Mum back in the nursing home again

Mum won't leave the nursing home alive. I went up there to see her and tears started to fall when I was turning off into the road that passes by the Epping shopping centre. So many memories. A place I have driven to so many times. So many good memories.

I met mum's GP by accident at the nurse's station on the first floor after I signed in with my name. We talked. He has agreed to using palliative care at this point in time. I told him I had an appointment at the haematologist's to cancel, and he said just to call them. The haemetologist had complained about the hospital sending mum back too early last time they had done so.

Going down the hallway to mum's room I wondered what sight would greet me when I pushed open the door to her room. It is a place I have visited so many, many times in the past. I have left part of myself there due to these visits over the months. It has been 18 months since mum moved here from the Coast.

Inside her room I saw mum in bed wearing a yellow striped pajama top. On the left side of her bed they had put down a pressure mat to call the nurses when she steps on it. Under it was a soft mat. On the right side of her bed there was just a soft mat. The soft mats were blue, the pressure mat grey. She had a blanket over her body and her legs, and a bedcover over her legs. The bed was low to the ground to prevent her getting up unassisted.

I went over to the table and put down the iPad box I was carrying. I took out the iPad and called my brother. I turned the control to show him mum lying on the bed and he looked hard at the picture revealed by the electronics and the software. I closed down the conversation after a little while and put the iPad back on the table, and plugged it in at the power point. I sat down and picked up the Kindle and started to read where I had left off reading last night in bed alone. It was the story of Karl Ove in Bergen, the university town he had gone to when he had left home as a teenager.

I read for mum for about an hour then went over and kissed her. I asked her if she was ok. She had been pushing the covers down with her hands while I was reading from the Kindle and so I asked her if she wanted the bedcover taken off her legs. She said "Yes" quite clearly. You have to listen very carefully because she cannot enunciate whole words now. She is incapable of talking, poor thing.

Mum's last day in the hospital

This is mum smiling bravely for the camera when I took her picture in the hospital this morning. Today will be her last day in the hospital. This afternoon they are moving her back to the nursing home where she will undertake palliative care.

I arrived at around 11am as usual - the start of Ryde Hospital's visiting hours - and she was sitting in the chair next to the bed. The nurse told me that she had eaten most of her breakfast. She had eaten all the eggs and half of the porridge. Then she had tried to get out of bed so the nurse had put her in the chair next to the bed instead.

Mum was not coherent when I came. There were a few words but mostly parts of words coming from her mouth. She was obviously confused. Whether she was delirious it is hard to say because I could not really understand what she was saying. She was pulling at her gown and dragging at a sheet that emerged from underneath her as she sat in the chair. The nurse told me that she had taken her gown off a few times already this morning. I kept on going over to her and saying, "Don't take it off mum."

As I had the day before I read to her from the first book of Karl Ove Knausgaard's My Struggle series. Today it was the two men going back to the house where their father had died. Despite the grizzly details mum seemed to enjoy it. Yesterday she had been even more vocal, and answered the questions that had popped up in the narrative as part of the dialogue, happily chiming in with "No" and "Yes" as the need arose. It was sweet.

Poor little thing. She will be back in well-known surrounds by the end of the day, and so I rang the nursing home to tell them she was coming back as I had received a call from the hospital to that effect. I got onto the deputy director and had a quick word to her. She said they were happy to have mum back. They are a great team of people at the nursing home, I am so grateful that they have been taking such good care of her. It makes my life so much easier knowing that they are doing whatever they can to make sure she is comfortable and cared for. I think nursing homes are fantastic places, the staff at my own place are always so responsive to people, always trying to give good service.

Mum goes into palliative care

So today brings the sad news that mum is being placed into palliative care. In the morning I spoke with my cousin who had brought my attention to mum's AHD, after mum had been moved overnight to the Cardiac Care Unit from Ward 7. Then I came back to the hospital this afternoon after Clare had returned to the road for the trip north and I spoke with mum's attending doctor. I had also earlier spoken with another doctor - who goes around to different units to help out where needed - and he had spoken to me about mum's AHD. (He was the same doctor who had spoken to me once before in the Emergency Ward about the AHD, and had advised me to think about what it contains.)

