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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…
“Hello, hello…oh hi Carol, it’s me. Paula. Yes, that’s right. Umm, yes just walked in. Five minutes ago. Yes, yes, no trouble. No, none at all. Rain of course, yes a lovely waterlogged view! We did…and Morna? How’s she been?”
The first thing I do on arriving home after an ecstatic welcome from dogs, beside themselves with excitement, is to pick up the phone to see how my mother’s been.
“Not too bad actually. Yes, she’s eaten a little better. No, not a lot but she seems to be enjoying what she’s had. Okay, yes…she’s been walking up for lunch. On the supervised table. Yes. No, she’s tucked up in bed now. Okay…look forward to seeing you tomorrow.”
Ever since she caught Norwalk virus back in February she’s remained frail; suffering from persistent UTI’s and chronic anaemia. Her seemingly unstoppable delight and interest in food and eating has become virtually non existent, waning to tiny mouthfuls of once irresistible treats. Tempting titbits, cajoling and remembered stories of where we last enjoyed a dish together have no effect.
I’ve brought her back surprises and morsels from Marseilles and a famous market in Aix where tiny sweet local wild strawberries jostle with out of season nectarines and butt heads with tat, treasure, saucisson and cheese: I’d found her a bunched, tied bundle of pungent Provencal lavender; ‘biscuit artisanaux’ – local biscuits, shaped as shuttles, with flavours of orange-flower water, almond, citron and cinnamon; ‘olive’ chocolate covered almonds; famous Marseilles olive oil soap; and small sachets in vibrant colours and designs of the Provence.
Relieved and happy at the news I could now settle my mind down to unravelling the animals, farm and vaccination logistics.
I set off to see her yesterday lunch time, remembering at the last minute to throw in my laptop and camera with photos that she might understand and enjoy. I rang the bell…
“Oh hi Paula. We’re just taking Morna down to her room. She’s…well, not too good actually.”
My stomach lurches. I go to her.
“It’s me, mummy, Paula.”
“Oh, darling, is that you? How lovely. How lovely. It is you Paula, it is you?”
“Yes it is. I’m here right beside you”
My heart opens, swells and hurts. Her frail, bent, jack-knifed-twisted body isn’t coping too well anymore. Doubly incontinent and often unable to translate messages from her brain to her limbs we carry walk her to her room. Her bones crack and creak with the effort and her breath gasps in laboured rasps and wheezes. I carefully clean, wash and dress her before making her comfortable on her bed. She’s hot and rustling dry to touch; her thin blotched papery skin no longer disguising jutting bones and blue-black bruises. I encourage her to take small sips of water, but she falls asleep, exhausted. I sit on the bed, softly stroking her face gazing pathetically at her crooked twisted body still seeing the beautiful strong vibrant woman she was. My emotions are turbulent and potent. I kiss her. I leave carrying my untouched basket of surprises.