Vale Dr P: his last day

To write is pain. To remember is pain. To forget or to obliterate is worse.

On Sunday, knowing that old friends were to visit him, I had a sort of day off. I went to the crochet clinic, and then saw a film, after which I went home by bus, and then drove straight to the nursing home, and stayed with Dr P for almost two hours. He enjoyed seeing his friends, the widow of a friend, whose life he saved, he said, by diagnosing a rare illness she suffered from, and one of her sons, another former colleague. These families were close for many many years, but as they aged, contact became rarer.

I had telephoned to let them know Dr P was in the nursing home and she organised her boys forthwith. Another friend had visited him on Friday, from Adelaide. They used to share a house and were good friends for many years. This friend intended to visit Dr P again on Monday, but it was not to be.

His catheter had been changed earlier that day, which he said was most unpleasant. When I left Dr P on Sunday evening he was in pain, not in the lower back, but around the shoulder area, which evidently was not relieved. The nursing home telephoned me twice during the evening and told me he had been given a a morphine patch. I thought all would be well, and there was nothing I knew of to indicate otherwise.

During the night his condition deteriorated, and they sent him by ambulance to hospital at about 4 am. The nursing home rang my mobile phone, which was downstairs, and I knew nothing until I checked the mobile in the morning and found the message. I telephoned, and was told he had gone to hospital, but it was not clear whether he would be sent back again. I was unable to contact the friend who was shortly to pay his visit. While I hesitated about where to go, a doctor rang me from Emergency to tell me of his condition. He had an infection from the catheter, had gone into toxic shock, his pulse and blood pressure were extremely low, and there were indications of heart attacks. Treatment of one condition could cause further problems with others. The doctor told me that if it were his father, at such an age and with such conditions, he would not choose intensive interventions. I drove immediately to the hospital and on arrival saw the doctor, and another one. I telephoned his daughter, and the doctor spoke to her. She came to the hospital and he son arrived some time later. Another doctor from the Intensive Care came to assess Dr P. The risks of intervention were high, and would most likely be futile. We decided against intervention.

When I arrived, Dr P was conscious and aware, but intermittently. He knew me, and where he was, and I told him he was very ill. He responded to my words and my touch and caresses. Gradually he became comatose, and failed to respond to any stimulus.

We knew he was gravely ill, and would not recover, but did not realise his death was imminent. They took him to a ward, in a single room, and within 20 minutes he died. I held him, stroked him, kissed him, told him gently that we were with him, and loved him, recollected our good times together, thanked him for our life together, and told him it was all right for him to let go.

There were two exhalations, and then no more.

We stayed with him for over an hour. His daughter telephoned her sisters, one of whom had booked a flight to arrive next morning. Then his daughter and grandson left, and I stayed longer with him, still stroking him, until I was ready to have him prepared for the mortuary. I helped wash him, and clothe him, farewelled him, and then drove home, to begin the task of telling people of his death.

He was my husband and I loved him, and I mourn him greatly. I am glad he was spared a lingering death, and more suffering. It is three weeks since he was taken to hospital. We knew then that he would never come home again, and that our life together was over. We could not know then how little time remained.

It remains to endure until his funeral on Friday. It will be a good one, I believe.

Requiescat in pace

My husband, Dr P, died this afternoon in hospital, with his daughter, grandson and me by his side.

Should this all become a TV soap?

Yet another exhausting day. BUT! there were good bits, both yesterday and today. I went to my Italian class, having missed the first one last week.

We meet in a cafe, as the class at the community college was cancelled prematurely a couple of years ago, and some of the students wanted to continue with our excellent teacher Barbara. We made private arrangements with her. We found a cafe which was happy for us to meet there once a week, and we made sure we had a late breakfast there, so the cafe made money out of us. We have become quite close, in varying ways, and helped our teacher when she had a problem with getting her daughter's passport.

I had persuaded my friend Nora to join the class. She and I met on a jury, which lasted almost seven weeks before we were discharged because we could not agree on a verdict. (On the third trial the defendant was convicted of murder.) We, including her husband,  have become firm friends and they have come over to help with my occasional computer crises. Nora can always think of a topic to write about, whereas I agonise and always wind up doing it at the last minute.

I did not get to the first class, because of expecting Dr P to be moved to the respite care nursing home, but I got there yesterday. We are meeting at a new cafe, as the other one is in a building to be demolished shortly. There is a new class member, and as reasonably advanced students of Italian are not all that numerous, we get to know each other.

Naturally I had much debriefing to do, and it was good to have all their support and sympathy, especially when I spat bile about the WSDs.

