Daughterly Concerns

When I get back from Mother’s I am always in several minds; relief to be home and guilt at leaving her make uncomfortable partners. I also need to reflect on how things have been, as when I am there I seldom have much opportunity.

It wasn’t great timing coming home on Friday afternoon. For starters it was very hot and I had left Not Cat’s pillow that I can chill in the freezer in London. He had the ice blocks for my food instead, wrapped in towel underneath the shredded paper in his pet caddy. Probably a bit bumpy, but I didn’t want him overheating. That happened to Cat once on the relatively short journey to the cattery and it was very frightening.

My rhubarb survived without its cold companion. The mushrooms looked decidedly sorry for them selves and the hummus fizzed.

But the main reason I felt bad leaving was because of Mother.

When I arrived on Tuesday I saw her foot was swollen. I asked the carers about it. Neither knew how long it had been swollen. A District Nurse had been in the morning to do the dressing on her heel (it’s the same foot) and not said anything. I asked the carers to make a note so that the DN would look at it when she came on Thursday as I was likely to be already away on the boat, chugging along to the pump out, a journey that was more than necessary. But I’ll spare you the details.

A week ago, after a discussion with the GP, Mother’s nightly dose of Mirtazapine was halved. She had been sleeping late in the morning and very drowsy. On Monday night she was very unsettled and the carers blamed the reduced dose. They asked me repeatedly what I was going to do. In turn, I repeated what the GP had advised; we needed to wait at least a week to see how it panned out. This response was met with pursed lips and shaking heads.

On Tuesday night, Mother went to sleep in seconds. She had been delighted to see Not Cat. I don’t think she realises he’s mine, but she knows he’s not Cat, and points at him excitedly with lots of “Look, darling! Look! A little dog!” When he goes up to her and rubs her hand she beams. Just watching him soothes her More than ever I feel that there should be animals in every facility for the elderly. In fact one of the best ideas I’ve come up with is for a care home combined with a donkey sanctuary. In the hospital where Mother has had her three incarcerations this year, even PAT dogs are not allowed. The reason is Health and Safety, yet I know my mother’s health is improved by the presence of animals.

The guest room was booked on Wednesday night, so I tried out the new Aerobed which I inflated in Mother’s sitting room. The bed is fantastically comfortable. The problem was getting the chance to be in it.

Mother had been nodding since six o’clock. At half past seven we got her washed and into bed. I planned to have a glass of wine, play with Not Cat and go to bed early with my book.

So much for plans.

No sooner had I kissed her goodnight than Mother sat up. She was full of questions and fairly determined to get up. I tried reading to her, but that only made her more alert.

Not Cat was weaving around my legs, plainly asking for attention. Like Cat, he has quickly understood that when we are at Mother’s she gets my attention during the day, but once she’s in bed, he can have his time. It wasn’t happening.

I began to understand Elder Abuse. I’d been on the go since eight in the morning. It was now gone ten at night and I’d had no more than five minutes to myself all day. Fearing I might say something I’d regret, I went out into the garden and sat for ten minutes. When I came back inside, Mother was sitting on the end of the bed. I heated some Complan. She drank it, and finally began to doze.

Unsurprisingly, when I did get to bed, I was too tired to read. Unfortunately, I was also too tense to sleep. I lay listening for any movement from the bedroom. Not Cat, who had been racing around the garden now began to race around the flat. The previous night, he’d fallen asleep almost as soon as we reached the guest room, tired out, I’d assumed from all the exercise in the night air.

I fell asleep. At one fifteen I woke up. Mother was getting out of bed. She wanted the loo. Mission accomplished, she went back to sleep after only fifteen minutes chat. I went back to my own bed.

I must have been sleeping pretty deeply, because the next thing I knew it was five in the morning and I woke with a start to find Mother beside me. She’d taken herself to the loo again, and as it was light, come through to the sitting room. It took a deal of persuading to get her back to bed.

The carers come to give her her meds between seven and eight, so I knew I needed to be up by then. I felt surprisingly fresh. Mother went back to a deep comfortable sleep after the carers left. I deflated the bed and had breakfast.

Fortunately the person who had been in the guest room had removed all her stuff and the cleaner had gone in early, so I was able to leave a disgruntled Not Cat there while I was out on the boat.

I fetched him when I got back and headed for Mother’s. The DN had been. “What did she say about the swelling?” I asked. Blank stares. No one had asked, and she hadn’t commented. I wasn’t happy. Again I was asked if the medication was to be increased again. I gave the same answer.

Mother seemed under the weather, even pushing a chocolate pudding aside. She kept saying her heel hurt.

On Friday morning, I called the GP. when I described Mother’s foot, she immediately said one of the team would make a visit. I waited, though my intention had been to leave before the sun got into its stride. Mother was sleepy and quiet. She had her porridge and Complan, but could not be tempted by anything much at lunchtime. She sipped some banana milk I made up for her.

