Friday 5 August 2011

I visited Helen twice yesterday - morning and lunchtime. She was better than the night before. Much more alert and connected. We talked and I shared her breakfast and lunch (she only really likes the eggs, the toast and the desserts). I moisturised and oiled her dry skin bits and brushed her hair (including untangling the tiny dreadlocks starting to form at the back from being in bed too much). We both enjoyed the idea of her having dreadlocks like me but I don't think she's really ready. At my second visit I crossed over with Robert the physio and together we helped her stand and walk through the room and out to the outside area. It did involve me being pretty bossy so I'm not too surprised she hasn't done it with anyone else - particularly the palliative care nurses who are sooo nice. She was very weak and shaky by the time she got there and had to sit down for a rest but she did do it!
My impression after these visits was that they don't think death is imminent and that we do need to seriously plan for discharge so I have asked Kate the junior doctor to organise a case conference next week involving: palliative care, GP, rehab team, NT Carers, Jo, Susan, Louis, me and possibly the nursing home if that looks like the best option.
Robert the physio suggested Helen could go into either the public rehab or for a private rehab admission as an alternative to the nursing home and to see if she can improve her functionality at all. To my mind that really depends on prognosis. If it is likely or possible for her to live a reasonable time longer - a month - more? Then it's worth it because it makes it possible for her to come home to us again and it makes general quality of life better even if she does hate the actual exercise bit. If she is likely to die in the next few weeks then I am perfectly happy for her to spend all of her time lying around peacefully occasionally eating a morsel of dessert.
So...hopefully I can covey those opinions well at the case conference and that will help us get some clarity. If she does go to the nursing home - Pearl at Fanny Bay - it is newly built and pretty nice, and close to the Gardens for visiting.