NHS Hospital

By Nick Gilmore

Published: 9 Jun, 2023

Friday

Eldest Sister got a call with an update from The Hospital just after lunchtime today. They said they were concerned that there may be some cognitive issues but because they were unable to properly assess Mum as she is asleep most of the time, they were not sure how good/bad they were. The doctor also said that the infection markers had risen slightly, so she was back on antibiotics. They would continue to assess her across next week ahead of our meeting.

I was only a couple of minutes out from Paddington when her message came through. It would take me another 45 minutes to get to The Hospital. I hoped I would be able update them on what I thought about cognition provided they were prepared to talk to me. I said I thought Mum sleeps because she’s bored.

Both sisters disagreed. At length.

“She has always slept a lot & has done so for years.”

“Mum has always been able to fall asleep anywhere, most afternoons she will have a nap,  then would have a sleep in the evening for a few hours before bed. Since COVID she would usually have a nap in the mornings. It wouldn’t matter if she was watching something on tv that she wanted to watch. She would sleep through it and then ask what happened when she woke up. If she was going out for the day with dad the joke was that she would be asleep by the end of the road! Then would comment on how quickly they got somewhere even if the journey was a couple of hours. Those are just a couple of examples!”

I had to concede that more often than not when I’ve let myself in I’d found her asleep. But at least she’d stay awake while you were talking to her. She wouldn’t fall asleep while talking or eating like she was at present. Or would she?

“No, she would usually stay awake when eating as she always had a healthy appetite. It is rare for her to fall asleep during talking but not unheard of. She also has a knack of not listening to things she doesn’t want to hear, she has even admitted this.”

“Sometimes mum would fall asleep whilst I was visiting and only stir if I got up to leave.”

Again, I had to concede that the conversation had to be about her for her to retain any interest in it. When I spoke to her on the phone she would always ask how Lesley’s dad was but over recent months has become less and less interested in what the answer was.

Got to the hospital to find Mum on proper strong IV antibiotics and the saline drip was faster than yesterday. She had  a real thick cough too unlike yesterday. She was about as sleepy as when I arrived yesterday. I saw what they meant about cognition too and it wasn’t just the sleepiness. She was much worse than yesterday. Her breathing was laboured too.

A team arrived to fit a catheter. They were concerned about fluid intake and had decided they needed to monitor urine output more carefully. But, the nurse said there was no problem with her appetite. That resonated with something The Hospital had said to Eldest Sister earlier in the day. Mum’s healthy appetite is not what they expect of someone with her cognitive issues

I managed to get a good long chat with Dr M. It was all as Eldest Sister reported earlier with the addition of the catheter, concern over fluid intake/output and also blood pressure. It was seriously low. I said I saw the reading taken yesterday afternoon and thought the machine had malfunctioned. Clearly the nurse had too because she tried a different one. I didn’t see the second reading but it obviously wasn’t good either. Still, when asked, mum said she’s comfortable so that’s something.

Youngest Sister pointed out that Mum didn’t like to drink much at home as she didn’t want to keep getting up to go to the loo and that she may not be able to see where the beaker was on the table either due to her eye issues. There was a question as to whether Mum’s cognitive issues were caused by a UTI too.

I had already alerted Dr M to Mum’s attitude to keeping her fluid intake up. Mum had never drunk what we would think is a healthy amount and that the getting up in the night for the loo is part of the problem. I ruled out it being that she can’t see the cup or beaker because everyone who walked past asked if she wanted a drink and it was a resolute “No” every time.

The UTI thing could be the cause. I thought they may get a better idea now that they were collecting and measuring urine. Either way, her bloods showed an infection somewhere. Her breathing was different today and there was that cough…

Author’s Note

My Mum is in a nursing home in a small village in the Thames Valley. The photo is not of the home. I used an AI image generator to give the reader some idea of the home she’s in.

All, some or maybe even none (you’ll never know!) of the names have been changed to protect privacy and hide real identities. If you think you recognise someone then let me know and I’ll edit the post or remove it entirely

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