Fading from Memory

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Sunday 11 February 2007

Worst of both worlds

By Mike on Sunday 11 February 2007, 23:57 - Journal

In ones and twos we all assembled at mum and dad's place and discreetly checked mum out.

She seemed less somnambulent than I have seen her, but that is not saying much. She was, however, back to her old ways: refusing the Aricept, getting irritated at the family talk around her, and at times muttering and scolding for offences recognised only in her peculiar legislature. It was truly the worst of both worlds: the undeniably corporeal vixen capable of breaking her husband's rib, and the netherworld zombie who can say only 'yes'. Both were there today. At times I was asking myself 'what have we done?'

I shall call Dr Humerus on Tuesday and tell her what I see. There now seem arguments for all of the following:
  • staying off the Risperidone - as it has obviously turned mum into a vegetable
  • renewing the Risperidone - as the attack-mother has not been banished
  • trying something else - as neither of the above is desirable
It looks as if we are getting snookered, but an alternative, such as Seroquel perhaps, may kill our two birds with one stone.

And that is just mum. Dad is losing his minor plot almost as comprehensively. Several times today Rachel or I had to give up while trying to explain something to him as it was just clearly too difficult for him to understand. Example:

Rachel is concerned because, although we make sure that food is left in the house so that the careworkers are never short when they make the evening meals, hardly ever does it appear to get used. We just don't see what mum and dad are getting to eat. Dad could not understand that we wanted to know what he was being fed. In fact we didn't even bother asking him. But he wanted to be part of the conversation and kept asking what we wanted to know. Each time it was explained he simply said either 'oh, yes we get our meals here,' or 'we get fed all right'. Yes, but what is it you actually eat? That question could not be answered.

So today, several times I said to dad, 'it is obvious you and mum cannot look after yourselves any more. You get about 15 visits a week, yet you are still on the phone to us with calls for help up to ten times a day.' No, he didn't make the connection. Apparently you can be this helpless and still be looking after yourselves all right.

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Living dead

By Mike on Sunday 11 February 2007, 10:12 - Journal

Dad called us all today, one after the other, to say that he was concerned about mum. Not only had she spent hardly any time awake, but dad actually said she was 'all stiff'. This was something Dr Humerus had asked about when I called her about mum the other day. We presume that the sudden cutting of the Risperidone does not imply an immediate decline in its effect. Either that or something else is wrong. There was a brief round of inter-sibling telephone calls the end result of which is that Greg, who was going to the house today anyway, will see how mum is doing and take whatever action he feels necessary.

The switch from the old faithful attack-mother to the latest model walking dead has been one of those salutary experiences that force home the message that doctors and medicine are something to be taken very seriously indeed. We have not yet, fingers crossed, had a major mishap but this could so clearly have happened.

Tomorrow all dad's chickens come home to roost - but in the most desirable way. It appears that, of the family, all those of us in this southern hemisphere are about to converge on the house. It is as if we are heading in for a family conference or wake, mum being very much the subject of either option. I have a feeling we will be coming to a conclusion.

There has been a sense of acceleration over the last few weeks. I have sensed the growing desperation of dad for vital human contact. I have seen - perhaps - the final dissipation of all that was our mother, leaving a shell that either lashes out or passes out. There is dad's obvious recognition that no longer are he and mum 'managing all right'. And there are the numerical curves leading mum to her end: if she continues to spend more and more time asleep she will soon never wake. If she continues to eat less and less she will soon blow away.

Tomorrow we see the start of a new phase, or we report an anticlimax.

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Saturday 3 February 2007

Nurse, nurse

By Mike on Saturday 3 February 2007, 16:37 - Journal

Yesterday Patrice called me to say goodbye. Patrice, you may remember, is the nurse who does nearly all of the home visits to mum and dad, of whom mum has been heard to snarl, 'I don't like that woman!' She is not a bad person, but the fact that she is moving to another round, and that someone will be permanently replacing her, is nevertheless quite welcome. In fact, permit me to indulge...

Hurrah!

From now on we will be visited by Carrie, who has been before, and seems to get a slightly warmer reception.

The other thing that Patrice had to say is that she feels the Risperidone is working well for mum. She has apparently, been getting plenty of hugs and little pats on the arm this week. Maybe we ought to cut the dosage!

On a more serious note: we think mum, who was already spending increasingly long spells asleep, is actually spending even more time in bed now that she is on the Risperidone. If so, so be it, I say. We can't expect everything.

Earlier in the week (actually, it would have been earlier in the day) one of the fill-in nurses rang me:

'There are some antibiotics for Mr Pritchard in the box!'
'Yes, I put them there,' I said.
'Well I don't know anything about this! What are they for?'
'The reason you don't know anything about it is that I did not request an authorisation for you to administer these pills, and the reason I didn't do that is that it is such a short course that it would be almost over before you got the paperwork through.'
'It is prescribed by a Dr Ulna. That is not his GP.'
'I know.'
'Why is that?'
I was getting thoroughly fed up with her imperious and interrogatory tone.
'Look, is there any reason you actually need to know all of this?' I asked. And then I gave her enough to shut her up and let me get back to work.

Dad has been struggling - and just succeeding - to obey my phone instructions to administer the antibiotics himself. I think he lost one tablet behind the escritoire, but that loss is not going to kill him. Rachel was there today and reports that the swelling seems to be shrinking already.

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Thursday 25 January 2007

Compromised

By Mike on Thursday 25 January 2007, 17:05 - Journal

Well,

I got a reply to my email to Lana, the case manager, but she says there is nothing more she can do. I wonder. Could there be another nursing service? How much would it cost? Would it be any better? Is there some way the family can try to pick up the process when the nurses drop out?

Something that worries me a little is that she mentioned that Dr Humerus told her about dad's 'injured' rib. Of course, we signed away patient confidentiality when we agreed to let social services help us. The doctor is free to tell Lana anything she thinks she ought to know. But pretty soon the story will get around to everyone and will, possibly, be used to our disadvantage. I wish I had never mentioned it to Dr Humerus now. I am sure I didn't need to.

The social services are a mixed blessing. Instead of just thinking about how to deal with mum and dad, I now also spend rather a lot of time thinking about how to deal with the social services. We seem to have entered phase 2.

The first phase was characterised by them offering services which we didn't ask for, in place of those that we did request. The argument was that until mum and dad were 'comfortable' and 'familiar' with their careworkers, nothing else such as food preparation and other services would be accepted by them. What happened was that mum and dad simply got confused because they could see no reason why they needed companionship from strangers.

The current phase is different. The unwanted services have been withdrawn, and the originally requested ones - food and cleaning - have been instigated and are working well. The other difference is that instead of getting more than we asked for, we are getting less. I think we have come up against the limits of the system. We get the folllowing:
  • cleaning - two hours per week (one visit)
  • food preparation - two hours per week (over two visits)
  • day care - ten hours per week (over two days)
  • medicine - five visits a week
The two changes just about to take effect are that the food preparation will be extended to three hours over three visits and the medicine will revert to seven days a week.

I suppose the other services that we need to mention are those that we do ourselves:
  • shopping
  • weekend evening meals
  • bills and financial tasks
  • lawn mowing (contracted out)
  • laundry
  • minor repairs

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