Day 2,270 in the Nanny June Care Home

The One With The Day of Reckoning

Is that being over dramatic?

Today was care plan review day. These usually take place with a nurse in a clinical little office in the heart of the building. Today I was taken to an outer room with an extra member of staff. Not an office, more of an informal meeting space.

This is not my first dementia rodeo. I know that this is Not A Good Sign.

It is somewhere quieter, where we won’t be interrupted.

Because this is going to get heavy. Emotional.

Because Nanny June is ever progressing towards the end of her/our dementia journey together.

There is weight loss. A lot of it. And it is unexplained. Nanny June has a good appetite. She is now classed as immobile so not expending calories. So the weight loss is unexplained.

She is more compliant than before.

And she is visibly more slumped and giving off major defeated vibes.

I know my mum very well. As children we learn to read our parents very quickly. Depending on your childhood and your parents, we read warning signs and red flags to a greater or lesser degree.

I can read Nanny June very very well.

She is not happy.

She can not communicate this verbally but as the majority of our communication as people is non verbal then it is quite clear.

It turns out all the times Nanny June has seen a doctor since Covid it has not actually been in person. It has been via phone call or zoom.

Actual Doctor Visits are like hens teeth.

And (I am informed) only undertaken at the specific and justified request of the family.

So here we go. I have to verbally request that we have a visit to see my aged and dementia ridden old mum who I know barely meets the threshold to land on anyone’s radar anymore because she is (as stated) old and dementia ridden. Because why would you waste the petrol? Why indeed. Time is money and both are precious. Especially when you are going to see someone who can no longer use either as a transaction for what they need. I would like my mother to be examined so that she may be considered for low level antidepressants.

My reasons for this are that:

1. She is losing weight despite eating, a lifelong indicator that she is depressed. I too also lose weight like a stone if I am not happy. So does she.

2. If she improves in mood this will also have a positive impact on her.

3. Her improved mood is essential to her well-being as a person.

4. An improved mood may encourage her to improve her mobility,

5. An improved mood may also improve her appetite and stem her weight loss.

The care home will pass this all on in a less passive aggressive, more professional way.

Then we move on to discuss end of life care. The DNAR (Do Not Attempt Recsussitation). Nanny June was against it. And I don’t have authority over Nanny June’s health because Nanny June legally blocked me from doing so (people are complicated and Nanny June was no exception). So do I agree to a DNAR? Well, no. This is not the first time we have had this conversation. Nanny June wanted resuscitation. But "- her ribs… her body. The compressions would... " explained the care home manager. I shrugged. I know that. They know that. But I can’t agree to a DNAR. And quietly we all know in our hearts that any doctor will just call it, that this is an arbitrary discussion for legal purposes only.

Because in those moments, when the care professionals have to make a life ending/changing decision - I have found that medical care is at its finest and most compassionate.

Notes are taken. As heart wrenching and gruelling as this is, this is still a meeting.

So Nanny June is not to be transferred. The nearest big hospital is an hour away and she would not be a resilient person taking that journey. She would be also be far away from me. Visiting would be difficult. She becomes an anonymous patient wrongly being called Constance. If she stays at the care home she will receive care by people who have now know her for years. Who know her as June. Who have travelled this journey with us.

My mum will end her life in the same building my dad ended his.

Now however, there is an after death plan. So everyone knows what to do with her body. If I could please email the instructions and wishes so it goes on file.

Conveniently this is already planned. Because when my dad died and my heart was destroyed and my head was all over the place, I had to plan a funeral and get a death certificate and tell people what had happened including family, friends, neighbours, banks… and become immersed in an intense world when all I wanted to do was sit in silence, stare at a wall and cry. I had my lovely aunty to help me through that but now I know that when someone dies there is a stillness and a silence and an absence. And this while an end in itself, becomes the beginning of putting your grief on the back burner and having to function with clarity. So before my brain and heart break at the same time, there are plans. I want future Liz to know that this Liz was looking out for her and planned stuff. I did it on my own this time. Booked burial ground. Contacted the undertakers.

Ultimately she will be laid to rest under some trees. On the side of a hill in the middle of nowhere. In the adjacent field to where my in-laws ashes are buried. So at least she will know someone when she gets there.

Both my in-laws knew my mum pre dementia and watched Nanny June's journey unfold until they died.

Everyone dies in the end.