Friday

Friday

Had a good long chat with the senior doctor on the stroke rehab ward today. She’s the doctor who will be at the Family Meeting on the 21st.

They were perplexed by Mum’s infection markers which had been ramping up. This didn’t respond to antibiotics as we knew and further tests for ‘usual’ viruses found nothing. But today the index had spontaneously dropped from 110 to 70.

Mum had been encouraged to feed herself but didn’t manage it today. Her capacity to eat is still interesting and even amusing them. The doctor said Mum can be sound asleep and unresponsive but when the food appears she’ll wake up and be quite active. Mum would even be happy to eat a second helping.

No real physio had been done at that stage. Mum’s Up’n’Down-ness wasn’t giving them the chance to establish a baseline. They were hoping the ‘Never Knowing What She’ll Be Like From One Day To The Next’ and big swings from poor to promising and back again would have settled by the time the meeting came round.

The doctor said they were aiming for discharge as late as they dare but just being in The Hospital was a considerable risk so the earlier the better.

The one firm factor in deciding whether a patient could be discharged back home was whether the patient was bedbound or not. If she could cope with 4 hours in a chair then that’s not bedbound. Make of that what you will.

While Mum had been awake and aware of who I was when I first arrived, she was sound asleep during this conversation. That gave me the chance to dig into the definition of ‘Bedbound’.

It turns out that it’s one of those words that has a slightly different meaning when used in a technical or clinical context. English is full of them. To a ‘normal’ person, the word Bedbound would mean someone who can’t get themselves out of bed. Mum was obviously that and it left us all a bit confused as to how she might not be classed as Bedbound.

That 4 hour time frame comes from the maximum gap between carer visits to the home during the day. If the first carer puts the patient in a chair and the patient cannot cope with being in the chair for the period before the next carer’s visit then they can’t be put in a chair and must be left in bed. If that is the case then the patient will not be discharged to their home. That made a bit more sense.

There was one more thing to consider. I had done the big update to the family from the ward’s lounge while Mum was sleeping, I went back to mum to find her still sound asleep. Head back, mouth open. I leant in to talk right into her ear and shake her arm to tell her who I was and thought “What on earth has she got in her mouth?” Called a nurse who fetched a colleague to help. They were trying to fish whatever it was out with those little pink sponges on sticks. Mum would either refuse to open or would assume they were giving her some food and tried to eat them. What they fished out eventually was the last mouthful of mum’s lunch. She’d fallen asleep without swallowing it.