem to Mum, but we could tell she wasn't really taking anything in.  All she could hear was "operation" and "anaesthetic," and she was terrified.

The consultant was incredibly patient. Over and over again, he explained what they would need to do; he said they would try an epidural, rather than general anaesthesia, so she would be awake during the operation.  She was visited by the anaesthetist, a jovial chap, who told her even if she did have to have to be asleep, modern anaesthetics are so good, and out of the system so quickly after an operation, they were much safer than the ones used when Mum was young, and she should really have the confidence to go ahead. 

Somewhere in her head, I think Mum realised all along that there was no option but to sign the consent form, and get on with it; the longer she left it, the more difficult things would get.  At last, after more cajoling from the surgeon, and reassurance from all the staff on the ward, Mum got hold of a pen, and, with a flourish, signed the form.

"That's it!" she cried, throwing the biro down. "I know that will be the last of me! I feel it in my bones, and I'm psychic!"  

Following that outburst, Mum calmed down a bit; and then the staff ran a battery of tests on Mum which, amazingly for her age, came back as pretty good!

When Mum was a child, she had rheumatic fever, and we knew this had affected her heart. She had been diagnosed with a roughening on the mitral valve, and had always been told to ".......be very careful.... no exertion.....take care of your heart."  

I think that all her life, Mum has been scared about the problems with her heart; yet looking back, you have to think, what a life she has had - and is still having!  She grew up; got married; had a baby. Went out to East Africa; had a great career as an accountant. Travelled back and forth on many occasions  between Africa and the UK by ship (in those years - the 40s, 50s and 60s - it was the only way to travel!) and then in the 70s and 80s, by air. When my Grandma died in Durban in 1985, and Mum came back to live in England permanently, she got herself another job in London, and carried on working until she was over 70! Not bad for someone who had been told to "...... take it easy, and be careful. "

After the Break (Part 2 - Hospital Life)

After the Break (Part 2 - Hospital Life)

As I had promised Mum on the evening she was admitted on the ward, I was back at the hospital very early the next morning.

Because of her age, I was allowed in to see her. The nurses said Mum hadn't had a bad night, but neither had she had much sleep, and it was clear she was not going to co-operate until I arrived.

Mum doesn't like having her face touched, and would not allow anyone to help her to brush her teeth - she may not have many left, but she does like to attend to them herself! and she does not have false teeth. Fortunately, I had brought toothpaste and her toothbrush with me, so I said I would help her. With her broken ankle, obviously Mum couldn't get to the bathroom, so I had brought a beaker with water, and a dish to rinse into, which meant that even though she was lying in bed,  she could manage everything herself.

It is surprising how quickly you can get used to a completely new way of life - one governed by hospital visits, getting into a new routine, as well as coming up against bureaucracy, and having to find ways round it, to make sure the person you love is going to get the best possible attention and treatment.

Mum has always been a pernickety eater; in this respect, Mum and I are alike. We are not at all adventurous in a restaurant, and like very plain food, with nothing added.  We like to see and know exactly what we are getting.  I think this probably stems from when we lived in East Africa, and some of the food could be a bit suspect. I remember on one occasion being served fish for dinner at an exclusive venue; it lay on the plate, smothered in a very pungent sauce. Even with the smell of the herbs, or whatever was in the dressing, I was still wary, and scraped everything off - my father was angry, and kept telling me to stop being ridiculous and get on and eat it, but I persevered, until the fish was completed exposed; and it was clearly "off!" Great apologies from the manager of the restaurant followed, but by then I was also "off" pretty well anything else he tried to tempt me with, and ended up with some mashed potatoes, carrots and peas. That suited me just fine.

Mum also found the food in hospital left a lot to be desired, and she wouldn't eat it. I didn't expect the meals to be as good as good home cooking, and I was also concerned about the cleanliness of the crockery. I have no idea how the washing up was achieved, but when we were offered tea in cups that had not one, but several stale tannin rings still inside them, it was clear they had missed being cleaned properly. I was very concerned about this lack of attention to detail.

There were other problems, too. Mum cannot swallow pills easily, and takes them on a spoon with her cornflakes.  This may not be the ideal way to take one's medication, but at least everything goes down in the end!  The nurses were putting Mum's pills in a little plastic pot, and expecting her to take them like that; the pills sat on the bedside table all day, and no amount of persuasion would get Mum to swallow them.

This could not go on. I had a discussion with the senior ward manager, and got permission to bring Mum's food in for her, and so began a routine where I would visit Mum twice a day. When I arrived first thing in the morning, Mum had been washed and was sitting up in bed; I then helped her to do her face and teeth. After that, I served her cornflakes, with lots of full cream milk, which she loves. (At this time, it was considered skimmed, or at the most, semi-skimmed, milk was all that people should use; I took the view that at 92, if Mum fancied full cream milk, she could have it!)  As the cornflakes went down, so did her medication; she happily swallowed everything.  It really was not difficult, and I think the staff were reasonably happy to know there was at least one patient on the ward being given "special" attention.

For a snack at lunch time, I made either ginger jam or strawberry jam sandwiches;these were left at Mum's bedside for her to enjoy when she wanted something to eat. After breakfast, and whilst Mum had a morning nap, I went back home, to catch up a bit on things I had to do.

At about 5.30, I began cooking Mum's evening meal; as soon as it was ready, I would quickly dish up. Carrots, peas - whatever vegetables Mum fancied - potatoes and perhaps fish, or a dish of cauliflower cheese - all beautifully separate on the plate, and steaming hot.  A swift wrap of foil, and then the plate snugly fitted into a hot box we had made, and I was in the car and off, back to the hospital.

Even allowing for the drive, and finding parking, and getting up to the ward, by the time I uncovered the plate for Mum, the food was still piping hot, and she tucked in. When you have an ordeal to face, you need to keep your strength up, and I could not bear to think of Mum not eating properly.

What I didn't know on the morning of 5 November, was that this routine would go on for another four and a half months! For the whole of the time Mum was in hospital, at least one member of the family visited her twice a day, every single day.  It was not a case of, "Well, it was nearly every day...." or "We only missed going on a couple of days...."  Someone was there, without fail, to help with her washing, her medication and her food.