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The hearse like hospital car crept down our mother’s street and returned her to us. The two front steps were now another challenge. Only eight weeks ago, all this had been routine.

That was before a cerebral haemorrhage and resulting homonymous hemianopia cut off half her world and transformed daily activities into a series of complex projects, requiring strategic planning.

The Occupational Therapists accompanying our mother were attentive. ‘Now Irene, can you find your lounge?’ ‘Of course,’ she replied, as if it were a silly question. It was coming back to her now. They practiced walking, getting in and out of bed and on and off the toilet. The poor women were given a compulsory tour of family photographs. ‘Irene is special,’ said one of the good ladies, ‘She is positive and has great faith.’ ‘Will she be able to cook?’ I ask. I had lost half a stone since my mother’s admission and I was fading away! The girls went through the care package options and help with activities of daily living.

This was the NHS at its finest - caring, holistic and realistic. In no other part of the world, would there be such an attempt to rebuild this disabled, elderly widow’s life. In other countries, we would have lost thousands of pounds on hospital care and rehabilitation, over and above the distress of caring for a stroke victim.

How treatment has moved on! We had already visited this scenario fifteen years ago with our father. Things were very different then. Dedicated stroke units were rare and my father was admitted to a general medical ward. As he deteriorated we had to bring intense pressure on the doctors to organise a brain scan. As a stroke victim my father had “not for resuscitation” written in his case notes. At ward rounds a cursory nod was commonplace for the stroke victim. He survived, rehabilitated himself, stopped taking the Phenytoin that had been prescribed for a ‘twitching’ episode, returned to driving and had a further thirteen years of good life.

My mother on the other hand was in a stroke unit from the beginning. At her bedside there was a traffic light system, which let all care staff know the stages of her physical limitations. She had a scan within an hour of admission and a detailed medical explanation of her condition. I have no doubt that the overwhelmingly informative, positive, caring, attitude of the doctors, nurses and rehabilitation team, played a crucial role in her early recovery.

‘Well, I can just stay now,’ she proclaimed. ‘No mummy, remember this is just a home visit.’ The night before in hospital, she had asked me for ‘the answers’. ‘What answers? What are you talking about?’ I was worried she was becoming confused again. ‘The lady next door has failed and can’t go home’. Then it dawned on me that she meant the mental function test that was prerequisite for discharge. I felt like a conspirator in a crime. Would her sentence be diminished because of my answers?

The home visit came to an end. Mummy headed for the steps. She remembered, good foot to heaven, bad foot to hell. How could she forget? She had heard it all before fifteen years ago. To nearly lose one parent with this condition was bad luck but two was sheer carelessness! My mother waves at us from the car and my sister and I arrange our widest smiles.‘ Dad. You can come back for her another day but not today’, I mumble to myself.

Sureshini Sanders

This is the personal experience of Dr Sureshini Sanders who works as Hospital Practitioner for care of the elderly at St John's in Livingston and as a general practitioner in a practice within the catchment area.

BGS Newsletter, May 2009
Issue 21 ISSN 1748-6343 21