This morning there was the other Italian class, and I was supposed to summarise and comment on Cantos 1 and 2 of Dante's Inferno.  Another friend offered to do these for me, but we compromised by my doing Canto 1 and with her doing Canto 2 (and 3 and 4). As all my activities are done intermittently and on the run, it took until late at night. I went to choir and left at supper time, thinking to get home early, but due to roadworks the trip took twice as long as usual. I managed to produce a piece I was pleased with, and my kind friend did wonders with her three Cantos - she was a professor of literature and totally erudite and wonderful, with the kindest of hearts. I love her.

I wrote my piece on my old computer, which has a CD-Rom of English and Italian loaded on it. I cannot get the new computer to accept this CD-Rom, and have not been able to start my computer classes at the Apple Store in the city. Every so often the old computer dies, and its logic board has been repaired twice. I thought it had died again the other night, but I think I must have switched it off.

When I returned to the new computer, the mouse/mice totally died, so there I was, unable to execute a single command. Oh horror! I switched the mouses/mice around, replaced the batteries, tried to reconnect, put all the plugs into different USB ports, all to no avail. Finally I resorted to the standby technique of switching the computer off and then back on, and an Apple mouse was finally recognised. Why does switching on and off work??? I do not understand.

The new and you-beaut Magic Mouse remains totally and resolutely useless. I was given to understand that if I switched it on (having been shown how to switch it on) and stroked and patted it a trifle All Would Be Well. After the Italian class I bought an ordinary wireless mouse and it works, praise be given! The stroked Magic Mouse remains totally frigid, and it is time I went and did some classes - which I have not been able to do, what with it being impossible to leave Dr P alone in the house).

After the art history lecture I caught the bus home, and then drove to the nursing home, where I found Dr P looking glum and lugubrious. I had an email from Vixen telling me to bring a radio for Dr P (there have been radios, with headphones, there all week which he has not wanted to use.) She also suggested the old TV be taken across to the home for him. This is a really stupid idea: it is large, too large for the room, it is a cathode ray tube TV, and it would not have digital channels.  I replied saying all of this, and that I had already obtained quotes and made delivery arrangements. She also suggested his old computer be brought to him so he could play his card games on it. It is about nine months since he stopped playing these games, as his mind cannot think them through any more. I could just imagine his rather small room cluttered up with large TV and very elderly computer.....Good one, Vixen!

He is still carrying on about how I just want to make changes for change's sake. I did my best to soothe him, saying if he did not want to move, he would not be made to do so. All the while a woman with dementia was screaming. He did not like the noise. Had he gone to the other nursing home, he would not have been in a secure dementia ward, and would have been mixing with people less seriously afflicted, but he is no longer capable of understanding this. He likes to play the blame game.

I told him he should have a TV in his room, and that I would buy one and have it delivered. Shortly afterwards Vixen arrived, and despite the email and my reply, brought with her a large ghetto blaster.

Some time after I arrived home another Vixen email appeared, copied to her sisters Jinx, Junx, and Kinx, saying the staff 'kept asking her' why he did not have a TV, and suggesting he have one forthwith. I replied that I had already told him I would get one, which was probably why he responded positively to the idea, but that evidently he had forgotten the conversation.

She makes my blood boil, makes me spit chips, infuriates me, drives me crazy, and I believe she is trying to make it appear that she is the one doing everything and that I need to be pushed and goaded into action. Funny that the staff have not been asking me why he does not have a TV! Who can you believe?

I must stay calm, and have another glass of wine. Tonight I made some pesto and actually had an evening meal. And it was good. Now I am listening to glorious Renaissance choral music, including a piece by Victoria, Ne timeas, Maria, which our choir will perform at our next concert.

Music has charms to soothe a savage breast.

I just looked this up, to make sure I got it right, and found out, inter alia, that the words for the song The Lost Chord, by Arthur Sullivan, were actually written by John Keats, in The Eve of St Agnes. I never knew that! You live and learn. It is never too late, and my savage breast is indeed becoming calmer and responding to the beauty and tranquillity of the music, and the glory of the singing. It heals and uplifts both body and soul.

This is one of the many reasons why I went back to choir as soon as I could. Choir is better than a TV soap, any day.

Tune into the next exciting episode

All our drama has been going on for about a month now, but it seems longer.

Dr P's first few days in his respite care nursing home were difficult. He was confused, forgetful, and did not know where he was or what day it was. Furthermore, he was adamant that no one had been to see him or been in any contact with him. Much soothing and firmness were necessary. It really was like dealing with a two year old having a tantrum. I kept wondering had I done the right thing, and kept investigating alternative nursing homes. I saw another few. Vixen visited him, but not while I was there. Let's face it, she is an interfering bitch, and she keeps demonstrating this all too clearly.

