One of the most discouraging developments has been the breakdown of mum's toilet behaviour.

Rachel was the first to notice that there had been a sudden deterioration. There was more than one clue. There was a strong smell of urine around the house. A bucket was being moved around. At one point a pair of dad's socks were found in the bucket, soaking in urine. Mum was seen a couple of times looking a bit lost and hitching up her skirts in the kitchen. It seems that she had been urinating in the bucket - one that has for years been used as a garbage bin under the sink. The reasons for this are hard to determine, since the toilet can be seen from the kitchen. Moreover, mum and dad have now been in that house for two decades (though to me it is still new, not home, and now never will be). I would have thought that 20 years of repeated daily trips to the same toilet would have reinforced and embedded the behaviour pretty deeply. Maybe it did. Maybe the deterioration is just as deep.

So, one of the main criteria in determining what level of care people need, along with the ability to feed and dress themselves, has broken down for mum. The argument for keeping her at home in 'familiar surroundings' is also breaking down.

Several times this last week we have found that mum has wet the bed at night. There has been a raised level of care and support, with Rachel and Regan taking away sheets and washing them. They also both bought waterproof under-sheets which we have now fitted to the bed.

There was sufficient reason for me to take a longer stay at mum and dad's this week - with the elevated need to watch mum, and a vet's appointment for Fluffy which required that she not eat for several hours previously. I arrived on Wednesday evening and hid all the cat food. Mum was already in bed. In the morning I took the cat to the vet and waited for mum to get up. When she did I went to check the bed. It stank - or something did - of urine, but it appeared to be dry, I took the sheets off anyway, and changed them, but even the mattress below also seemed dry, despite recent history.

We have a suspicion that this bed-wetting may be related to another urinary tract infection, but the doctor was not disposed to examine mum or get tests done. Instead, she simply prescribed a week-long course of antibiotics. Rachel got the visiting nursing service to take on the administration of these tablets, even though we, the family, would have been present for nearly every day of the course. This entailed about an hour's worth of paperwork on Thursday, already three days into the course of seven.

And there is more. At some stage on Thursday I went to the toilet and found excrement smeared on the seat. I cleaned it, only to discover the same thing later in the day.

There's no point asking mum about this, she doesn't understand, can't remember, and can't say. There's no point asking dad about this. He denies everything and blames it all on mum anyway.