Through a veil of half-consciousness, I heard the phone ringing this morning. When I finally awoke, there were four messages waiting for me. First, it was the nurse who, having read the letter I left for her yesterday, informed me that:

  • she couldn't administer the antibiotic to my mother, as she had not yet received the authorisation
  • she could see no point in taking a urine sample (the antibiotic would interfere with the results) and she didn't think it would be possible to persuade my mother anyway
So much for that. The next message was also from the nurse. She said that my mother had flatly refused to take the Aricept tablet, and there was nothing the nurse could do about it. In the background I could hear my mother's voice:

'No, no, I will not! No, NO!'

I presume she was talking to my dad, who was probably persisting in trying to get her to take the medicine. The next two calls were both from him, each asking me to call. When I did call him back, the conversation went like this:

Me: 'Hi dad. It's Mike. You asked me to call you.'
Dad: 'Yes, I did. Now what was that about?'
I pause, since it is sometimes better not to lead the conversation too much.
Dad: 'Ah yes, I remember. You know that lady? Well she was round here today and, to put it bluntly, your mum abused her. She wouldn't take her pill. She got very agro, and I was quite upset about it. Are you going to be coming over today?'

I explain that Greg will probably be over, as he arrived back from the UK yesterday with Regan and Cassy. Next I call Greg and explain the situation to him. He will make an attempt to get mum to take both tablets later in the day.

This whole thing is so frustrating! The problem in Australia is not that there are no services to look after old people, but that there are too many and they are only very weakly coordinated. Here we are in the ridiculous situation of having one service tell us mum needs a treatment, two other services required to play along bureaucratically, and then the first service saying it cannot do anything because the bureaucracy wasn't done properly. Meanwhile, if my mother does have a urinary tract infection, she continues to suffer!

I can see what is going to happen is that Greg and I will end up giving mum the daily antibiotics (it is only for seven days), and her Aricept program will just be allowed to lapse. I don't worry too much about this. We were sceptical about the Aricept right from the start for several reasons:
  • mum has a history of refusing pills
  • Aricept results are short-lived, minimal and, some authorities argue, non-existent
  • Aricept has a fairly high probability of the usual side effects: nausea, vomiting, headaches, dizziness, etc.
  • Aricept is less effective for patients who have passed the early stages of Alzheimer's
Nevertheless, the prospect of a daily visit by a qualified nurse seems a very good thing to initiate, whatever the pretext - that was the main reason we went ahead with the Aricept. Dad appears to be happy to take his Aricept for the time being, so the nurse's visits will continue, and her professional surveillance will be good for both mum and dad.

I sometimes feel like banging my head against a brick wall. Since we started to get involved with the social services in April I have tried to stress over and over again that the priorities for mum and dad are good nutrition and good hygiene, but this has not had much effect. Here we are in July, and the only progress we've made on either of these problems is that Pauline can help mum to take a shower once a week - providing Pauline is available. Regardless of our progress in other areas, I am beginning to think that we may be better off just arranging something ourselves, and cutting out the complexities of dealing with the social services. For example, I shall ask around at a couple of local cafes to see if they could deliver sandwiches to the house every afternoon. Then we would at least know that mum and dad had something to eat each evening.