Sunday, 23 April 2017

From a field in Cheshire..



Not France, but Cheshire...but it is a field.
You don't have to browse our blog that often to stumble across Gill's musings concerning the bucolic charms of 'a field in France' -- a place forever bathed by a warm summer breeze, with a meadow full of flowers next to a languid, poplar lined river reflecting the deep blue sky scattered with wispy clouds lifted straight from Monet. This is not a fantasy, we have camped in such places, and many others where you get the sense that reality has taken on a dream-like intensity, that the actual scene in front of you seems hyperreal, the result of CGI enhancement. The mountains in Lungeren valley were like that, and the prospect of the Gulf of Argolis from the citadel of Mycenae, or the Eden-like landscape on the northern slopes of Etna near Radazzo. Add to these our account of days spent wandering around stylish cities with a great café culture or driving through empty landscapes with huge skies and quiet roads, then it is difficult not to conclude that, despite the occasional glitch, life over the past three years has been great. Just how great has been brought home to us by the experience of first four months of 2017, which, by any standards have been horrible.

We knew last summer that our days of wandering for weeks on end were about to be curtailed. Our youngest had requested that we stayed closer to home during her final year at university. Furthermore, Gill's dad required more frequent support. Even last summer, when on the face of it he was looking very hale and hearty for someone aged 92, we sensed that time was catching up with him, his mobility was declining, and the dementia that he had tried so hard to outfox began to make living independently ever more challenging. Nevertheless, Denis was nothing if not determined, mixing time between his own house supported by daily home care visits, and weekends spent with his companion, Lillian, he still managed regular meals out, occasional short breaks at 'Warner Hotels' and even a cruise around Northern Spain, Portugal, Madeira and the Canary Islands. It was only when he got back that we discovered that he had overcome the reluctance of travel insurers to cover him by simply not bothering to buy any! 


At 92, Gill's Dad still exudes a real zest for life.

and manages to look quite dapper too/
Still, we felt confident enough in the daily homecare support he was receiving to chance an extended trip last autumn through Spain and Portugal. At times we worried if this had been wise. Increasingly Gill received calls from her father's carers expressing concern about his reluctance to eat and an emerging problem with chest pains that seemed to defy the medical profession's ability to diagnose the cause.

When we visited in December to accompany Denis to an appointment with a haematologist, blood tests revealed a chronic leukaemia - The consultant felt this was the cause of his weight loss and lack of appetite. We were told that this could have been a latent, undiagnosed problem for years and though the condition was serious, it was not acute, and he was in no immediate danger. We stayed with him again over New Year, and this prognosis seemed to be the case, he was a little more frail, thinner, and his mobility was in decline. Still he was able to have a coffee at a favourite hotel with a view across the river towards Tynemouth, and on New Year's Eve stayed up to see in 2017 and had a glass or two of Prosecco. Gill's sister arranged with the care company to increase his home visits to cover most meal times in the hope we might reverse his weight loss. We went home planning to return towards the end of January to accompany him to his follow-up visit to the haematologist.


Little Haven Hotel, South Shields - on New Year's Eve.
The day before we were due to return, Sophia, Denis's main carer phoned to report that she had found a first responders ambulance parked in his drive when she arrived for her morning visit. He had phoned the GP complaining of chest pains. Taking no chances they phoned the emergency services. By the time we arrived next day, Gill's dad had been moved from A&E to the haematology ward, despite further blood tests they had no explanation for his recurrent chest pains.

Later that evening the hospital agreed to discharge Denis into our care and we took him back to his house. In retrospect this was probably an error, as it soon became obvious that in the past few weeks he had deteriorated rapidly, both physically and mentally. His was mobility was such that the thought of climbing the stairs frightened him and at times his grasp what was happening seemed minimal. With difficulty between the pair of us we managed to half carry him upstairs to bed. It was clear, that for the moment at least, his capacity to live independently was questionable, though this was not something he was prepared to countenance. After a difficult few days we managed to half persuade and part cajole him into agreeing to spend a few weeks in respite care in the hope of improving his diet and building up his strength. He was always lightly built, but now he weighed less than eight stones and looked painfully thin and frail. All the while family discussions revolved in finding a longer term solution. Could the house be adapted so he could continue to live there independently? Would he settle eventually in the local care home, or might another one suit him better? What about a care home in Derbyshire, closer to where we lived. There was no solution, just  least worse options, and the costs were breathtaking.


Denis's room in Harton Grange - Gill experiments with his mobility aid

He put on a brave face, but we know he never settled in the care home - not even on a short term basis.
Gill tests out the products at Gateshead's Stannah stairlift showroom


In the end these dilemmas were overtaken by events. While still in respite care, Denis was admitted again into A&E after complaining of chest pains and breathlessness. After a scan, finally the doctors were able to make a diagnosis, he was suffering from metastatic prostate cancer, it had reached an advanced stage having spread to the bones of his spine, chest and skull. We discussed how this was not spotted earlier with his GP. The diagnosis of serious illnesses in dementia patients is a real problem, because they find difficulties in remembering symptoms. Furthermore, the symptoms themselves - weight loss, eating disorders, mobility issues - all can be mistaken for the effects of advancing dementia. I can appreciate how this is a problem, particularly for people with dementia living at home on their own, but the impact on Gill's dad.was devastating.

