Get real: so sick of those boasting xmas letters

My poor old demented mother received one of those ghastly boasting letters from a friend (also an elderly lady), and I actually enjoyed the fact that Mum couldn’t remember the person. I’ve changed their names, but the rest is the real content of the letter…

Dear Margaret,

Already November is coming to a close and I am ill-prepared to celebrate Christmas. As the years go by I seem to get less able to do as much in a day as I used to do, and I enjoy more wee breaks too. However, I keep well and among other things I enjoy to potter in Lesley’s garden, that is when the weather allows me to. We did have a lovely early spring but after that conditions were less acceptable and spring planting was very late. However, Lesley had a very good apple crop and now has lots in the freezer.

The family are all doing well. The twins are now in second year at their universities and each finds their course very interesting but requires a lot of study. Their results last year were excellent and they hope to maintain that this year. They are finding life in a flat quite a change from Halls and have had to adjust to less heating. Ethan still enjoys cross country running and has run for Britain on several occasions with reasonable success too. Ginnie has had a few issues with stress fractures which has limited her achievements this year.

Susan and Gordon are both doing well. Gordon travels the world with the ___  ___ team attending to track conditions and safety. He and Ellie are well-settled near ___. Susan and Gerry are house hunting in the ___ area but have not found that house that ticks all the boxes for them yet.

Patrick has now retired and is planning what the next move will be. Lesley is still head of her Practice but feels that she too will retire whenever the time is right.

I keep well with any check ups being very positive. I trust you and yours are all well too. I wonder how you are and am sorry I have not been able to visit you this year: I do not drive longer distances now.

Best wishes,

Lilian

Here is my reply on behalf of Mum (not sent of course):

Dear Lilian,

I was admitted to hospital towards the end of November with severe constipation that probably arose because I had not been eating properly and attending to my usual rituals that ‘keep me regular’. The underlying reason for this is almost definitely a turn for the much worse in my cognitive function. I was in an acute medical ward for four weeks and was transferred on 23rd December to a cottage-hospital-type place in our county town.

My family are all probably a bit depressed, although none except myself with a clinical diagnosis. My grandson failed his Higher English exam in May but passed two or three others, depending on whether you call a D a pass. My daughter and son-in-law (who as you know both have doctorates) can’t help but be a wee bit puzzled and disappointed at this turn of events in their one and only much-loved offspring, and inevitably they are worried about what his destination after school will be. He is back doing a sixth year, resitting Higher English and also doing two other Highers. He says he wants to become an accountant via an apprenticeship with one of the Big Four accounting firms, but has not yet applied or even looked at the selection process information. He went to an open evening at one of the firms but only because my daughter found out about it, registered him for it and drove him to the door at the appointed hour. My daughter is very sad and fed up that he does nothing, takes no advice and replies in monosyllables to any attempts at communication.

My son-in-law passionately dislikes his job, which is supposed to be facilitating knowledge transfer between industry and universities, but is actually an underfunded, resourceless vehicle for bringing in EU grant funding. So, he is not very sorry that Brexit will probably be the death knell of it, especially since he has been limping on for years on nine-, six- or even three-month funding extensions. Unfortunately, 53 is too young to retire, so God knows what will happen to the family when the plug is finally pulled.

My daughter is fatter than she has ever been, but at least my infirmities mean that she has rarely drunk alcohol this year, as she has needed to be able to drive at the drop of a hat if I phone in a confused state to say I can’t remember how to turn on the TV, or if I fall and press my red button.

My son and his new wife (they married in 2015) are having fun renovating a new house they have bought. He was very fortunate to be able to retire at 60 in good health and is enjoying himself immensely. Although he is 500 miles away, my daughter is quite happy with the way he is providing her with moral support as she deals with all my issues.

The other bit of light is that my grandson continues to enjoy all his musical activities and his band has qualified for a European competition at the end of next April. This has given my daughter and son-in-law a tricky decision to make about whether to allow him to take part in this one thing he shows any enthusiasm for – the rehearsals will be from January to April and his first exam is four days after the competition.

Our Christmas day was a washout, as my heart rate slowed to 49, so the cottage hospital decided to transfer me to the general hospital for tests. This transfer took all day, as ‘code red’ calls kept diverting the ambulance away from me. No underlying cause for the low heart rate was ultimately found and I didn’t understand that it was Christmas day anyway, so I was not upset, although my daughter was. At least it kept her off the drink for the day.

I’m really pleased you were not able to come and visit me in 2016, as when I am not demented I am still very angry with the lack of professionalism your daughter Lesley showed in her care of my good friend Agnes in her last years. If I had spoken to you I probably would have said a few things that would have offended you. My own daughter is very relieved that I now cannot recall the distressing circumstances of Agnes’ end of life care.

I’ll probably never see you again and as my daughter seems not to recognise your name on your letter you will probably not hear any further news of my decline.

Best wishes,

Margaret

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Mental capacity contradictions

Can an old lady with a documented history of refusal of treatment with an anti-depressant really consent to treatment when she no longer even remembers who her daughter is?

Over the course of the last year Mum’s mobility has deteriorated so much that she essentially can only go out of the house if it is to get into a car and be driven somewhere. She also has a degree of dysphasia which frustrates her, as she loves to chat.

Unsurprisingly, she has become quite down in the dumps, but she has some old-fashioned views about mental health and doesn’t admit to depression although her GP saw fit to refer her to the Community Mental Health Older Adults Team. Mum got on well with the CPN and enjoyed her visits but did state unequivocally that she would not agree to be treated with antidepressants even if a formal diagnosis of depression was made.

So far, so in line with Mum’s categorical refusal to be agree to having carers at home. On that issue, even though lots of people think Mum would benefit from carers (including the Social Work key worker and her GP as well as family & friends), Mum has been entitled to refuse the carers – or so the social work people tell me.

Mum has been hospitalised for a nearly two weeks now, having been admitted with severe constipation. She is more confused than ever and cannot tell me when I visit what has happened to her that day (even though I know she has had physiotherapy, for example). The doctors have explained to me that this ‘delirium‘ is common when elderly people are hospitalised.

This morning the doctor told me Mum definitely can’t come home without an extensive care package. So how are they going to get her to agree to it?

After the first week, during which Mum was often tearful, she was put onto an anti-depressant without anyone consulting me, even though the doctors had had a full history from me in which I told them Mum’s attitude to anti-depressants.

Now, don’t get me wrong, if they had consulted me or my brother, we would have agreed that Mum should be treated, but they say Mum consented. She wasn’t asked in my presence, so I don’t know how the question was put to her. I don’t think she was fit to consent; she doesn’t even know who I am some days.

I think this is an abuse – albeit for the ‘right’ outome- of the capacity to consent rules, and as a carer it leaves me more frustrated than ever about what my role is. It seems that the medics can do whatever they like with impunity when they think it is the right thing to do, while the family carer cannot insist on anything at all – in this case a care at home package – even if it is obvious to all concerned that the person is making a really bad decision.