Day 1,179 (not) in the Nanny June Care Home

The One With The Doctor & Rose & What Happens In The End

Lots of lovely people asking how Nanny June is right now. The truth is that it’s really tough to know.

No visits due to the pandemic means we are relying on phone calls and (more bizarrely) zoom meetings.

However, dementia seems to bring with it a real lack in concentration. As our calls take place at her end in a communal space, as soon as someone walks past Nanny June we lose our place in the fragments of conversation we have and it takes a while to get back on track. The care home is full of old people wandering about so we are probably having three minute conversational loops with a two minute break as we reset the device, set it back up, get back in the zone and restart the conversation until another resident walks past three minutes later.

However, dementia seems to bring with it a real lack in concentration. As our calls take place at her end in a communal space, as soon as someone walks past Nanny June we lose our place in the fragments of conversation we have and it takes a while to get back on track.

Nanny June is also increasingly distressed at her words being mixed up and her conversational ability being poor. I imagine she has had another small stroke but it's impossible to diagnose formally without a MRI and the distress that would cause out weighs the value of a diagnosis.

The Doctor Who Doomsday episode from 2006 features the farewell story of David Tennant’s Doctor to his love and companion, Rose Tyler. In an array of dramatic scenes Rose falls into a void created to expel the evil Daleks and Cybermen but is saved at the last moment by being transported to a parallel universe from which there is no return. The Doctor and Rose are left, where they stood just moments before - now either side of a wall which separates them through whole universes, yet they can still sense each other.

Virtually seeing and hearing Nanny June creates the illusion she is present, when the vast majority of the time she is not quite. There is a parallel universe where she exists, and there is a wall that separates us. Sometimes we connect despite the wall but those moments are getting less. We are in a state of suspended animation where she is frequently frustrated and agitated and at times quite lonely. I understand other days are good but I don’t have enough information from the care home to get a balanced picture.

My wish is not for Nanny June to live indefinitely - but the pandemic is bringing many uncomfortable truths to light for many people, including the impact and limitations of choice.

This includes end of life care.

As doctor's surgeries crassly and clumsily ask for clarification on end of life wishes during these strange times, the press have a field day as people receiving these letters understandably get upset.

End of life decisions made on behalf or with the patient in palliative care, and ideally with family usually take place in the quiet corners of unseen spaces. Such decisions are now compromised in ways most of us can barely imagine.

I do not fear Nanny June dying from COVID-19 (she would not fear it herself either even if she could) but I fear a death for her that is lonely, isolated and distressing. As far as I know there is no immediate threat of infection from within the home, but this week I have to contact the care home to discuss these plans and make sure that the outcome that is most in line with what Nanny June would want and is recorded for when it is needed.

Whenever and whatever that might be.