Dear Readers, I was visiting my Aunt Hilary in Somerset last Saturday when I received a call about my elderly Mum in Dorset. Outside Hilary’s window, a flock of fledgling sparrows was gathering in the shrubs and carrying on a conversation that seemed comprised of a single note, uttered with different degrees of urgency. But on my mobile phone, I hear that Mum is in a sorry state, vomiting, feverish and getting on and off the commode every twenty minutes. Paramedics were called in the morning, but had deemed her not ill enough to be admitted to hospital so she was at home, distressed and with Dad not able to help much because of his own infirmities.
When the carer visited again on Saturday afternoon Mum had worsened and the carer called 111. She was informed that a doctor would be with her within two hours. Two hours passed. The carer called again, and was told it would be another two hours. The carer was so worried that she called 999 at 8 p.m. I asked her to call me when the paramedics arrived, however late it was. They arrived at 12.50 a.m. and again didn’t admit Mum to hospital, in spite of a day spent vomiting and passing water every twenty minutes.
I should back up a little here, and explain. For you or I, a urinary tract infection or a bout of norovirus is unpleasant, but usually clears itself in a few days after a dose of antibiotics for the former, and starvation/lots of fluids for the latter. For someone like Mum, with heart failure, diabetes, COPD and a whole host of other stuff, a simple infection can quickly turn into something nasty like sepsis, or at best can cause her condition to deteriorate quickly. But Mum’s vital signs were still good, and so there was not enough cause to admit her.
At 5 a.m. the doctor arrived and gave her some antibiotics and some tablets for the nausea. It’s hard to take tablets when you have nausea, but she managed it somehow.
On Sunday morning I grabbed a taxi from Broadway in Somerset to Milborne St Andrew in Dorset. My taxi driver was a delightful chap in a top hat and shorts. I sat in the front seat and we drove through the rain, while he told me about his life: how he was an engineer and inventor by trade, and how he’d almost succeeded in getting funding for his master project, a way of helping the companies who fill in potholes to operate in the rain. I was happy to let him ramble on with his tales of lasers and oil on surface water and the difficulties of gauging the depth of a pothole when the light is being refracted. It took my mind off the situation that I was walking into.
I got to the house and walked into Mum and Dad’s bedroom. Mum was half asleep. She didn’t have her teeth in, which always makes her look about 105 years old, and changes her voice. She hadn’t eaten, or taken any of her medication, because she felt too sick. She was burning up with fever, but said she felt a little better since starting the antibiotics. Her green eyes looked enormous in that little white face. I helped her onto the commode and realised how very weak she was. I’d no sooner got her settled into bed than she wanted to get out again. She was too hot, then too cold. By Monday morning Dad had decamped to the living room to sleep in his reclining chair because Mum was so restless, and I was starting to get a bit frazzled. I know how awful that feeling of a UTI is, the way you want to keep going to the toilet even when there’s nothing left in your bladder. I also began to understand how hard it is to keep lifting someone off a bed onto a commode, and then get them back into bed when they can do almost nothing to support their own weight. However strong your core muscles are (thank you, pilates!) sometimes the angles that you have to get into to lift someone put a terrible strain on your back.
On Monday the diarrhoea started, but I’ll pass over that quickly. The doctor popped in to visit her, and pronounced her vital signs acceptable. She still wasn’t taking any of her medications and what we now recognise as withdrawal was kicking in: some of her medications are addictive, and without them she was starting to shake and become even more agitated.
On Monday night she needed assistance twice an hour. I would go to bed for half an hour’s shuteye and be roused instantly by sounds from Mum’s bedroom – the sound of the door banging against the bedside cabinet, a sure sign that she was trying to get up, or her cries for help. She would usually have already swung her legs out of bed and was laying at a most uncomfortable angle, which explained the urgency of her cries. No matter how many times I asked her to call out before she started moving, she was determined, even in her weakened state, to be independent. I sensed this was a recipe for disaster, and I was right.
At 1 o’clock in the morning I heard an even more desperate cry for help, and went into the bedroom to find her on the floor. There is no way that Dad and I could lift her back on to the bed, and besides I really wanted the paramedics to take another look. I dialled 999 and explained the situation, and they called me back to get all the details. They warned me that they were extremely busy, and that it might take a while for the paramedics to get to us, because the situation wasn’t life-threatening. I completely understand.
We covered Mum in blankets, tried to get her comfortable with some pillows and turned the heating up. Dad and I took it in turns to sit in the bedroom to keep her company.
Mum wasn’t happy.
‘I’m really uncomfortable’
‘I’ve got to get up’
‘I’m too hot’
‘Can you put a pillow behind my head’.
‘Can you take that pillow away it’s hurting me’
‘I’m really uncomfortable’
‘Somebody help me, please’
‘I want to get up’
‘Can’t you help me to get up?’
