A Day In March

My story relates to the events of a day in March, the day my beloved mother suffered a stroke and the ups and downs of her time in hospital.

To appreciate my story you have to know my mum, so I am going to tell you a little about her…

The daughter of a farm manager mum grew up in rural Yorkshire. It was here she met her future husband, a Merthyr boy, a volunteer wartime airman who was stationed nearby. Our dad was a lucky man as she was the prettiest girl in her village with her striking auburn hair and they married in 1943 when Mum was 18. They moved to Merthyr Tydfil in 1944 where the first of their nine children was born. In 1973, after a long illness, my father died leaving mum to bring up the four dependent children who were still at school. This was a very tough time for her and the children; especially as she had to take a variety of jobs to help make ends meet and it is only now that I am the age my mother was then that I truly appreciate the hardships that she endured.

She grew to love Wales and never contemplated moving away. She was immersed in her local community and was well known and respected. She was proud of and supported her husband’s role as a local councillor and justice of the peace and of his RAF record (DFM). She spent time in the Civil Defence, joined the St John’s Ambulance, and during the Aberfan disaster she worked almost non-stop for 3 days dispensing tea, coffee and sandwiches to the rescuers.

She was a loving mother, carer and young widow. She was very strong yet had a soft heart. For example, if any of her offspring brought home a stray animal it was adopted. She was a warm, generous woman.

She was a superb cook; her apple and blackberry pies were heaven. For an English woman (sorry mum a Yorkshire woman) she also excelled at Welsh cakes, Barra brith and cawl. Her Sunday dinners and teas were legendary and if any of her children’s friends happened to be around they were welcomed to join the family meal.

She had a mischievous and dry sense of humour and a twinkle in her eye when telling us anecdotes or making observations on life. She had a sharp mind and if she had been born in different era could have been successful in any career … except perhaps as we joked in the diplomatic corps!

She was a proud person and fiercely independent, she loved her little house that she moved to after all the children were safely married off.  As ever, everyone was welcome in her house and she helped care for a number of her grandchildren as they grew up.

It was a very sad day for her and the family when illness forced her to move out. She moved in firstly with my younger sister and her husband before finally settling in with my husband and our two children. There are only 13 months between my sister and I and the fact that we were brought up like twins may explain the very strong bond between us, and it was between us that we continued to care for mum.

It wasn’t always easy, mum found it so very hard to give up her treasured house and beautiful garden (yes she was also a keen gardener). There were difficult times and both my sister and I will be forever grateful to our partners for understanding the bonds between ourselves and our mum.  My two daughters were amazing and helped out in ways they will never truly appreciate. Even our dog welcomed her into the pack and looked after her, adding her to his nightly patrol list (although this may have had a lot to do with the treats she slipped him when she thought we were not watching).

She had a number of serious health events which laid her low, but from which she bounced back and whilst mum may not have been as physically active as she once was  mentally she was still able to run rings around her many children.

She was a person worth fighting for…

Back to that fateful day in March. It should have been a very happy one. It was the day of my mother’s 85th birthday. My younger daughter was having a duvet day (aka bunking off) and along with my elder daughter and two of my sisters we had planned a trip to Swansea and booked lunch out.

It was a bit frantic that morning, everyone trying to get themselves ready and also helping mum who always liked to look her best. The day started badly and just got worse.

Mum wasn’t feeling so good that morning and a “little accident” appeared to scuttle our plans for a nice day out. My sister and I debated whether or not to cancel but mum was not the sort of woman to allow such things to interfere with a lunch out and the promise of a Joe’s ice cream and so we set out for Swansea a little late and somewhat flustered.

We enjoyed our lunch at Morgan’s and set off for Joes Ice Cream parlour. I left my mother and sister in the car and my daughters and I went to buy the ice creams. Returning to the car 99’s in hand we had no idea how much our lives would change in such a short time.

In those few minutes my bright, articulate and fiercely independent mother suffered a stroke.

I am a nurse, I am supposed to know what to do but it is so different when it’s your own. I knew my mother had had a stroke but could not translate my thoughts into words. Through my frustrations I must have made some sense because an ambulance duly arrived.

My sister and I were both aware of the window for effective treatment and I think we irritated the crew with our pleas for speed. They tried to warn us that mum was considered too old for clot busting therapy and the stroke pathway. They did their job though and got us all to the hospital but it was there our problems really started.

On arrival at the hospital mum was left on a trolley in the corridor with no sense of urgency apparent from any of the staff within the unit. My sister and I both have a reasonable knowledge of the care my mother should have been receiving and we questioned why mum wasn’t receiving that care. We asked for her to be seen more urgently, for her to have the necessary tests to enable them to give her the correct treatment but we constantly came up against the brick wall that was the senior nurse on duty.

