Not signed off by the Community Health Team.

The doorbell rang. The deaf dog didn’t notice, but I took him by the collar to the door so that he could bark loudly at any hawkers of circular distributors who had disregarded the notices on the gate, which read, helpfully,  “No Hawkers or Circulars”, and, “Beware of the Dog”, and so end their visit in a cacophony of misunderstood welcomes.

However, it was Mum’s Community Mental Health Nurse. I had been half expecting her for a while, since the last visit by the lovely psychiatrist, who had come to discharge my mother, who had getting on for a half a century in the care of the NHS Mental Health Services. Mum deserved a gold watch, but was about to get the steel toe capped-boot.

I had been given about a month’s grace to prepare myself for the inevitable, and had been dreading this visit. It felt like we were being cut adrift from the familiar Mental Health Service raft of support, floundering into  a sea of hazards of fragility, falls, pharmaceutical rock-ups by high street chemists, while the hydra headed  monster of paranoia lurked in the shallows,  with only the GP lifeboat service to send out flares of distress to.

“Soooo.”, drawled the nurse, drawing some papers out of her bag, and looking nervously at the dog, who was actually quiet. “You know why I’ve come today.”.   But as it happened we spoke very little about the discharge papers she had in her hand.

I was pleased to see her, because she was kind and familiar, and we had a problem. And even if she could not solve our problem, she was someone I could talk to.  That morning my mum had been in a lot of pain and had called me at about seven in the morning, unable to take her weight on her feet. I had had to put her in a wheelchair and assist her to get to the loo, and help her get dressed. Things were not looking good.

She had had a fall the previous week, caused by vertigo, when I had been at a meeting about carers’ rights. It wasn’t a bad one but I had called the GP and she was assessed as ok.

Mum had been falling over for the past couple of years  for a few reasons. Over the decades anti-psychotic meds have had a lasting pseudo-parkinsonian effect on her body. Because of this she has to work really hard to stay mobile and to stay upright. In recent years she had been on too much medication, and drowsiness had caused her to have several falls, which had resulted in a lot of pain and some crush fracture damage to her pelvis, which is slightly osteoporotic. She also has vertigo. But despite all this  Mum is pretty robust, and spurred on by my brother-in-law’s predictions of wheelchairs and nursing homes, I was determined to help her stay on her feet in her own home. Things had been going well in the last few months. She seemed to be on the right meds. With help from an osteopath she had been getting more mobile, with less pain, and significantly better balance. In fact until the very recent fall, she had not required any medical attention for several months, which was great.

Now we had a set-back.

The nurse put the discharge papers back in her bag, and advised calling the GP, and left. The GP said take her to X-Ray. And we were off into hospital world. I had to leave the dog for, oh, two, three hours at a time with predictable consequences for the floor as I oscillated between the hospital and the wet kitchen floor, a ten minute drive apart, with a Tesco Express handy for more kitchen roll. I also had to pick my grandchildren up from school.

At least we were still on the Community Mental Health list.




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