Mum's attending doctor examined her records and came to her room to have a look at her. He tried to get her attention but was not successful. We went outside the room to talk. There were two young doctors also standing there on their training rounds. The attending doctor told me that mum was getting worse. Her heart rate had gone up to around 140 bpm and she was struggling. Even when, two days earlier, she had looked well and was responsive, she was not mobile. Her likelihood of recovery was poor and even if she did beat the infections - in the right leg and in her bladder - and get out of the hospital she would likely be readmitted shortly due to the MRSA infection in her right leg.

He asked me if he could put mum into palliative care instead of putting her through more uncomfortable procedures, and I agreed. He said "Ok" and asked me if I was alright. I said I had been looking after mum for seven years and had seen the degeneration of her health over the previous months and years. I went back into mum's room and said goodbye. The doctor came in and turned off the heart monitor and a little while later a nurse came and disconnected mum from the machines. The room was suddenly less active. It was almost quiet except for occasional footfalls in the hallway outside the room where mum lay alone apart from me, sitting there in the chair in the corner. Mum lay there with her mouth open. A nurse came in to put cream on mum's lips to prevent them cracking and causing pain. I stayed for a while then I left and drove home.

Mum is a bit delirious

When G and I arrived in the ward today we could hear mum talking out loud - obviously disturbing the other occupants of her room - and the word that was most obvious in her monologue was "rabbits". She didn't make much sense. It was clear that she was delirious and that therefore she had slipped back a bit compared to yesterday. Yesterday she was talking normally and making perfect sense. Today she was ranting deliriously.

There was no wall between what she wanted to say and what emerged from her mouth. She would react to the slightest snippet of conversation overheard from a nearby bed. She would react with disdain to the suggestion of a mouthful of food. She would yell when the doctor picked up her arm to examine the skin on it. She was just voicing all her feelings without any barrier between the inception of the feeling and the final word that emerged. It was just not the way she normally is. It was the infection talking.

We tried to get her to eat something but without much success. We had more luck with the coffee - a flat white - which I had bought at the kiosk outside the hospital's front door. They make decent coffees there so I don't blame mum for not eating the chicken breast and pumpkin and mashed potato that the kitchen had prepared (I tried some and had no trouble eating it but it wasn't exactly cordon-bleu).

After the visiting hours had ended we left and came back home, then walked up the street to have some Vietnamese food for lunch. I had a chicken pho and G had summer rolls. Tomorrow G goes back home to the Coast.

Mum feeling better in hospital ward

G and I went up to see mum this morning in the hospital and she was awake and talking to herself when we arrived. She speaks slightly awkwardly - the jaw doesn't seem to move unimpeded at the moment - but at least she can make herself understood. She was amenable to humour and we had a bit of a laugh as the nurses came in and out, connecting a bag of antibiotics to the cannula in her hand. There was a vitamin supplement to dissolve in water and drink as well, which we accomplished during lunchtime. The cleaner came by and mopped under the bed.

So it looks as though the difficult time of mum's recent illness has finally disappeared, which is a relief. It took a bit longer than usual to go - four days - but she is now sitting in bed with open eyes listening to what is going on around her. That's a long way from where she was even yesterday, let alone on Wednesday when she finally was admitted to the hospital. At that time her health was very touch-and-go. Now she just looks like she's just waiting for the nod from the doctor to let her leave to go back to the nursing home.

About the future, I spoke last night with mum's GP. He called while we were in the restaurant having dinner. He told me that the periods between illnesses was getting too short - ten days in hospital giving you two weeks of free time in the nursing home - and that he would prepare a letter for the nursing home staff for next time mum gets sick. Which will be soon enough, there's no doubt. When it happens the GP will be recommending nothing more than palliative care in the nursing home. This means - sadly - that mum's days are numbered.

She has done well however. Back in November 2014 when she first got the diagnosis for the myelodysplastic syndrome the haematologist gave her a prognosis of only six months. She did a lot better than that, it's clear, and has kept herself together for a bit over 18 months now. She has had a good trot overall but it's going to be time soon to put aside the tubes and the drips and let nature take its course. I'm only glad it's not my decision in that case.

Mum is in hospital ward again

Yesterday I picked up mum's old housekeeper G from the airport. We went up to the hospital in the late afternoon - a bad time for the traffic - and saw mum but she wasn't really talking much. She was mumbling sort of incoherently and could barely answer you when you spoke to her. Today she was a bit more compos mentis and even opened her eyes at one point.

