Friday

I got an an update from Lesley at What We Have To Refer To As The Hospital pretty soon after she got there today. This was something I used to do when visiting Mum at The Home. I thought it was only fair to give some clue about how she was, how long I’d be with her and how I’d be when I got home. From the look of things, Lesley was in for another tough visit.

Dad still hadn’t had his hair washed in the week that he’s been there. He’s only getting bed baths. Lesley had never known him to have a shower – he’s always hated them and now can’t stand for long enough to have one – so the en suite wet-room that had so impressed her sister was useless to him. The hoist for the bath on his floor was still out of action. There’d been the suggestion that he could go and have a bath on another floor but he’d flatly refused other homes because he’d have to go in a lift so that plan seemed to have been a non-starter too.

Dad was now solidly back into his old routine of wandering around at night. He’d fallen on one excursion so they’d re-arranged his room so that one side of the bed was against the wall and the other side had the fancy laser Unsupervised Movement Detector that had impressed Lesley’s sister so much. They’d added crash mats too. It was only on Tuesday that his Social Worker had convinced herself that he wasn’t a falls risk.

He had been getting more and more cross with each excursion and had taken to lowering himself off the bed, sitting on the crash mats and complaining bitterly and loudly that he wanted to go home and that he was being held “prisoner”.

He was still cross when Lesley got there. She got a good telling off for not letting him watch the “old people racing in Israel”. She didn’t know how to respond to that. He also wanted to watch the cricket. He’s never liked cricket. He’s never liked any sport.

The hallucinations were back too. Picking up things only he could see, discovering they were no longer in his hand and looking on the floor to see where he’d dropped them.

Lesley had had accounts of the strange conversations and hallucinations that I’d witnessed with my Mum so she knew how significant they were. She headed off to report them to the most senior nurse she could find. The nurse agreed.

“I thought he’d been hallucinating too. He was telling me a long story about all the activities going on outside his window this morning. It’s been lashing down with rain and there hasn’t been a soul outside all day.”

That wasn’t the only news from the nurse. Dad was now unable to swallow his painkillers. He couldn’t cope with the capsules any more and they would be switching to liquid formulations.

Fantastical conversations, hallucinations and, most importantly, a failing swallow reflex all sounded horribly familiar. It was the route my Mum had taken. Lesley and I both realised where this was heading and that it probably wouldn’t be very long before we got there.

She returned to his room to listen to a monologue about Vespa scooters and “bolshy people trying to win”.

Lesley’s new-found rapport with the nurses showed the first signs of bearing fruit. During the assessment for continuing healthcare on Tuesday he was judged to be a resident who was stable and who had “ages left”. The application for his fast track end of life funding was declined.

Now, they could see he was in rapid decline and that his condition was worsening visibly day by day.

“We’ll make the application on Monday.”

Lesley returned home surprisingly unperturbed by her visit. I remembered the detachment I felt when the person in front of me wasn’t my parent any longer. Not that it wasn’t distressing to see another human being struggling at their end. It just wasn’t a human you knew.

We took The Dog out for her evening walk. Lesley shared more significant details.

“He didn’t eat his lunch today. It was still sitting where they’d left it when I got there. They can’t have given him any dessert either because surely you’d take the main course away if you were bringing him his dessert. I think they just brought his main course and left him to feed himself. And he just didn’t.”

“I found out more about the Fasttrack funding process too. The system changed last September so that’s why everyone is so confused. It used to be that a nurse in the home could apply…”

That made sense to me. Nurses who are with the resident the most would be the first to recognise a rapid decline and would have the best idea about how close the end was.

“.. but now it was to be an NHS employee who makes the application.”

Ah, so it was the palliative care nurse, the one who was rubbing everyone else up the wrong way, who would do it.

So all in all, it was the perfect day for Lesley’s sister to have her scheduled Facetime session with him.

Lesley had sent her the same updates that I’d had. They brought no response other than to conclude that he must be getting too much morphine.

“I think they’ve got the morphine right. He might be completely away with the fairies but it’s the first time since he’s been there that I’ve seen him without pain.”

No response at all after that. She doesn’t like being challenged or contradicted.

The post-Facetime update we got made no mention of what Lesley had experienced and made light of a strange account about a man coming into his room to put the Christmas lights up and the complaints that he hadn’t made a very good job of it. Her main beef was with the carer’s who’d come in to take him to the toilet which interrupted her call after 10 minutes.

“She just doesn’t get it does she? I told her everything that you saw with your Mum as it was happening. She’s got to understand what all this means. Hasn’t she?”

Bloody hell.

Author’s Note

My Mum was in a nursing home in the Thames Valley for a year and a half until she passed away in December 2024. My Father-in-law went into the same home the following January. But Lesley’s sister didn’t approve and made the situation so awkward that he had to be moved. The image is not of the home itself. I used AI to generate an image of a typical modern nursing home. Names and locations have been changed or hidden to protect the identities of those involved. Which, for the new home, is probably just as well.