I arrived at my mother’s home and found her, her body a poor old jumble of bones, crookedly crumpled on the bed.
“Mummy I hear you’ve had a fall?”
“Oh yes darling, I think I must have.”
“Where do you think you’ve hurt, sweetie? Can you tell me where the soreness is?”
“Oh yes, it’s up along there.” She indicates the ceiling with her index finger.
Dementia is an unkind and horrid thing, for both the sufferer and the carer. Normal things like pain, hunger, thirst become extraordinarily difficult for the sufferer to communicate or pinpoint. Usually I’m lucky enough to be able to interpret my mother’s needs, though when she’s overly anxious, agitated or distressed it becomes much more difficult.
I gently stroke her head. “Mummy, I wonder if you can do something with me. I need to find out where you hurt so I can make it better. I’m going to feel all the bones – little and big – in your body. When I touch one that feels different, do you think you can tell me?”
“Of course I can. Don’t be silly. Why are you asking me that?”
I continue to talk gently to her, telling her exactly what I’m doing. The first thing that knocks me backward is the smell – I’m sure she had a massive UTI (urinary tract infection), which would explain the series of falls. Funny the doctor hasn’t mentioned this. She’s hot to touch, her skin papery dry. She has a fever. I carry on, asking her to grasp my arms as I move her shoulder – no pain here. I gently work through each of her ribs, her shoulder blades, her spine and yes, there is a definite tenderness down her left side. I reach round for the softness of her kidneys…
“Ooh, ooh that’s sore.” This confirms my suspicion of an UTI.
I move along her pelvic girdle, her femur – no pain or soreness at all. And then I see it – it’s glaringly obvious, her left knee – it’s huge, weird, completely out of shape, and hot. Gently I cradle it with both hands and apply pressure…
“Oww, oww, oww . Don’t, don’t do that! Oh owww. Oh no.” She’s deeply distressed and in agony. It’s isn’t her hip, it’s her knee.
I phone the doctor. I explain that I’m desperately worried about her going in an ambulance to Derriford, Plymouth’s main hospital, on New Year’s Eve. She’s too frail and ill. He agrees. I explain about the UTI and the knee and ask if I can pick up antibiotics and painkillers. We also agree that she should be x-rayed in Tavistock, just a few miles down the road, first thing on Friday.
I hurtle into Tavistock to pick up prescriptions, hurtle back. Another problem has arisen, her skin is breaking down and she’s developing pressure sores on her heels and feet. Julie has coped brilliantly creaming and wrapping her feet in sheepskin as well locating a ripple mattress that can be delivered tomorrow; she’d also tested her pad for infection and found her urine contained large quantities of blood…no wonder she was so hot.
At last I leave and dash home – it’s dark, late, I’ve animals to see to, bales to move, hopefully Ben is coping with the cooking and Robert will be back with our French family. I’m exhausted, feverish and developing a hacking cough. I’m worried about what tomorrow will bring and if I’ve made the right decision in keeping my mother away from hospitals for the next twenty-four hours (often in the case of elderly, demented patients it’s NHS policy to treat ‘conservatively’ i.e. do nothing). I’m beginning to doubt my own judgement, it’s clear that everyone else believes it to be her hip. There are a million thoughts spinning around and around in my head. I’m not concentrating properly and don’t see the ice, black, thick and shiny smooth over the whole lane. I touch the brakes, the wheels lock and I’m powerless, a telegraph pole is racing towards me at an alarming rate. ‘Please. Please, please,’ I pray, ‘if anyone is out there, just don’t let me hit the pole. Ditch, ruts anything, but not the pole, please, not tonight.’ I brace myself for the impact…