She has a bad infection and the doctors in the ward are still uncertain how she will go. It's a bit touch and go at the moment, frankly. G and I spent an hour with her this morning. We gave her half a bottle of water to drink - in a cup through a straw - and offered her some cake which we found in a packet on the tray near her bed. But she refused the cake. She looks very frail still although she is talking more than she did yesterday. We will go up again to see her tomorrow.

If anyone wants to visit mum in Ryde Hospital she is in Ward 7 out the back of the main entrance and up the ramp. She can respond to words quite well although her replies might be a bit confused. She has been very sick indeed, so you have to be a bit patient with her. Cake might not be eaten, not sure.

Just a quick trip up to see mum

I quickly dropped in to see mum at the nursing home today because the nurses there told me that she wasn't taking the antibiotics the hospital had given them to give to her. The antibiotics are oral type, and when I saw her with her head on her pillow, breathing deeply through her mouth, I understood the situation immediately. She is almost completely incommunicado. I talked with the RN, who told me they had been trying to get onto the GP but that since he had moved his practice, they had difficulty contacting him.

I only stayed for a little while. Mum was washed while I was there and during this procedure she uttered incomprehensible sounds that gave you the impression of displeasure. She didn't like being towel-washed. The nurses are doing for her as much as they can but it is difficult for them. They also told me they would be getting in touch with an after-hours doctor at 4pm. I called the nursing home a little while ago but they just put me on hold. They were obviously busy on the first floor with dinner. Then I called later and confirmed they would be installing a spray to keep mum's mouth moist while she is in her current state.

Tomorrow G - mum's old housekeeper - is coming to Sydney to visit. I had asked her to come down earlier. Originally she was to come down from the Coast on Friday. When I pick her up from the domestic terminal we'll go up to the nursing home on the motorway.

Another hospital visit for mum

When I got up to the nursing home to visit mum today she was like she looks in this photo: quite incommunicado. Not hearing, not responding to words. We called the ambulance. I popped downstairs to have a word with the deputy director of the nursing home. She heard me out as usual. I got from her the message that mum is getting close to the end. I went back upstairs to wait for the paramedics to arrive, and when they did I talked to them to answer their questions, then went outside with them and drove to the hospital.

I sat in the emergency area waiting room for about 45 minutes then snuck outside to the kiosk and bought a sandwich and a drink for lunch. I was hungry and the simple food they serve there was exactly what I craved. I went back in the emergency waiting room and went to the desk to ask if it was ok to go inside, and if the doctors inside had asked to talk with me.

They let me in. The nurse at the desk told me to put on a plastic apron before going into mum's enclosed room. (She is quite toxic because of the MRSA in her leg.) I sat there with the white apron over my outdoors jacket feeling a bit odd, like a cook without a stove, and talked to mum gently while she lay there. Occasionally she would say something like "My legs are cold" and I would get a new blanket for her. Mainly though she just lay there breathing with the heart machine beeping away happily.

I spoke to the young female doctor. She brought me a copy of the AHD which the nursing home had included with mum's things to go with her in the ambulance. We talked about it. Especially the part where it says that in the case of a terminal illness she is not to be given antibiotics. I told the doctor that my inclination was to give her vancomycin but that if the hospital said otherwise I wouldn't complain. Then when the doctor had left to get back to her work I called the nursing home and asked to speak to the deputy director.

The nurse I was speaking to talked to me gently and told me that I could choose for mum, but that she understood it was a terrible responsibility. She said it was an awful thing to have to decide; whether someone lived or died. But she said she understood if I wanted to end things because the vancomycin - although it is a strong antibiotic - was only a "band aid" (the exact word she used). If we gave it to mum today then in two weeks' time she could be again on her way to the hospital in an ambulance.

Then she said I had done everything possible for my mother. I had been a good son. And this made me weep. The idea that I could have got this right - this caring for mum in these awkward days I had not prepared for - made me break down and shed hot tears. I tore off the apron and headed outside to the emergency nurse's desk, and said I had to go home. The nurse however followed me out into the hallway and asked if I was ok. I told him that I thought that it was pointless to keep treating mum because she was just going to get sick again, and that we should respect the words in the AHD that mum had herself signed off on two years earlier. I told him through the tears that I had been looking after mum for seven years now. And that now I was tired of the constant worry and anxiety the sickness instilled in everyone around her.

