Where do we go from here?

DM is now settled back in her care home but is horribly tired.

Nursing assessment tomorrow. I do wonder if DM could do with a couple of weeks of bed rest. She is currently back in the residential section.

@Crikeyalmighty that must be so frustrating. DH shutting his ears and pretending it won't happen.

I do wonder if some people get stuck with an impression that one or other parent is immortal or unchanging.

There is the risk that decline or risk gets missed. Failing memory is dismissed as a temporary blip. Trip and fall hazzards get ignored.

My DB is caught by a few things: hates change of any sort, anything going wrong must be somebody's fault, he has to be in control.

DB does not want to accept that DM almost certainly has dementia. He doesn't want that to be true because if it is, things will have to change.

There will have to be an acknowledgement that DM no longer has capacity. The LPAs come into effect. The LPAs name DB and me. This means DB is no longer in control.

If DM has dementia then her 'non compliance' can't be blamed on DM being 'difficult'. DB would rather blame DM than just accep that this is the way of dementia.

@Weenurse that is such a hard choice put on you.

I was grateful that it was the surgeon who explained the realities of resuscitation to DM. I do wonder if people see dramas and see the sanitised portrayal of resuscitation.

Today is a day of allotmenting and sewing. Tomorrow I will visit DM in the afternoon when I may get to see her awake at last.

Much of my role in DM's care is to do the practical things. DB is retreating ever more from actual engagement with staff etc. He wants me to do that.

DM is beyond having that sort of conversation now. Even if we were to have the conversation she would have forgotten what was said immediately afterwards.

Just before the surgery DM was asked about DNR. She said quite robustly 'I'm not ready to go yet!' but the surgeon explained the realities and a DNR was signed.

DM is now back at the care home in her old room with a nursing assessment booked for Monday. DM has declined significantly since going into hospital this time. She is no longer able to feed herself and bowel continence is now an issue.

I don't know if these things are permanent or just something which will take time to resolve. It is possible DM will be moved to the nursing care unit within the care home.

@WinterFrog it is probably easier to have these conversations (hopefully) further out. I have now started to discuss this with DH. We will be doing our LPAs in the next few weeks. I am intending to add an Advance Directive to decline any treatment other than palliative if I am unable to give informed consent.

I don't see this as gloomy, to me it is positive. I want to enjoy my life. However, I have always been someone who likes to leave a party early rather than staying to the end.

Thank you @Weenurse . We shall see later today if the move actually comes off.

I have warned DB that we need to see this as a temporary reprieve. Each go around the UTI block has left DM lower physically. If DM is infection free now, another UTI will be waiting in the wings.

This sounds a gloomy prognosis I know but we need to be realistic. Enjoy each day as it comes.

@WinterFrog if not the same chain then certainly one very similar. I hope your DM is settling in her new environment.

So far I have no complaints. One of the team contacted me a few days ago to ask how DM was doing.

I was in the care home a couple of days ago to pick up pjs and glasses for DM and one of the care workers unprompted asked after DM by name.

Of course DB has complaints but I think this is because he still hasn't got to grips with idea that the fees bring a certain level of service and furniture. If we want something different we have to provide and pay.

Last night DB received a call from the hospital to say that DM was being moved to the discharge lounge last night with the intention DM would be returned to her care home today.

Cue panic from DB as he is envisaging DM being flicked out of a wheelchair onto the front step of the care home.

It is all a bit hasty but the hospital is overwhelmed at the moment. Patients like DM do have somewhere to go. DM is getting better. Yesterday she was put into a chair for the first time. It took 3 people but was managed.

Any road up, I messaged the care home to confirm DM returning today and left DB to his panic.

@Randommother that is a long hospital stay. I hope your mother settles in quickly at the nursing home.

Thank you @WinterFrog and I'm thinking of you.

Yes, I think the set up of the homes sounds very similar. They do have a good staffing level and I find them very friendly.

No actual plan as yet but the words 'readied for discharge' were said to DB.

The care home will do their own assessment of DM's needs. We chose a home with different levels/types of care: residential, dementia, nursing.

It is possible that the home will say DM needs to go into their nursing unit first and assess again from there. We are keen for DM not to go to the rehab unit if it can be avoided. It isn't a great place.

DM has lost even more strength in the last couple of weeks. She wasn't walking before and now is only partially propped up in bed. I also don't know what DM's cognition is like now. I have only seen her delirious or asleep in the last two weeks.

Even if DM does manage to get back to her care home I think it will only be a matter of time before there is another infection.

@Anjo2011 Thank you for asking.

Turns out that the whole ward DM was in has moved.

DM is still on ABs but no longer IV. She is waking but still sleeping an awful lot. Fluids drip is also gone.

So sounds good but DM is eating and drinking very little and is needing to be fed.

But in hospital terms this is all good so they are getting ready to discharge DM.

I genuinely didn't think we would get to this point several times last week.