I wonder how many other colleagues share in wonderment the lives of some of our patients? One of my elderly ladies who I have seen regularly for the past decade took up residence in a nursing home on Friday, in some unhappy circumstances. Being widowed at 56 she lived alone without any relatives as far as I knew, until one day she confided she had a son who lived in Spain. He rarely visited following an argument between the mother and daughter-in-law many years previously. Hilary was a remarkably independent woman - and an active volunteer in the local church and charity organisations. Once a district nurse, she kept good use of her skills often visiting elderly and infirm parishioners in the town. Four years ago she started being forgetful and absent minded, occasionally at first, then with an ominous regularity. Two years ago she was diagnosed with vascular dementia. For about six months she was lucid enough to appreciate what was happening to her - she wanted to stay at home with help for as long as possible. She wasn't wealthy but had some savings and owned her own house - and could certainly manage private care. I assumed she had made some provision for the future when her son showed up unexpectedly one weekend - and stayed for six weeks.
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By the end of his visit, there was a significant deterioration in Hilary. Her son had taken her out each day - away from her usual routine - and she was physically exhausted when he returned to Spain. With the help of some neighbours and friends, she made it through last winter, though her dementia advanced significantly. Since then she has deteriorated more slowly but steadily and now needs someone with her for most of the day. I often get phone calls at 2am or later.
A couple of weeks ago her son came back over and last week arranged her admission in a local nursing home - and not the best by far. Speaking to her GP on Friday, I discovered that the son and his wife had arranged a will with Hilary a couple of years ago and had gained power-of-attorney then. Hilary's pension covers the monthly nursing home fee - just - and her house is up for sale, the proceeds heading to Spain, no doubt.
I got the distinct impression her GP was as disgusted as I was by developments and it will be interesting to see how many times the prodigal son return to see how she is doing - and I'm sure most will have witness other deeds in families, but ain't life unkind sometimes?
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