I went out to the car and stopped off at the servo on the way home to refuel and buy a sandwich. When I got home I opened a bottle of wine and poured myself a glass. Never had wine tasted so good. I was so exhausted by the neverending worry about mum and her leg. Later, after I had eaten some dinner, the nursing home called me to tell me that mum had returned, but that she wasn't able to take the oral antibiotics the hospital had sent along with her. I called the hospital to confirm what to do and they called the nursing home. The nursing home called me back a while later and we had another conversation, the nurse and I. But I feel as though my mother is already calling from beyond the grave.

Walk to the park with mum

In this photo taken on our way to the park mum looks happy enough but it was hard going for her, especially once we hit the grass on the way to the second bench. Mum might be grinning in the photo but she was soon muttering under her breath and groaning with the exertion required. We took about 15 minutes to get to the second bench, and then we sat there for about 25 minutes. We left not because mum was getting cold but because of the lunch to be served, and because of the time it would take to get back inside the nursing home.

On the way back to the nursing home, as we were going down the footpath alongside it, mum ran out of puff completely and I sat her down on the walker. I guided her down the footpath to the gate, then opened it and pushed the loaded walker inside. Then I went up to the entrance and found a wheelchair in a cupboard on the ground floor. I brought it outside and put mum in it, then took her inside and upstairs to the lunch area. I sat her down at a table and went to put away her outside clothes - jacket, scarf, cap and sunglasses - then put away the wheelchair downstairs and went outside to get mum's walker, which I had left near the side gate.

Mum is very frail. Actually, this will probably turn out to be her last unaided walk outside to the park. In future I will be taking her out - but from now on in the wheelchair. Getting to the bench and getting back inside is just a bit too much effort - for her, now - and so it is going to have to be me pushing mum around in a wheelchair from now on. It's just too risky for her. A fall outside at this point would be awful. I can't contemplate how unpromising it would be for her to fall when we are in the park.

But regardless, she is still going. Her right leg - the one that has given her so many problems in the past two months or so - has stayed inert. It is not inflamed and sore. So for the moment things are under control and we can hope that she will keep going indefinitely. Nevertheless it is only realistic to anticipate that the infection will return at some point in the future. The question is when. How long will there be between hospitalisations - when she will receive treatment using vancomycin (pretty much the last antibiotic that works on her)? How long will she have in the nursing home in the interim?

A couple of days ago I spoke with the nursing home's deputy director about these issues. Things that I had already spoken with mum's GP about. We agreed that we would treat mum again next time she needed hospitalisation, and then take it from there. It is the frequency of admission to hospital that is key. How much time does she get that has real quality of life in it, between stints in the hospital? We'll be looking at this as we go down the track.

Negative gearing is good policy

I completed a voting intentions survey from the SMH yesterday which showed that my place on the political spectrum was closest to the Greens. I thought this was a bit funny since I'm planning to vote LNP on 2 July, and I said so in the Facebook post. But a person I know asked how it could be possible for me to vote conservative, and so I explained. He wasn't very impressed to put it mildly.

But as George Megalogenis, the journalist, has written in his recent book, immigration is the underpinning of Australia's economic strength. We've been taking in a couple of hundred thousand immigrants annually since the 1950s, which is why Australia is one of the strongest economies in the world. These people all need somewhere to live, and rental accommodation will be the solution for the great majority, at least in the beginning of their residence here. Cheap rents are important therefore, otherwise we fail all these people. So we need negative gearing to help maintain the supply of new properties. The "oversupply" of new constructions of late is for example just the result of three years of strong home price growth, and if you take away the incentive to build the supply will dry up and rents will rise commensurately.

We also need to support the tens of thousands of honest mums and dads who buy investment properties to ensure a secure future for themselves in their retirement. Not only do we help the government minimise the cost of the aged pension on the Commonwealth purse, we also make it easier for individuals to have a better quality of life, and more cash to spend in their twilight years.

