Wednesday, 19 July 2017

Restraints in hospitals....

A patient was admitted to a mental health hospital in Japan.
For 10 days he was tied hands and feet to the bed.
After 10 days he had a heart attack - the family suspect Deep Vein Thrombosis.......Economy Class Syndrome...whatever it is you want to call it.

Lack of movement and exercise in a mental health hospital. Restraints.
Something apparently long criticized as inhumane by international commentators.

Sound familiar?

A very sad story about a Kiwi English teacher in Japan.
you can read it here. 

Okaasan is doing ok. DS told me.

He went to see her Sunday. She was up in the wheelchair and trying and failing to stand. She had lunch at the table in the day room. She chatted to him. He came away happy. This week the physical therapy will start.

Tomorrow Dear Son will meet case worker and social worker......

Sunday, 16 July 2017

Visiting dementia

Not a great visit to Okaasan yesterday.

No big crisis. Just the sad reality of a lady with dementia....and an hour of silence and a few words exchanged. a smile or two.

We came home sad. Drank beer. Ate dinner. Felt sad.
As soon as we walked into the room we could see it: her face. That face of dementia. She was on the bed, slightly curled up - looking at the wall with an anxious face. The nurse bustled in with us and started raising the bed and talking brightly about family visitors and dinner-soon.

We unpacked the things we'd bought - special shoes, another mug cup with straw...a magazine that....will she look and enjoy mangazines anymore?

Dinner arrived. We sat with Okaasan for 45 mins while she picked at dinner. Alternating between chopsticks and a spoon. Seemingly enjoying the orange jelly....a little miffed that the veggies didn't have soy sauce. 

DS encouraged her to eat gently. He and I talked a little about his customers and the weather. Okaasan ate. Stared at us. Stared at the name card on the tray. Stared at the food. Eventually we turned the name card around - because she stared at it so much and tried to process it. And didn't eat.

Stared. Long.....stares. As if every thought process was taking time. Which I guess it is. SO different from saturday, when she sat and showed me the South Africa pictures - elephants and hotels and friends. Laughing, informative. So different.
Why? She is taking the meds. But maybe yesterday was a lot of stimulation...and she reacted well. A day in the bed in hospital...with a few visits from well-meaning nurses....staring at walls.

It's a 3 day holiday weekend. No physical therapy is going to happen till Tuesday. We worry.

Can she really come home again? Ever? In August, when DS has the rich customer for 10 days of bike taxi work - will I be sitting with Okaasan for lunches and dinners with her like this?

What IS going to happen?

This IS dementia. I feel as if the last few years have been a gentle preamble. A confused old lady, who was able to do most things herself with our reminding and encouraging.

What is here now, and what comes next. Suddenly in 2 months we are here. And it doesn't look good.

Saturday, 15 July 2017

Third hospital...

Okaasan is in her third hospital in 10 weeks.

This time a large, bright Circulatory Hospital - with super bright nursing staff and a positive mood. She is in a sunny, two-person room near the nurse station and has already run a bunch of tests and preps for getting her UP and MOVING independently.

We hope that this hospital can achieve mobility without the need for the brain-fluid draining operation - that meds and physical training can do it.

Hospital decorations

We feel positive.
We think.

We moved her  from mental hospital to circulatory hospital ourselves yesterday afternoon. Sapporo was sizzling in a once in 127 years July heatwave. temperatures at 34 C.....I saw a deadcrow and another one thrown back when he tried to land on a cable....

First mental hospital. Pay the bills, get all the meds, check all the correct letters and mails have been sent between the doctors. get two huge bags of clothes and washing things, diapers.

Okaasan arrived in a wheelchair. Happy enough to see us.
Loaded her in the car. Drove quietly and gently to the other hospital.

Waited, endless tests...and finally admission.
More bedside tests for Okaasan.
Finally she is sitting happily in her bed and looking through photo albums with me - talking about South Africa again. It's the best conversation I've had with her for weeks. Entirely normal. Happy and good conversation.

I was so happy. I moan a lot about Okaasan. But I have - strangely - come to love her. When she is in a good place mentally it is such a relief and so welcome.

The hospital had a good vibe. Like a smart business-style hotel in Japan. Decorations, pictures, nice furniture. View from the window of the forests and hills.

The admissions procedure was exhaustive/exhausting. The staff interviewing us about Okaasan and her recent events - even the hospital dietician  talking about her food tastes (no cheese or milk or mince. No prawns, but loves crab etc)

And this is maybe a strange comment, but foreigners who are living/have lived in Japan will understand: the staff treated me as a human, NOT a foreigner.
They made eye contact while talking to DS and I, talked to us equally...asked me questions. Just treated me as the family member. It's a small but good point about a group of people.