One of our friends came with me to visit a nursing home on Friday. We both agreed it was lovely and that I could feel very comfortable if Dr P were to go there. I had seen several others in the meantime. It sure fritters away the putative leisure hours. The only snag with this place is that there was no single room available. However Dr P would have been second in line for any single room vacancy. Of course, people have to die in order for there to be a vacancy. Friend K and her husband visited Dr P at the weekend, and she hated the nursing home. She is more sensitive and squeamish than I am, and flinched at the secure dementia ward situation. I look reality in the face, and value truth and honesty, try to not mind the unpleasant aspects of illness and ageing, and aim to get on with things. I agonised about the decision, but then it seemed to me that seeing more people would do him good, as he sparks up quite a lot if he has good company. I decided to move Dr P.

Yesterday I went to visit him, and to let him and the nursing staff know. Vixen was there when I arrived, and I asked her to wait so that I could tell her personally. Big mistake. She was very hostile and had not the sense or sensitivity to voice her views to me separately. Did I say she was a bitch? And VERY ugly. Ugh!  Like onomatopoeia, appearance mirroring personality and character. Dr P was upset, and said he did not want to move. He was settling in and getting to know the staff. I discussed it all with the Deputy Director of Nursing, and then went home and agonised, ringing a couple of friends to seek counsel.

Eventually I decided to return in the early evening, to say that if he really did not want to leave the nursing home, I would leave him be. Although I feel like a bit of a wimp, it did seem to me that as he was the one in care, he should have some rights. So I saw him again in the evening and he said he did not want to move. I reassured him that I would not force him into anything. His condition has improved in the six days he has been there, and they are looking at his pain management, and the staff have been good and attentive. And there is the possibility of change if it all does not work. The other nursing home is holding the vacancy until Friday. I have sent a general email to all the family but I would bet my bottom dollar that Vixen will have sent a hostile and misleading email ahead of me. So be it.

Next week I will change the locks on the house. Would it not be lovely if I never had to see any of them ever again?

My second daughter and her children visited at the weekend. It was lovely having them. When the children were told that Dr P was not there, they were very pleased, as he has never been one to tolerate small children. Indeed, I understand he was one of those fathers who just just disappeared without notice or notification. They rode up and down his stair lift with gay abandon until somehow they made it stop working. We had a lovely time together. I had not seen them since August.

In between visiting spouse, nursing homes, and attending to telephone calls, I have been cleaning out cupboards. Video tapes, not touched since we moved here more than ten years ago. Old decrepit phones, answering machines and fax machines. Medical books dating from the 1950s.  Old medicines, and the contents of Dr P's bathroom cupboards. The rubbish bins are full this week. So we remove parts of our history, and our records. Sad, but inevitable, and it helps me feel that I am managing my life, and can get myself in order and organised for whatever happens next. People tell me that I have done well, and in many ways, I have indeed done so. But there remains sorrow and desolation, and immense pity, for Dr P and all the other old people thus afflicted. I wander around this large and empty house, and flit from one activity to another, to distract myself from my sore and sad heart, and I hope that life will get better.

Snowflakes

This afternoon Dr P was transferred from the hospital to the nursing home which had the respite care vacancy. I went over earlier and did all the paperwork. He arrived later than expected, as the hospital sent him across to the major hospital for various tests, and it seems they are twiddling with his medicines. He was quite cheerful, and lucid when he arrived, despite a long and complicated day.

He has his own room, and his own air conditioner, and he has a nice window, and has two chairs in the room. He does not have his own bathroom, but it is just across the hall, and as he needs help to get there, it does not matter. The staff seem good, kind, cheerful and pro-active, and they brought me a pot of tea while I waited for Dr P to arrive. I hope these first good impressions are the real thing. The Nursing Director and I bonded over our divorce experiences!

Vixen went there yesterday, whether to inspect or to assert an essential role for herself I do not know, and thought it politic not to press for information. She  appears not to have impressed the staff at the other hospital.  Probably she never went to charm school. But on reflection, neither did I! Nature, not nurture?

I have been very sad and miserable for the last few days, adjusting to being alone in the house, and occupying myself by tidying up shelves and cupboards, cleaning out the genuine antique collection of medicines, and sorting out Dr P's clothes, deciding what he needs in the nursing home. It felt as though I was cleaning out and disposing of the possessions of someone who had died. It was awful, and I wept all over all sorts of things as I worked. Such work helps with all the mixed and conflicting emotions.