There is nothing worse than that feeling of helplessness, which so easily transforms into a kind of rage. I found myself getting inpatient with Mum, and close to tears. I went outside and sat on the bench in the dark to calm myself down.
A tawny owl called from very close at hand, a wild, otherworldly cry. It reminded me of someone calling out from the other side of a great divide,urgent and distressed.
Of course, this suited my mood perfectly, and had nothing whatsoever to do with the owl, who might have been in an excellent frame of mind for all I knew.
The paramedics finally arrived at 4 a.m., got Mum back into bed in a jiffy and, whilst worried about her, didn’t find enough warning signs to admit her to hospital.
I heard one of them say ‘How on earth is she managing?’
‘She isn’t normally like this’, I said. ‘She’s normally mobile enough to get about in the bungalow with her walker’.
And this is another problem – when you don’t know the patient, you may assume that she is always confused, or unable to get about, because you have no baseline to go by. It’s why I make sure to tell hospital staff that although Mum is a little forgetful, she doesn’t usually hallucinate or talk absolute rubbish.
And so Monday faded into Tuesday, and Wednesday. Several times I had to call on a lovely carer who lives locally to help get Mum back into bed when she got herself into a position where I couldn’t lift her on my own. I got better at getting her to and from the commode, but she was getting weaker and weaker. We managed to get her to eat some custard and a little porridge, and she was drinking lots of milk, but it obviously wasn’t enough. She was back on her medication, and at least had stopped shaking. Nurses popped in from time to time to check her blood sugar and see how she was doing.
The doctor visited while Mum was asleep. He took her blood sugar and her blood pressure, and she didn’t stir. He looked at her with concern.
‘I wonder if this is a turning point?’ he said. ‘She’s always been such a fighter. I’ve never seen her like this before’.
‘She’s still a fighter’, I said. ‘You might be surprised’. I was taken aback by the flare of anger that I felt.
Later, when Mum was a bit more alert, I opened the blinds so that she could see the garden, and I heard her call for me. I went in, and sat on the bed beside her.
‘Are they sparrows in the gutter opposite?’ she asked. ‘What are they doing?’
I leaned down so that I could see things from Mum’s eye-level, and we both called out as we saw a spray of water fly into the air.
‘They’re having a bath’, we said, and settled back to watch. When I looked down again, Mum was asleep.
On Friday, I had to leave to go home. I had had about three hours sleep in four days. I was bursting into tears over every little thing. I arranged for carers to be in the house for most of the time. I trialed some overnight adult diapers for when the carers couldn’t be there, because I didn’t want Mum getting out of bed when there wasn’t anyone to help her. I thought Mum would object because of the lack of dignity, but I think it’s a sign of how unwell she felt that they came as something of a relief, and they seemed to be comfortable and effective.
I sat by her bedside and held her hand.
‘I’ve got to go, Mum, but I’ll be back soon’, I said.
‘Don’t worry’, she said, ‘I’m getting better. You go home and don’t worry’.
And then I really did cry, which wasn’t very helpful.
‘Earlier on this week, I was laying here thinking that I was 83 and I’d had a good innings’, she said.
‘Mum, you’re only 82’, I said.
‘Oh!’ she said, and smiled one of those toothless grins that I’ve become so familiar with this week, ‘You’ve given me back a year, thank you!’
She thought for a minute.
‘Maybe I’m not ready to go just yet’, she said.
And so I left, and got on a train, and by the time I got to Bournemouth I got a call from the carer who said that she’d called the paramedics again and this time they were going to admit Mum to the hospital. I spoke to one of them, a chap called Alan.
‘Her vital signs are not bad, but there’s obviously something wrong so we’re going to admit her and see if we can get to the bottom of it’, he said.
I could have kissed him.
My train carriage wasn’t busy and so I spent the rest of the journey looking out of the window and being occasionally gripped by paroxysms of crying. It feels as if I am rebounding from one crisis to another, being pinged about like the ball in a pinball machine. I am encouraging the parents to think about getting a live-in carer, but Dad says having someone else in the house would drive him mad, and Mum only wants to do that if they can buy a bigger bungalow, which is completely inpractical – moving is stressful enough if you’re well. I feel as if they are one step away from disaster the whole time, and as if my whole life is on hold because I am trying to keep this little boat afloat by sheer willpower.
I get back to London, walk through to the kitchen, and see this.
The finches have been planting sunflower seeds, and this one has come into bloom while I’ve been away. And here I am crying again, because it is such a cheerful, hopeful plant, and I could almost believe that it’s looking through the window to welcome me back, and to tell me that everything will be well. And the cat comes down the stairs miaowing, and the buddleia that I was planning to cut back this weekend has a second flush of bee-covered flowers. I feel something in me that has been unanchored for days settle and grow still.
I will get through this, whatever it takes.