It always bothers me when young people who want to live in tony suburbs like Stanmore and Newtown complain about the cost of housing. I want to tell them to look further afield, where there is plenty of housing for reasonable prices. But they will have their lifestyle no matter the cost to the public more generally. The debate on negative gearing has been going on for some time so this is not my first blogpost on the subject, but I hope that it will be the last. I predict a win to Mal with a margin of 5% in July, so the debate will hopefully finally be put to bed at that time.

Mum's bruised hands

This is how mum's hands looked after her recent hospitalisation. In fact, they've improved in this photo since she was first released from the ward. But they were so badly bruised because of the cannulas they put into her hands to accept the IV antibiotics and direct the flow into her body. A cannula is a small plastic pipe with a tube at one end and a clip at the other. The clip end faces out and the IV feed from the bag of antibiotics is fastened to it.

Because mum's skin is delicate and because she has the bad habit of taking the cannulas out of her hands when they're not connected to the IV feed, her hands become bruised like this because new sites for the cannulas have to always be found. It'll be the same story if she's readmitted to the hospital again at some point in the future. But when she got out of the hospital she forgot that she had been in hospital, and so she had to invent a reason why her hands were so badly bruised. This is how she works it out:

I don't know what's wrong with my hands. Something to do with an unrestrained horse in the back of a car with no bridle. I don't know how I got into that situation but I was in a sedan with a horse in it.

I tried to talk her around it:

It's not true you know.
Why?
You were never in a car with a horse in it.
Oh [well], it was a good story.

Finally she accepted my version but you can be sure that if I bring up the subject again tomorrow when I visit her in the nursing home she will revert to the story of the horse in the car. That's just the way dementia works. It seems strange to us, almost willfully blind, but to her it's the only realistic solution to an intractable problem: how did her hands get so banged up?

Decisions to be made about mum's future health care

Mum and I went out to the park again today with the wheelchair. The children were playing soccer on the field and I put mum next to the second bench, and I sat on it, and we watched the kids kick the ball around the place. Some of them were quite good. After about 15 minutes we went back inside due to the cold.

I had managed to get onto my brother in Houston on the iPad this time, and I told him about mum's frail condition, and how she was prey to infections, and could be back in hospital at any time. When we had finished talking I went down the hallway to the nurse's station to ask if they could dress mum's leg as I wanted to take her outside in the wheelchair. The nurse told me that they had seen that we were talking on the iPad and so had not disturbed us when they had called earlier to dress the leg in mum's room.

While the nurse was doing the dressing another nurse came by to talk about various things that had been my preoccupation for some weeks, namely the likelihood that the nursing home would one day soon call me again to ask if mum should be readmitted to the hospital. I had also been pressingly engaged with the request that I knew would come from hospital staff - because of the advance health directive (AHD) we have in place - as to whether mum should be treated with antibiotics to cure the infection when it came. This had happened last time. It would again be my decision to make.

The nurse told me that it might be possible to put in place an alternative AHD. She also suggested having a meeting with the deputy director of the nursing home and also the GP so that we are all on the same page regarding mum's health care, when it comes to making decisions in future about it. She said she could organise this meeting for next week and asked what day I would be available. I checked my calendar and said I was pretty much free the whole week.

The reason I think it is important to have this kind of meeting is to make sure that mum's wishes - as expressed in the AHD - and common sense are adequately allowed for. Take the way the hospital has been handling mum's case since her last admission. Not only did they call me to ask if antibiotics should be used - because the AHD says not to use them for terminal illness - but to ensure that there is a degree of common sense around her treatment. In this case I like to keep in mind that the hospital kept mum in the ward for a second round of IV antibiotics because she obviously needed them, but also because the only way they could be administered when she is in the nursing home is through a pick line: a tube inserted in the arm and into the body for the fluids to enter the body through. A pick line was clearly thought to be too invasive, and so they chose the less invasive option.

Even in the best cases there are invasive treatments involved in hospital admission, including for example the catheter that is inserted in the urethra when the patient is still unconscious in the emergency ward. Then there are the cannulas - which mum is always wont to take out of her hands because she forgets what they are for when they are not plugged into a bag of antibiotics. Cannulas are like small plastic devices that accept the IV feed and direct it into the vein, but they can easily be taken out of the vein by busy fingers. The number of cannulas mum needed this time is attested to in her case by the extent of the bruising on her hands and arms. (The poor woman has devised a fantasy - she was in the back of a car with horses - to explain how the bruises came about. "The horses smelled," she said. "You couldn't make that up," she told me, looking in my eyes, as though seeking agreement.)