The doctor came. He looked at Mother’s foot and felt her leg. “Oh darling,” she said to him, “please don’t. That hurts so much.” She has an infection due to the sore on her heel. He prescribed anti-biotics. We discussed the Mirtazapine. He reckoned that the infection was the more likely cause of her restlessness, as she is obviously in quite a deal of discomfort. As he pointed out, she is very slight, so we’re leaving the new dose as it is for at least another week. I told the carers. they were silent.

This has been another learning curve for me, as I felt under quite a lot of pressure to ask the doctor to increase the dose again, despite feeling we had not given it enough time. I hope the news that Mother has an infection will make carers more vigilant, not just with mother, but with other tenants, when they notice something unusual. Or maybe the problem is that they hadn’t noticed. However good the carers are, they are not as focussed on any one resident as a relative is. Yet over and over I have been told subtly and unsubtly that they know her best as they are there more than I am. It’s a tricky one. Particularly as diplomacy is not my strong point.

So I felt bad leaving Mother. I felt she could have done with me being there a couple more days while the anti-biotics got to work, and I could have made sure she had lots of fluids and rest.

Not Cat would have been happy to stay. He shot out of the guest room like a bullet on Friday morning and scuttled round the corridors to the staircase to the ground floor by Mother’s flat. It has a fire door so he had to wait for me. He raced down the stairs. We met a carer at the bottom. She checked with me, then opened the door and Not Cat sped round to Mother’s door.

He has loved the easy access into the garden, and this little film, though rather dark, shows him enjoying it at night.

11 thoughts on “Daughterly Concerns

  1. Morning Isobel, this is sad to read. I’m especially saddened that no one had identified the infection when dressing the heel. I know I asked a little while back about a heel pressure relief, but I can’t find that comment or see a reply.
    Nutritionally you’re doing all the right things, but is this being carried through when you’re not there?

    • Oops sorry, I didn’t answer your other question.
      Complan has proved a lifesaver. I buy it in all the flavours I see, though I’ve yet to find the veg one. I ask that Mother has it in addition to a meal not instead of, and by and large that is happening, so I know she’s getting fluids and nutrients. Also that she is always left with a drink, either of Complan or apple juice. The carers should record everything she has in a food diary. Some are better than doing this than others, but I can see that generally the carers like the Complan too; I don’t mean to drink themselves, but it’s an easy way of giving Mother something to keep her going. I still haven’t managed to stop some asking her if she wants a drink, and not leaving her one anyway if she says no.

      • That all sounds pretty good. DO you know about supplementing milk etc with skimmed milk powder to increase calorie input?

  2. Hope the ABs kick in soon so that heel stops feeling sore and your mother can feel more settled. Oh, and I think you display wonderful diplomacy, in the circs! 🙂

  3. What a splendid idea, Isobel. A care home and donkey sanctuary and dogs and cats. Brilliant.

    Health and Safety objections would of course be insurmountable, since these people believe in perfect everything. Perfect safety, perfect health and so forth and refuse to understand life is a continuum of trade-offs.

    One person a year might be bitten but tens thousands would live happier lives.

  4. I’ll ring mid afternoon and see how she is today.
    although I’ve already passed on the doctor’s comments about the meds verbally and in a scribbled note, I think I’d better email them too and ask all carers to be made aware.
    I did answer your question about pressure relief Pseu, I’ll look for it later and post a link here.
    Some people use health and safety as an excuse. I’m guessing whoever is in charge at that particular hospital isn’t keen on pets, as elsewhere they are welcomed on wards even with the sickest patients.
    Badger, if you could set to work creating such a care home, can I put my name down to live there please?
    Jan, I have to do a fair amount of counting to ten, but sometimes I forget!

  5. Its a really difficult position for you to be in Isobel. It would be wonderful to think that all of the recent publicity about the caring profession would lead to overall improvements, but sadly I don’t think it will. Your obvious interest might make the carers think twice, but it is quite sad that they appear to want to use a sleeping pill to make their lives easier.

    • The Mirtazapine is to help control Mother’s anxiety but it can also have a sedative effect. I checked it out on the net, and apparently reducing the dosage can make people restless and more confused until they adjust. It just depends how long it takes.
      I’ve spoken to one of the carers today. Mother’s foot is still swollen, and she’s on fluids rather than meals, but she’d stayed down in the communal area, so i am guessing she might be feeling a bit more like herself.

  6. There have been studies done in the States about cats and other pets at homes for the elderly with the not surprising results that they make everyone a lot happier, alert and content. But it seems few facilities take note of these studies. Allergies, I suppose, are problem and the even more challenging one of finding someone to care for the pet. Though, as everyone is supposed to be a professional care giver, you’d think that wouldn’t be a problem…

  7. Thanks Pseu, I didn’t know about that. I doubt if i can get the carers to do it, but i can when I am there.

    There are many studies showing that having animals with the sick and elderly makes a huge, beneficial difference. The Blue Cross magazine recently had an article about one particular organisation that is working hard to get more schemes and homes to have pets. Age UK has a number of advice leaflets on the subject too.

    Many hospitals have PAT animals too. It’s such a shame that the one Mother has been admitted to doesn’t.

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