Last night we had a call from mum’s emergency alarm button people to say she’d fallen and was on the floor. Fortunately we were at home eating our dinner, so whizzed round and were there in an instant. Unlike the previous fall nine months back, she hadn’t hurt anything but just couldn’t get up without assistance. So we did the hot sweet tea and reassurance thing and I got her to bed. That took longer than you may think, as she likes to know that the curtains are pulled just so and the iron is flat not standing up, and so on. I suspect I may be the same, when there’s only a limited area in which I have control.
I took her blood pressure last night and this morning and it’s definitely up. Back in August, where she had a less-than-satisfactory 5-days-in-hospital experience, the hospital doctor took her off one of her blood pressure meds, one which she’d been on for 20 years, and he told me if her BP went over a certain number I should put her back on them again. I wasn’t very happy about that because I’m not a clinician. However, the key figure had been more than exceeded. The GP has monitored things and it hasn’t gone that high in the time after she left hospital, but the GP didn’t seem thrilled at the idea of me being in charge of the meds. So what to do?
It’s a Saturday. That means calling 111, the NHS service which has replaced calling a duty doctor. And, goodness, it isn’t a great experience. We should have known this after a recent incident when a neighbour fell and the promised ‘clinician’ only phoned back several hours after I’d finally stopped the bleeding and the neighbour had gone home to bed. There is plenty online about the failings of the algorithm that 111 uses. To be fair, there are also some optimists, but I’m not one of them.
I explained the problem with mum’s blood pressure but a simple ‘should I reintroduce the pills or not?’ wasn’t on their radar. They just can’t handle that, even though the service is advertised as offering ‘medical advice’. Had she been given a medical assessment when she fell? Er, no, because she was OK and only shaken, and it was 7 pm on a Friday and who is going to give her a medical assessment then? So off we went with the assessment questionnaire, which she had to answer herself, although the advantage of a speakerphone is that I could hear the questions too and bring her back if she was going into lots of detail when all they wanted was a yes/no. Yes, she can raise her arms in the air. No, she hasn’t had a recent kidney operation. No, she hasn’t had any heavy bleeding in the last 3 days. And on. And on.
After a lot of that, it was decreed that she would be passed on to a clinician. This person would phone within 30 minutes and if nobody phoned we were to take her to an emergency centre. I refused. She’s nearly 91, she was still in bed resting, and she didn’t want to go anywhere. This led to being told I would definitely be phoned within the 30 minutes. And I was.
This time it was a nurse. She took my mother through the same questions and got the same answers. It seemed endless. At the end, she decreed that we had reached the next level (it does feel like a computer game). A doctor would phone within the next 6 hours. That’s not a typo: 6 hours. Unlike the two previous people, he or she would have access to mum’s medical records.
However, those records are pretty dodgy. The discharge letter the hospital sent in August had errors on it – not just the claim that her eye drops are to be put into the ears (!) but a statement that she has a serious condition which she doesn’t in fact have. Hopefully, access to full records would clarify things here, but it seemed to make sense for me to stay at mum’s flat in case any clarification turned out to be necessary. And guess what? Right. 7 hours later, and no phone call. Now what? I have no idea, but I’ve gone home and will go back later to supervise bedtime; and maybe to give her that pill anyway?
***update*** They phoned back after 12 hours to say maybe don’t give the pill but get her to the GP on Monday. That was a long wait that didn’t get us anywhere.
The retiring academic 