When it comes to this

Spending time recently with my aged father has prompted a range of emotions and observations. Clearly, as anyone goes beyond the age of ninety, those close to him or her appreciate that things – and they – are not how they once were and therefore in one sense you are dealing with a whole new person.

In such a situation you keep having to remind yourself of what’s happening – and sometimes it assists to have a carer pointing these things out because inevitably sometimes you temporarily (and naturally) forget it.

Seeing an elderly person regularly every week also tends to give you a different perspective from someone who sees them only once every six months or longer.

Early this week, for example, we had to take my father to his local hospital for an endoscopy, which I understand is always an uncomfortable procedure, the effects of which are routinely offset by the application of an anaesthetic spray.

In the end the procedure never took place.

Firstly, because although my father had been carefully ‘coached’ by the carer and myself as to what was going to happen and why, he had to see the ‘receiving’ nurse, who took him through a basic questionnaire.

Things began to go awry when he was asked for confirmation that he knew what he was there for, he replied “No idea”.

When it got to him actively confirming his consent for the procedure to take place, he replied “Well, I don’t want to have it”, at which point the nurse stopped the session and suggested that the carer and I took my father down the corridor for a chat, after which – having seen the next patient in the queue – she’d call us back in again.

When we returned, my father then said that he was now reluctantly prepared to go ahead with it.

Later I wheeled him into the ante-chamber where the surgeon, who had an excellent beside manner, took him through what was about to happen and asked him to sign the consent form, which my father did. I then retired to the waiting area for what was advertised as a “four minute procedure, if that”.

Nearly fifteen minutes later a nurse came out, collected the wheelchair off me and said that my father would be coming out soon. When they emerged to join us she then explained that he had thrown a wobbly the moment they tried to begin the procedure.

His version, given later in the car on the way home, was that he had begun fighting like crazy and effing and blinding with great enthusiasm. It became plain that they had accordingly abandoned the procedure – the nurse adding that they would be supplying a report on the incident to my father’s GP.

I mention the above episode today because (presumably) it highlights one of the vexed issues involved in seeking to give the best possible medical attention to an elderly person who – at that stage in their life – may not have more than the vaguest of ideas, let alone a full comprehension, of exactly what is going on around them in the world.

It actually begs such issues as when does, or can, in reality an elderly person consent to anything(?) and whether, beyond a certain point, it is even worth contemplating procedures on aged patients since in a sense there may (or ought to) be a trade-off between doing everything you can to prolong their lives and and what might be broadly covered by “Oh, what’s the bloody point?”. These are deep, complex issues.

Anyway, that was Monday.

Yesterday (Tuesday) was as expected an entirely new day for my father. By this I mean to impart that for him what, if anything, he had done or been involved in the previous day was now not so much a distant memory as a non-existent one.

Just before lunch – and we have now abandoned the long-established practice of serving him a gin & tonic at noon lest this affects his brain and leave us unsure as to whether any mental lapses are natural or possibly to a degree drink-induced – he came up with a belter as he and I were sitting alone together on the terrace at the side of his house.

Out of the blue he suddenly looked at me:

“Can I ask you something? Where does my mother live?”

I felt pretty confident that I could tell what was about to happen – previously on a small number of occasions he has expressed a worry that he wasn’t doing enough to look after her.

I therefore responded with the truth, i.e. that his mother had died forty-one years ago.

He reacted with a mix of puzzlement and semi-embarrassment, as people with memory issues sometimes do when they realise that they have asked or said something bloody stupid and simultaneously rendered themselves in a position where they can do nothing to disguise the error, e.g. by deploying a deft conversational diversion.

(When you have been clean-bowled middle stump there is no real need to wait to see if the umpire has raised his finger or not).

It was a little like the incident which had taken place a week or so before as we arrived at our hotel in the South of France for a four-night stay. Engaged by a lady in conversation, from what my father has responded, she had gained the impression that we had travelled a long way to arrive.

She therefore asked my father from where he had come.

“Cambodia” came the instant reply.

Although at the time this satisfied the lady’s curiosity, I’d like to point out to my readers this morning that my father has never been to Cambodia in his life. It left me wondering where the hell he had got his answer from …