Mr. Mayhew sat with his files, reviewing his patients progress and treatment at the end of an already long Autumn day. The coffee at his elbow was growing cold and the pool of light from his desk lamp appeared brighter as the daylight at the window, faded. His cardio day clinics were full and work spilled over into geriatric assessment wards as well as the normal thoracic surgery he and his team were responsible for.
One particular case, quite typical these days had his attention for the moment : an elderly woman, already into her 90’s, had an irregular heartbeat but was otherwise quite healthy in most other respects. She was not English; still struggling with the language despite living in Yorkshire since 1947. However, Sofia made it quite clear when he had visited, that she simply wanted to go home as soon as possible.
Her case cited a chest infection turning into pneumonia, due to a reluctance to be bothering her doctor. That had brought on a physical weakness that saw her collapse, and brought into A&E by an ambulance crew. He remembered meeting her. Sofia’s daughter Lara, had explained that her mother had a morbid fear of hospitals at her age and simply wanted to get back to living at home.
Once the infection was under control and delirium no longer a problem, Sofia had revealed herself to be quite a character and mentally sharp as a tack. Reading the case notes Mayhew saw that social services had assessed her and found Sofia to be extraordinarily independent in her living arrangements. She was a long term widow and looked after herself for the most part. She did all her own shopping and cooking. Family help was only provided with cleaning and laundry, as the washing machine was in the cellar of her small terraced house. Otherwise, Sofia was bright, bubbly, very pragmatic and could be very sharp with her comments. She didn’t suffer fools… or interference.
Mayhew smiled. She was a warrior this fine old lady, and had family in the city who could take responsibility for her. He drained his coffee and decided that he would put her on his list for a pacemaker and then she could be discharged, if all went well.
Several months later, Lara visited her GP with all the symptoms of stress and fatigue.
She was drained she said, with all the responsibilities and calls on her time. It was impossible at 59, to manage a full time job teaching, especially through an Ofsted inspection, and endure her unemployed husband doing work to the house, and look after her son and his girlfriend, who were also living with them.
Her main concern however, was her aged mother who, having had a pacemaker fitted was filled with renewed energy but needed increasingly regular supervision for her activities. At 93 she now had a reckless disregard for the steep stairs in her home, or climbing in and out of the bath by herself. She would accept no outside help, or interference as she called it, from strangers and certainly wouldn’t pay them for their trouble. Lara she decided, could do what was necessary at the weekends even though she lived miles away, so all Lara’s time was taken up at her mother’s beck and call. There had been a sprained ankle and a burn to her hand when carrying a hot pan…
Lara could not sleep for anxiety and worry, especially for her mother’s safety on her own, when she was out at work. Her only brother had suddenly moved out of the area with his job and Lara’s husband was not very welcome as a substitute help, said her mother.
Lara’s GP was generally sympathetic but overall unable to help with any practical assistance. Once again he issued her with another prescription, for the tablets that would enable her to carry on trying to cope…
Image courtesy of SixtyandMe