The registered nurse in the nursing home had mum produce a urine sample, apparently necessary because mum has been getting a bit "confused" in the afternoons. I stayed with mum on the Tuesday for most of the day and it seemed to me that she was a bit subdued compared to other times I had visited her. Her across-the-hall neighbour came up to me while I was there and mentioned that mum had been complaining of backaches. After breakfast on the Tuesday - mum took breakfast in her room - and lay down on her bed straight away after finishing it to have a doze. But when we had to get ready to go to the specialist's appointment she complained a lot during the process of preparing for the excursion because of pain in her back. I mentioned it to the specialist and I also wrote some notes about it in the notebook the GP has left for mum to use.
I think mum's "confusion" in the afternoons is due to arthritic pain and we'll need to increase the pain medication dosage so that she can cope with it. I will email the nursing home later today to make sure the doctor read my notes.
Another shock was finding a half-dozen rotten bananas in mum's fridge. Along with the bananas were numerous paper bags - which the nursing home uses to put her morning toast in - filled with stale toast, as well as dozens of hard biscuits. All of this food mum had squirreled away in her fridge without ever checking it once it went in there. It's a type of unconscious hoarding behaviour that has everything to do with mum's poor memory, and nothing to do with the psychological motivation for true hoarding, the kind we read about from time to time in the newspaper.
What's certain is that mum won't get the kind of care she needs if I just rely on the nursing home alone. They don't have the historical knowledge - even with the participation of the GP, who has access to medical reports from mum's previous GP - and they don't spend enough time with her to find out what really is the problem with her. It's unfortunate but I think inevitable that people who have a parent in a nursing home have to stay connected to their parent otherwise the quality of care will drop away and with it quality of life. To maintain quality of life for your parent you have got to be engaged and participating in the routine at the nursing home.