Okaasan seemed happy in her new place. I worry that the change from quiet, non-stimulating mental hospital private room to a shared room near the bustling nurse station will be too much for her - but we have to hope it's ok. There are no private rooms available at the moment.

And so. We hope again - to get her standing and walking a little. To try and get her OUT of diapers and using the toilet herself. It's a holiday weekend in Japan now, so not much will happen for 3 days - but then we hope this hospital will get Okaasan's body matching her new, calm and happy mind.

She's been gone from home over two months now. In August DS has a demanding, regular customer for the bike taxi and in September I will be returning to the Uk for the first time in 5 years. At the moment it is easy for us to share the Okaasan worries - in the coming months our lives will be busier.

Anyway. Mercury is rising...I have sweated the computer chair into a mush. I am going to go and stretch out by Netflix and indulge in "Homeland".

Wednesday, 12 July 2017

Huge choices :-(

Came the message from DS on my smartphone at lunchtime.

"I'm in a different hospital with Okaasan :-("

And so our day changed...

The mental health hospital alerted him mid-morning: Okaasan's legs were swelling up, they were worried it was signs of heart problems etc. Please come quickly. 
He swept into a rush of getting away from work, taxi to the hospital, consultations, ANOTHER hospital recommendation - Circulatory Hospital? - then he took Okaasan by taxi to the other hospital for 4 hours of checks, advice...waiting and diagnosis.

Not heart problems....phew! - but circulation problems which are probably due to inactivity and blood thickening. Meds for thinning the blood...recommendations for circulation treatments and physical therapy...and recommendation of admission to THIS hospital to tackle these issues...

DS very shocked to realize in all of this that Okaasan couldn't stand by herself or walk....he was hauling her in and out of the taxi and hospital chairs. She is in diapers. Happy enough, luckily. Not over-stressed or angry.

He took her back to the mental health hospital - she was happy enough to be returning there. During the long waiting in the afternoon she'd constantly said to him: "Oh, it's busy here, we should go home" - but seemed happy enough that the "home" place she returned to was a big building with a smiling woman in a white uniform...

So. All of that.

And THEN he had to change tack and rush off for his 5 pm appointment with the lawyer to talk about the house sale and the legal problems of that....

Trying to summarize:

Selling the house is going to be hard.
He can't become her Legal Guardian for the housesale unless there is some major reason WHY the house needs to be sold.
Just "nobody in the family needs the house now" is not enough.
If she needs the money from the house for expensive care - better.
Hospital stay/general care home - probably isn't a good enough reason for a judge.
This is why - there are empty homes all over Japan. Many families are stuck with former homes they can't sell until the elderly person dies. 


Very unlikely/dangerous to try and get her to sign documents now - the fact she is in a mental health hospital and her dementia level has gone up - no legal professional is going to go near that situation and risk professional censure.
If she had signed the documents 2 months ago, before the fall, all would have been ok...


Oh .....and even if he and I get married....and then he dies before his mother...I would be able to take care of her life decisions and use her money for her care...but after she dies...the proceeds from the sale of the house would go to the Japanese State...and not to me...unless I have children. Cats don't count.

I don't need/want Okaasan's house money...all I want is to know I can make decisions for her in the event of his death by over-skiing.

Are you still with me?
I'm not.

So. We have had looong, sad discussions last night and this morning.....and it's only 7 am...

We both feel that her physical decline in walking etc is the most pressing concern. Bad.
The latest meds seem to be calming her mental condition. Good.
The mental health hospital is making her physical condition worse. Very bad.
She can't be at home unless she can at least walk to the toilet herself - even if she goes to day care Monday to Friday daytimes, that would still leave us nights and weekends of DS having to sleeping in her room to stop her walking and falling....and all the diaper changing.

So. If the mental condition is under control - she should be admitted to the Circulatory Hospital to get standing and walking again? They have a physical therapy training room and program?

IF she can stand and walk a bit.
THEN come home?
OR - find a care home for her?

TRY to start the process for DS to become Legal Guardian. TRY to get permission to sell the house?
OR: just leave the house empty and unsold, until Okaasan dies?

We are exhausted by all these choices and decisions.

There you have it.

The orthopedic hospital last month didn't care for Okaasan's mental condition.
The mental health hospital now isn't caring for her physical condition.

In 2 months her mental and physical conditions have declined sharply. All because of a fall.


Sunday, 9 July 2017


Sweltering with 27C here at 9 pm...pretty I can't sit near the computer very long.

Okaasan had another good week. The new meds seem to suit her. DS went to visit midweek, and we went together on saturday.

She was in a wheelchair...but calm...kind of over calm...just watching our faces and smiling a bit...looked at photo album...made a few comments...didn't recognise a picture of her late husband. Passive. 

I guess this is the new Okaasan. I miss the livelyness....but don't miss the rage and anger and paranoia.