Poor mum. She was sitting there while I was having these detailed discussions with the nursing staff about her life. On occasion she said, "I'll just go," as though this might make the decision any easier in future. I felt terribly touched when she said "I'll just go" because I know she is saying it to avoid burdening me with any more responsibility. Not that she really wants to die. (Not that she really wants all that terribly much to live either: we talked briefly about voluntary euthanasia and how it is dealt with by the state in Australia today.) But it is a terribly hard conversation to have - the conversation we had today - because when it comes down to it you are dealing with an infection that can only be treated by antibiotics available in IV form, and that only hospitals can dispense. In mum's case therefore you come down to admitting her again and again and again to hospital, and getting her out for a week or two at a time in between. What kind of a life can that be?

Took mum to the park in a wheelchair

Up at the nursing home today I first saw mum in her room watching TV. The first thing she said to me was, "I've been in the wars," showing me her bandaged finger and the bandages on her right leg. The finger bandage is for a haematoma that has formed on the last segment of her index finger. The leg bandages are for the always-to-be-feared cellulitis, the chronic infection that keeps landing mum in hospital. I agreed that it all looked very dramatic. In my heart I was thinking furiously, assessing the likelihood of another hospital admission, wondering when the next call from nursing home staff in the early morning would come.

In the end because it was a nice enough day today, with plenty of sun, I decided that the best thing would be to get mum outside. I asked her if she wanted to go to the park. "Not really," she answered. "Is it your leg?" I asked. "I don't know, I suppose so." "Maybe we can take a wheelchair instead of walking," I suggested.

So I went out into the hallway to the nurse's station by the elevators and asked someone there if I could borrow a wheelchair. He brought around a black one but it had no footrests, so I asked if there was one with footrests. He went away and in a few minutes emerged from the hallways with this lovely blue wheelchair, which seemed just right. It had footrests and everything.

I got mum into her jacket and gave her a hat from her drawer to put on. Then as we were going out the door mum said she wanted her sunglasses. I got them from the drawer in the chest of drawers next to her bed, and gave them to her. We went down the hallway, me pushing mum who sat there in the chair. Mum felt bulky and heavy in the wheelchair and I wondered if I would be ok with it.

When we got out the front door into the open air, mum made a sound that indicated that she was a bit cold. There would be sun in the park, I thought, so I kept going. We passed the lady at the end who always has cockatoos on her railings. Today was no different and I passed by the cockatoo at a distance of about a foot; the beast had absolutely no fear of me at all. We got to the gate and I opened it with some difficulty and then we headed up the footpath. I noticed that there were no handbreaks in the model of wheelchair I was using. At the kerb we rushed down the short slope to the gutter, then I pushed up into it and we were then in the roadway.

I took the wheelchair to the second bench and parked it on the grass next to the bench, on which I sat down. I had noticed that pushing a wheelchair on grass can be a bit of a struggle, but I decided to worry about the return journey when it had to be made. We sat there making silly smalltalk, singing silly songs we invented about the sun, and commenting on the temperature. After about ten minutes of sitting there mum said she was getting cold, so we headed back the way we had come.

Back up in mum's room she headed straight for the bed and lay down, obviously tired out by the fresh air and the exertion. I took an extra wheeled walker - a blue one; mum's is red - that was in mum's room to the front desk on the first floor, and then walked back with the staffer I met, who took away the wheelchair. I said goodbye to mum and headed home down the motorway.

Mum is back in the nursing home again

When I went up to see mum this morning she looked happy enough but was also a bit subdued. Her hands are still covered with bruises where the hospital staff put cannulas into the veins for the IV drugs she was given. Mum tried to give me an account of how these bruises occurred, which had to do with being in the back of a car with men and horses, but I told her she had been in hospital. She hadn't remembered this piece of information of course.