Gill and I were with the hospital doctor when she explained the results. She looked so young, in her mid-twenties I guess, nevertheless, she was very sensitive and impressive. She concluded, "Sadly, I am sorry say, we not going to be able to fix you this time, Denis." His reply was memorable. After a momentary pause, he squeezed the young doctor's hand, acknowledging, I think, that he recognised that it was difficult for her too, then said, "I know I cannot live forever, I am not afraid to die, I have had a happy life." It was a sad, yet powerful human moment. I was left pondering how many of us would display such a sanguine spirit in these circumstances. It was a remarkable response I think.

After a few days Denis was tranferred to the palliative care ward. There followed a few difficult weeks sitting by him as he faded away before our eyes. The twice daily visits were heartrending. We tried to find ways of engaging Gill's him, as he complained of how tedious it was, so, given his lifelong interest in woodwork, we made a 3D plywood model together. Progress on the construction of 'The Temple of Heaven' became a talking point among the nursing staff. '

Work in progress on the Temple of Heaven
finished!


Matthew Sarah and Rob drove up from London to visit
'Dr Ed' as the ward consultant liked to be called, explained to us that the progress of advanced prostate cancer could be likened to "a gentle downward slope followed by a cliff edge."  This indeed is how it seemed; the moments where Denis was cogent began to be outnumbered by those where what was occurring in his mind seemed more real to him. "I am living in two places" he would repeat. It was difficult to tell if this was a symptom of the disease or the effects of powerful opiate based pain-killers.

Gill's sister, Jackie came over from France We took the opportunity to go home for a few days, though we did wonder as we drove south down the A1 if Gill's dad would still be with us when we returned later in the week. The concern proved prescient, Denis died the day after Jackie arrive. We wondered if Denis had hung in there until he could say goodbye to Jackie and her family.  Dr Ed had commented some days earlier, 'He will go when he is ready to' and that indeed seemed to be the case. Our sadness at his passing was ameliorated by a sense that he had made his peace with the world, and that the suffering and indignities of his final days were now at an end.

The whole experience has been harrowing, made especially so because we were living in the family home surrounded by memories of not just Gill's dad, but her mum too. Though Gill lived in the house for less than four years, almost forty years ago, nevertheless, her dad was an inveterate hoarder. Memories of family life and the presence of  Denis and Joyce as a couple were everywhere, not just photographs, but the choice of furnishings and decor, the design of the garden that had been Gill's mum's domain. Her dad's presence was palpable in the woodwork great and small to be found all around the place, from the summer house he built in the garden to the lamp stands and marquetry dotted around the downstairs rooms. As he faded, it was impossible to escape  a strong sense of not just the end of an individual life but the end of an era. I think Gill was doubly bereft, and felt the loss of her mum as much as her dad, which mirrored​ my experience in 1998, when my father died, and clearing my family home involved disposing of both my parents' belongings. No matter what age you are this moment is difficult and seems like a significant milestone.

Gill's mum and dad were a stylish pair, and notwithstanding their relatively modest roots they managed to exude a bit of Hollywood glamour in their younger days. Even in old age they remained dapper, stylish and well groomed. They definitely pre-dated the post sixties jeans and tee shirt culture that Gill and I inhabit. Her parents exuded Swing era chic to the end. 



As his son in law, it would be crass to assert that I was affected by Denis's death as much​ his children and grandchildren. However, I found myself reflecting that I had known Gill's parents longer than my own, having lost my mother when I was 20, and being a 'late child' I was aged 43 when my father died in 1998, It is unsurprising given these circumstances that I too felt a powerful sense of loss.

The experience of bereavement is very odd, unique I suppose for all of us. To me it feels like living in a grey bubble, the practicalities​ of life go on, but they seem remote; you deal with them  automatically, yet at the same time remain quietly devastated. There is certainly a lot to deal with, funeral arrangements, the local council to inform, utility companies, DWP, banks, HMRC the list goes on - it's all somewhat overwhelming, even before Gill and her sister have to contemplate the question of what to do with the family home. It will take many months to sort things out I think.

However, right now, there is a momentary lull. Until probate is approved in about six​ weeks time there is little else to be be done. So, we have booked a ferry for next Sunday and plan to wander along the Languedoc Roussillon coast to the Costa Brava to find the colour south and some sunny days.On the face of it this may seem unconnected with why, right now, we are camping in a field in Cheshire. The reason - we are  staying for one night at Woodlands Park because the place is a about two minutes away from Spinney's the motorhome dealers. Maisy is booked in at 9:00am tomorrow for some minor repairs. It also gives us the chance to check the van is OK after sitting for almost five months in a wet and windy field 1000 feet up in the Pennines - and everything seems fine, apart from the shower head which has become clogged up with limescale - a good dunking in white vinegar is reputed to do the trick.

Surely I am not alone in finding mobile home sites profoundly strange, and somewhat sinister...
...see what I mean...
Woodlands Park is mainly a mobile home site that accommodates a handful of tourers as a sideline. Like most such sites it exudes an over-manicured, zombie-like bungaloid calm; the residents seem helpful and friendly, and though their demeanour leads you to suspect they are all members of some esoteric quasi-religious cult, they seem harmless enough. In truth it feels truly wonderful to be out and about once more, and even a field in Cheshire has some bucolic charm. This afternoon has been sunnier than forecast, so, as Ms Austen would have put it, we took a turn around the fishing lakes, appreciated the spring flowers, admired the ducklings and stared at the bright green reeds reflected in the placid  water. Nature is a wonderful solace, and no matter how sad you feel, after a walk in the woods it is impossible not to feel a little uplifted.

Small lakes - lovely places

Pete dong his Christopher Robin style trot...

It's One Hundred Acre Wood
What are these small blue flowers called again....










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