Social worker and DS talked about how things might be if Okaasan comes home - 5 days a week she would go to day service.. and we'd care for her at weekends. Need to do more about her walking. Not at all sure about the brain fluid draining operation - some friends tell me it can be really good....I don't know....another hospital...more poking and prodding...more strange faces and places...

And...finally. DS is going to see the lawyer I introduced to discuss becoming the legal guardian thingy for Okaasan. He still isn't sure she can sign all the necessary house documents...and understand. He said he mentioned the house to her...that it was empty and that they should sell it...she just responded in a general way...did she even know WHICH house? No mention of oldest brother...

Anyway. He will go and get legal advice and see what he should be doing. It isn't just one document...but several....official papers are registered in the wrong place. The buyer is being patient.

Sorry. Too hot and sweaty here...going off to sit somewhere cooler,

Sunday, 2 July 2017

Black Butterfly

First things first.

Okaasan is still in a better place, mentally.
Since last Monday she has been on new meds and so far the doctor is happy with her progress and stabilization.

And Okaasan is spending most days sitting upright in a wheelchair in the dayroom of the hospital - watching TV and even interested in newspapers. The restraints are used to stop her taking out the injection needles and tapes on her arm. The hospital will try to reduce their use...

She has slight pneumonia.....they are monitoring that.

All good. No feeling yet about when she might be ready to come home/move to a care home. Only 1 week so far of fairly stable condition.

BOTH of us went to see Okaasan in the mental care hospital yesterday.
It's a new, large hospital - nicely surrounded by gardens. Different buildings. I could see people sitting in day rooms with large tables and TVs...staring a bit vacantly.

There was a whole range of security systems to get in - and then the woman doctor came to meet us and I got invited upstairs with DS for the doctor/family meeting and Okaasan visit.

Okaasan SAW me and SMILED and WAVED!!!
As we came out of the elevator on our way to the doctor's room she was being wheelchaired to the meeting room - and she SMILED AND WAVED!!! I've never been so happy to see that!! Felt all overcome with emotion :-)

We sat and heard about the latest drug regime and how it seems to be working better. Her moods are better and she is more mentally alert.

And then the PET? MRI? photographs came out. I couldn't whip out my smart phone for a picture - so you'll have to make do with some stolen-from-the-internet images.

Okaasan's brain is like that right picture - she has a big black butterfly in her brain. It's the space. In Japanese the "heya" - which can be "space" or even "room". She has a lot of space, filled with fluid.

To be honest, it was a bit shocking. We've lived with her all these years and known her mental condition. But to see it in technical detail in a hospital. Kind of shocking.
In fact her brain has an even bigger, and fatter butterfly than this picture here. The doctor said she may have excessive brain fluid, which could be adding pressure...another hospital could ultimately do further scans and there are procedures to test by drawing out fluid thru the spine - and if it has good results to drain off fluid from the brain.

All a bit shocking to think of for an 86 year old, who has already suffered 6 weeks of hospital life.

That's a future possibility.

For now - the immediate concerns is continuing the drugs and hoping for another week or two of good mental/emotional condition.

And then we went to see Okaasan in the meeting room. Hiding our hospital visitor name cards. Sitting across the table from her in an all-white room. We stayed 40 mins.

She was happy to see us. Smiled. Looked tired. Kind of passive. Listened to our double-act, prattling on about stuff conversation (which we carefully did all in Japanese) and occasionally responded.

Yes, I've been to South Africa
Maybe Kenya
New York

Okonomiyaki pancakes? Yes, like those.

Dear Son had forgotten to take the holiday travel pictures to show her and chat about, so he and I waffled on and on. A strange conversation - Okaasan sat across the table from us and sort of followed it. The weather - food - travel - on and on.

Many years ago as a reporter in the UK I went with a woman to visit her son in prison. He'd hit another man with a baseball bat in a  fight and killed him. Mother was campaigning to prove his innocence. She invited me as a "friend" to prison visit, so I could write a story. We sat in the
prison visit room with her boy chatting about normal life beyond  the high walls - family news/food/sport...and it was pretty strange. 

Visiting Okaasan was like that. I think Dear Son was grateful to share the visit with me.


We can't really imagine Okaasan coming home for another few weeks....
Coming home. Care. Signing the documents about the house sale.

Any of that. Not yet.

And the whole brain fluid - whether it could be drained and make a difference? Not a priority.

So, there we are.
After the hospital DS and I biked downtown. Enjoyed the park on a Saturday - flower festival and sights. Rare for us to be together downtown.
We went to a big buffet place and ate ourselves stupid. There was a $6 dollar all-you-can-drink-wine plan. We drank. I ate ice cream with loads of dried fruits.
We came home and slept in the afternoon.