Friends have been very good, now that I have managed to talk to my friends instead of dealing principally with the stepdaughters. Word has spread to various of Dr P's former colleagues, who live in other states, and they have telephoned and been terrific. Other friends visited him yesterday. He  has always enjoyed their company, and they told me they stayed for 45 minutes and he talked and talked and was really lucid and on the ball.  What really helps is people having real conversations with him: then his mind snaps back into focus and he engages with the people and the topics of conversation. Let us hope he gets many such visitors.

Now that he is in respite care I can check other nursing homes and try to work out what offers best care, and compare costs.

As to costs....

Dr P's solicitor rang me yesterday morning with the news that the stepdaughters have agreed to  return the purloined money to a trust fund with the solicitor, which will pay for any accommodation bond. I wish I had been privy to those conversations and communications, as it seems likely that they may have been made to feel the impropriety and greed of their actions in getting Dr P to write those cheques. I was  most explicit in expressing my views to him. I was told that Dt P had expressed the intention of giving money to the others to balance the loan he gave to the youngest. But the point is, he never did so while he had the capacity, and they used his mental incapacity, feebleness, and desire to be loved (for what he gave rather than for what he is) to get that money.  Corruption, greed, rapaciousness, exploitation and deception.

I feel a fierce joy and sense of vindication, but absolutely no gratitude or thankfulness. I am as angry with them as ever, as the very idea of exploiting an 87 year old man not in possession of his faculties, and declining visibly day by day, fills me with rage and horror.

And my rage, determination, care and love have forged in me a steely ability to make decisions, protect myself and Dr P, and to work in ways which have achieved what should not have had to be an issue. They have seen my mettle.

I owe a great deal to my wonderful brother in law, my solicitor, who has acted on my behalf (and of course for Dr P's benefit too) with his wonderful legal ability, strategic ability, firmness of purpose and focus on results. I did not expect this result. I take some credit for it, in being able to express my outrage to Dr P's solicitor. He expressed no opinions, but he must have shared some at least of my views to have been able to reach this result. And I have an undertaking that nothing will be done by them without my consent. I think they have had the fear of God put into them. So to speak.

It seems that on rare occasions snowflakes can indeed survive in hell.

Tempering the temperature and soothing the fevered brow

Dr P is still in hospital. He is better than he was, and his pain is definitely less. He switches between lucidity, confusion and forgetfulness. There is a respite care bed being kept for him until Monday, but it is uncertain whether it will be reserved for him after that. I might get some idea after the doctors' rounds on Monday morning.

He was in a four bed ward, with three other men. The male sex is really very odd. Not one of these four men said a word to any of the others. Had it been a female ward, greetings would have been made, and names and details exchanged. Not this lot. Dr P wanted the ceiling fan on, and then the other three suddenly protested loudly. That night Dr P said he got no sleep, as at least one of the other patients yelled and groaned loudly with pain. I'd heard him yell myself, and he certainly made a lot of noise, poor thing.

This led to Dr P wanting a single bed room. He was advised against this, as there are only two single rooms, and that part of the ward is not air conditioned. It faces west, and gets all the afternoon sun, and as we are having a rather unpleasant heatwave, it has been extremely hot in that room. He moved anyway, despite advice, and got very hot, distressed and confused.

I wonder, and obviously so does the nursing staff, what administrative genius approved the air conditioning of half the ward, but not the rest of it. The hospital is an old building, and used to be a general hospital but now is partly for rehabilitation, and I am not sure what other conditions it deals with. It is understaffed, and missed out on approval for additional staffing, as it does not do acute care. But it does have many old and decrepit patients, and they are very labour intensive, what with constant calls for bedpans, being helped to move around, and frequent calls for help of one kind and another. I have been very busy with Dr P during my visits, soothing, calming, explaining, reiterating, fetching and carrying, reciting the sequence of events, fetching drinks, tissues, nurses, pans, etcetera.

His room was so hot yesterday that I wondered what I could possibly do to cool it down. I thought about my windscreen protector, which has suction caps to keep it on the windscreen, and went to the local bathroom shop to see whether they had any suction caps, They did, so I bought two, and went home, to retrieve a roughly window-sized piece of blockout fabric that had been used to keep heat and light from the window above my bed. The bedroom is on the top level and faces east-west, and gets fearfully hot. Possibly the architect did not know that hot air rises, nor did it occur to him that better climate control is achieved by putting the windows on the north side.  Perhaps I could have had a prosperous career giving out advice about such elementary facts.

I sewed strips of elastic to fit over the hooks. Alas, the suction caps failed to suck, so that was a waste of $26. Grrr!