She went to sleep after I had been in the nursing home room for about 20 minutes, and snoozed on and off for the rest of the time I was there. I read news stories on my iPhone and caught up on my social media feeds while she slept. We had a cup of coffee delivered during my stay. The nurse also came down to see mum and I asked her to clip mum's finger nails, which was accomplished while I was there. She then took a bandage off mum's right index finger, which had been covered where a coin-sized haematoma has developed under the skin. Because of mum's blood disease she tends to come up in bruises at the slightest provocation.

Most of the time while I was with her she just snoozed away the time in her own dreams. I sat there scrolling through social media on my iPhone while watching the time. I left her alone after about an hour and drove home, bought lunch and had a nap myself. I don't know how long mum will continue in the nursing home. She showed no inclination to go for a walk - although I didn't ask her if she wanted to - and seemed just very tired. We'll have to see how she goes in the days that follow. I am planning to go up to see her again tomorrow.

Mum getting used to the hospital ward

When I went up to see mum this morning she was a bit complainey and had just been on the loo, but got into bed straight away. She was feeling cold. I told her I had been unable to come up to see her the previous day because of the inclement weather. I explained that the emergency services had been telling people to delay inessential travel, and to stay off the roads. She didn't mind. It's just that she felt a bit unwell.

Then I reminded mum gently about her claim the last time I had seen her that she was "working for the government". "Oh really?" She asked. Yes, I said, she had said that she was working for the wife of the leader of the Opposition. "Oh yes," she said today. "I have been. Her name's Margaret." Apparently Margaret had been up to see her. They had become quite good friends. "I see," I said, laughing silently and with a smile on my face. "Are you sure you're not a bit delusional?" I asked. She looked at me in a way that made me understand that she was thinking hard.

Apart from this slight hiccup mum has been ok in the ward in the hospital. Today she refused the pineapple doughnut I brought her with her coffee (she drank all the coffee) but by the time I was leaving at the end of the morning visiting hours she was busily hoeing with her fork into her lunch, which today was ravioli with mashed potato, strained pumpkin and green beans. She at least seems to have regained her appetite.

I reminded her that she would be going to go back to the nursing home soon, and asked her if she preferred it. "Oh I don't know, it's alright here," she said vaguely. "But you have your own room there," I offered. "Oh yes, there's that," she admitted. I told her she might end up in the hospital again if the infection - which they are treating as one that is untreatable by most antibiotics - comes back. "Oh well, then I'll just cark it," she said mildly. I told her that they could probably just treat her again with antibiotics the way they were doing this time. She didn't seem particularly phased by anything that might happen to her, even a sudden end of her own existence. It was as though she has become pretty much resigned to whatever fate throws at her. Which I guess is part of her dementia. I assured her that she would most likely be fine.

Mum still in the hospital ward

Up at Ryde Hospital this morning mum was content enough but lacked some of that upbeat spark she has when she's really feeling well. Maybe it was just a bad day for her. She has been in the hospital this time for about a week but the release date has been pushed back because the doctors wanted to make sure about the infection before that step is taken. At the moment it looks like she'll be released on Tuesday but there's no absolute guarantee of this.

She seemed a bit dull to me today. I arrived at the start of the morning visiting hours and when I got there she was on the loo. When she got out she padded back to the chair next to her bed and sat down. I gave her the doughnut I had bought her and she ate the whole thing. We didn't talk much because she was not in the mood apparently - I didn't press her - but she was a bit confused, saying some things that suggested she had been delirious. "I'm working for the government," she said. "And I'm working for the wife of the person who runs the Opposition. Whose name escapes me. I'm terrible with names, I really am."

That was all she said but it was a bit strange. The last few times this week I had seen her there was nothing like this. She went to move her bowels later in the morning and when she came out of the bathroom she sat in another chair, in the corner of the ward room. She just sat there hunched over like she does sometimes in the nursing home, when she's not feeling tip-top. She came back to her bedside though when I asked her to, because I didn't want her to make the other person in the ward uncomfortable. When lunch came she ate a bit while I was sitting there. Then I went out to get something for myself to eat. When I came back she had opened the sandwich and the container of fruit, but she refused to finish her meal or touch either of these two items again. She opened the ice-cream and ate most of it, however.

I had to leave not long after she finished with her lunch, because visiting hours in the morning only go to 1pm. Overall I thought she looked a bit subdued. Not at the top of her game. She snapped at me for suggesting she eat more of her lunch, but otherwise conversation was not very lively.