We are our mother’s children, her stubborn Yorkshire blood runs in our veins and we were not going to stand there and let them decide that she didn’t deserve treatment simply because of her age. They seemed quite prepared to write her off as having had a “good innings”. Even if clinically there was nothing they could do for her she still deserved to be treated with dignity and compassion – and she was not. It’s bad enough that strokes are seen as less serious than heart attacks but if you are an elderly stroke victim then it seems the odds are against you. No one seemed to care that despite her age my mother had a good quality of life and deserved a chance.

Frustrated that no one was listening to us and desperate to get my mother out of the corridor I asked at reception to be put me through to a more senior nurse/manager and incredulously this was refused. Had my sister and I been rude or aggressive then maybe, just maybe I could understand their reaction. It is true we were assertive but we were always calm, polite and professional. Maybe that’s what they found difficult to cope with. Perhaps it’s easier to deal with angry people who are losing it because then you have the upper hand

It was with a great deal of disappointment in my own profession that we resorted to going outside the hospital building to ring  another family member to ring into the hospital and speak to someone more senior. It worked and mum was moved to a more acute area but should we have had to fight so hard and what of others, those who do not like to make a fuss or do not know the system?

Mum was eventually seen by a Dr however on the whole things did not improve. As a nurse I appreciate that sometimes families can take over and make taking a history more difficult. Had mum been well enough she would have answered his questions with a dry humour and barely veiled impatience at her interfering kids.  But mum was not well, we had been there, saw what had happened, we knew her better than they ever could yet no one was listening to us, especially not the Dr.

I remember standing there getting angrier and angrier on the inside, even at one stage thinking to myself that if he carried on I would “deck him”. It was with much hilarity that after the Dr had left the bedside my sister asked “do you realise you said that out loud”. Thankfully he couldn’t have heard me. One of the things we share as sisters is a black humour and it was this that kept us going for the long days ahead.

Eventually mum had the tests she needed and these suggested a clot was the cause of her stroke. Even though she was not eligible for clot busting treatment (and we now accepted this) we still had to argue for the second line of treatment and everything seemed to be difficult and take an age even down to getting her the correct medication.

Mum was eventually moved to an assessment/admissions ward where we were told she would be monitored overnight. When we walked onto the unit we were greeted warmly enough. However after the handing over nurse took the accepting nurse aside there was a palpable change in the atmosphere. We both felt we were an unwanted presence. We were not welcome and it was as if our fame had spread. I found them defensive and disingenuous. Health care professionals love to label people. I’m one of them, I have done so. We describe patients and families as being difficult or demanding.  Nurses only came to mum in pairs- for safety perhaps! An exaggeration I admit, but they were very cautious with us which made it very difficult to have any sort of relationship with them. This was something I had never experienced before and it was a real eye opener for me being on the other side.

Mum went through a period of acute ill health when she developed a serious infection and not for the first time we gathered as a family expecting the worst. It’s not easy sitting at the bedside of someone so ill. Feelings are so mixed, you want that person to recover so badly but yet because everything is so uncertain and totally draining you still crave a conclusion, either way.

You wonder if you are fighting truly for that person or just out of your own selfish needs. We even wondered whether mum had had enough and was tired of fighting.

In the end she made her own mind up…

Mum was transferred to a stroke ward for rehabilitation defying the consultant who said she would not walk again. As a result of the excellent care she received there and her utter contempt for pureed food and Jeremy Kyle she was soon up and about and wanting to come home.

A month after her stroke she left hospital maybe not as good as before but still able to return to her riser/recliner chair at the heart of our family.

Sadly mum experienced further ill health in September and was admitted to our own local district hospital and then finally to a community hospital.

Maybe it’s a Valleys thing, perhaps we share a humour that binds us and sees us through such times or maybe it was just because it’s a smaller hospital and I was known there, whatever the reason our experiences here could not have been more different. We had an easy relationship with the staff. We could laugh and chat and be consoled in equal measures. Every member of staff porters, domestics, care assistants, nurses and doctors seemed to pick up and respond to our needs and pain.

My elder daughter and I spent the first couple of days and long nights at her bedside, washing her, feeding her and talking to her. We were shortly joined by my younger daughter and sister. Slowly more and more of her children, grandchildren and great grandchildren arrived. There followed a vigil of memories and laughter and crying, and more laughter and more crying. I am sure it was not easy for the staff to deal with such a large family invading their ward but they did so with such good grace.

It was very difficult for me because the staff knew that I was a nurse, knew that I understood the situation and the dilemmas and could translate this for my family. But even though I knew the implication of the care pathway she was about to begin I just wanted to be her daughter and not her nurse.

Mum was a very special person and in her final hours she was surrounded by loved ones, she died pain free and with dignity.

Her passing has left a massive hole in the family.