This morning when I got to the hospital one of the nurses was up on a ladder tying the blockout fabric to the top of the window. That certainly helped, although the piece of blockout was not quite long enough to cover the window. In the afternoon I brought in a towel and used my handy packet of safety pins to attach it to the blockout, and thus cover the window.  There were three fans in the room all working very hard. I think the temperature today must have been close to 40 degrees C. Is it not amazing that family must resort to such expedients?

To help the patients cope with the lack of air conditioning, patients were moved into the TV/lounge, dining area, which is air conditioned, and Dr P and an old lady were parked there all day. The old lady obviously has dementia and she apparently keeps stripping off all her clothes, so there she was curled up naked from the waist up, and doing her utmost to remove her disposable pants. This happens all the time. Dr P was fretting that he had no buzzer to summon help when required, but the staff assured me that they were in and out constantly.

As well as researching/ringing, visiting nursing homes, in between visits to the hospital I have been paying some attention to tidying up Dr P's desk and sorting his documents, so that his stuff can be taken to a tax person to do his tax return for last year. Or I sit around meditating about the rest of my life. And sending emails to the step-daughters, before suddenly remembering that there are members of my own family, and friends I should ring. There are the legal and practical issues to deal with too, aided by my excellent brother in law. He is in contact with Dr P's solicitor, who visited Dr P today and who realises that Dr P cannot handle his affairs any more, and that there are matters to be resolved. I suggested that the stepdaughters should give the money back, to pay for an accommodation bond for a nursing home. My sister thinks that there is a snowflake's chance in Hell of this happening. I think she's right.

No rest for the just. The wicked continue to thrive.

My emptier house

Here I sit at home by myself. Dr P is in hospital. Although we struggled through the weekend, by Monday afternoon, Dr P went up to his room early, in case he could not get there later.  He had his meal there, and then his medicine and we hoped he would settle for the night.

Again, he was in considerable pain, and wanting more and more pain relief. Nothing seemed to give him more than very slight relief. When I went to him in the morning, his head and shoulders were on the mattress and the rest of his body out of the bed with his feet on the floor, and he was unable to move. I checked how many more pills he had taken, and it was more than I felt  was advisable. while I had not left him any of the stronger ones, he still had paracetamol and tranquillisers. Because he used to be a general practitioner he still thinks he knows it all and does not listen to or heed arguments, statements or facts to the contrary. He is exceedingly stubborn and obstinate.

I walked up to the surgery and my GP was already there, and so we briefly discussed the situation. She confirmed my opinion that he should go to hospital. Accordingly I rang for the ambulance and they came within a short time and took him to hospital. I followed by car.

There followed a long day, during which his pain was evidently very severe. I had to leave him to visit a nursing home, which does have a respite care vacancy available. In between being with Dr P I kept phoning about places. Eventually the Emergency people arranged to send Dr P to our local hospital, which these days does not function as a comprehensive hospital, but which does have rehabilitation and a few other functions. There do seem to be a number of old and decrepit people there. Dr P is in a four bed ward.

Today he is much more comfortable. He's had urinary retention so that is being treated and the cause investigated. He will be there for some days - no one is mentioning how long, but his hospitalisation will give me the time and breathing space to investigate options and places for nursing home care.

When I got home, about 6.30 pm, there was a telephone message from Vixen proposing to visit her father the next day. I rang her and told her about the crises and the hospitalisation and the likely consequences. She told her sisters, so I had a couple of phone calls and email messages last night. This morning I sent them all a comprehensive account, and have had replies from two of them. Vixen went to the hospital last night but her father was asleep. The staff told me this morning that she had been there, and had wanted to be informed of all his medical details and to be involved in the arrangement for his discharge. I agreed to the medical  information being provided, but not to her having any involvement in his discharge or subsequent care.  The social worker and I have talked and she knows my reasons, and was horrified by what she was told. I am next of kin, and none of them has rights over his care and future.

There were many phone calls to make last night, to notify my children and my sisters. My brother in law talked to me, and he rang this evening to report on his conversation today with Dr P's solicitor, aimed at warding off any further nefarious moves by the stepdaughters,  during which he disclosed the obtaining of the cash assets. I hope they all get a huge fright,  spokes in their works, and of course their just deserts.

I have seen my GP, and this afternoon a friend and I visited a local nursing home. Dr P is now on their waiting list, but it will indeed be a wait.

The bed sheets have all been washed and changed, and the house tidied a little. In between all the comings and goings, the researching and the fact-finding, and the decisions, I must come to terms with all the changes in our lives, and what is in all probability, for practical purposes, the end of our lives together. Relief and grief are mixed, with much anxiety about the future, but the absence of the immediate physical caring responsibilities and tasks does relieve much of the tension.

Overwhelmingly, I feel so very sad.