He was 73 when he went into hospital and now, two weeks on, he is 74. Not a great age by 21st century standards.
The bedside birthday party went as well as it could. My Loved One drowsed and muttered occasionally while the rest of us – both sons, one daughter-in-law and elder two granddaughters – worked our butts off to be jolly and upbeat in an appropriate register. Hard work but I think we pulled it off.
First of all let me say a huge thank you to all the people – many of them readers of this blog – who sent cards. We had four times as many as he would usually get. We painstakingly showed him each and every one and reminded him who all these kind people were. I had something in my eye during much of this. At one point I had to slip out into the corridor, comforted by GD2. The messages were so carefully thought out and the cards chosen with exquisite tact. Of course we all know that there won’t be a 75th birthday. That’s why it was so poignant.
I baked a squishy chocolate cake and took it to the hospital. After a muted rendering of Happy Birthday I made sure that the other three men in the bay and their visitors all had a piece. And I was tremendously touched by two doctors, to whom I’d spoken several times previously. We met them downstairs by chance, while we were waiting for GD1 and GD2 to arrive from Suffolk before we went up to the ward, “Oh we’ve bought balloons and we’re on our way up with them” they said. What nice people – but actually that’s been true of almost every medical professional we’ve encountered at Lewisham Hospital. And interestingly, every single doctor we’ve seen has been female.
He’s now been there two weeks, having transferred to “Care of the Elderly” from Medical after the first five days. They’ve done a lot of tests and drawn several blanks. An MRI scan shows Alzheimer’s (as did the original one at his diagnosis two years ago) but no Parkinson’s although there may be some Parkinsonism. Neither has he had a stroke and his heart, blood pressure etc are more or less normal.
So why has he gone down so fast? Well, it’s partly bad luck and a hideous, hateful, galloping illness. The average survival time from Alzheimer’s diagnosis is four to eight years. But averages, of course, are just averages. For some people it’s less and for others it’s more. But why – and this is what has been puzzling the medics – has the rate of deterioration accelerated so much in the last month?
The new theory – and let this be a lesson to us all – is dehydration. MLO has been pretty tiresome about drinks all his life – always demanding tiny cups and glasses and refusing to drink more than a few drips of anything. And lately it’s got worse. As one of the doctors observed on the day of writing “Lessening of appetite and thirst is part of the progression of the condition”. In recent weeks I’ve been struggling, really struggling, to get even half a pint of liquid into him each day.
At the hospital they’ve been topping him up with an intravenous feed into a cannula. The aim is gradually to bring his sodium levels down because excess sodium can add to confusion. It seems to be working and he’s now awake a little more often than he’s asleep and sometimes makes a sensible comment such as a muttered “No more now, thank you” when I’m trying to feed or water him.
When he seemed to be slightly more with me briefly this morning I said “Come on. This is serious. You must drink more. You know what happens to slugs if you salt them? They shrivel up and die. That’s what will happen to you!” He actually grinned (sort of) and mumbled “That’s horrible!” I replied: “Yes it is. That’s why you must drink more both in this hospital and when you come out of here.” But by then he’d gone out of focus again.
As far as I know he hasn’t been out of bed for a fortnight despite the best efforts of physiotherapists so he’s pretty weak. Apparently they (physios) will now try to sort him out ready for discharge – maybe at the end of next week. We’re not going down the care home route if I can possibly help it.
The hospital bed awaits him at home with me. I have yet to discuss the dreaded “care package” with anyone but I envisage supplementing whatever I agree to have arranged for me with the man-sitting carers I already have so that I can still go out and continue working. And at least I shall be able to prepare some tasty vegetable and fruit purees. He only eats a few teaspoonsful of anything now and really doesn’t like what they try to give him in hospital. His swallowing mechanism is now quite poor but the catering people don’t seem to have got the messages about soft food – especially when you want it to be vegetarian as well.
I suspect he’ll be more or less bed-ridden from here on. And I sincerely hope that “from here on” isn’t for too long because his quality of life is non existent. Who wants to live for months as decelerating, muttering, largely prostrate body while well meaning people shovel food in one end and clean up the other?
I often think about MLO’s father, my father-in-law. He died less than five years ago at the age of 89. Had he had the longevity of, say, the Duke of Edinburgh or my feisty next door neighbour, he’d still be with us now. Thank goodness he isn’t. I am deeply relieved that he didn’t live to see his only child as he is now.