Des personnes désorientées

And so it goes on…

The latest drama was that the woman who has been asking for gendarmes or advice on hotels fell out of bed. The pompiers collected her in the middle of the night and took her to Ganges for x-rays. Apparently nothing more is broken and she is back in her bed here – hopefully this time with the barriers up!

There is a new member of cast: a large woman in a superior wheelchair (her own), clearly a regular here, who wheels her chair up and down the corridor pinning down unsuspecting victims (me) in conversation, mostly about her ailments. She is not as dotty as some but she is driving us mad by the non-stop talking, which stopped both Deborah and me from sleeping this afternoon. Worse still, she is in the room opposite Deborah, so I’m expecting fireworks tomorrow, unless she is moved to the medical corridor which is apparently where she should be.

I asked Didier today what happens in the long term to patients who are disorientated or physically unable to live on their own and have no families. He said that many ended up in the retirement home in Sumènes (just the other side of Ganges). And indeed the website describes this place as receiving people “en perte d’autonomie et/ou désorientées”. It goes on to describe itself as having an enclosed garden (ie locked) suitable for people with Alzheimers etc.

Son environnement sécurisé (jardin clôturé) lui permet de recevoir un public pouvant présenter des maladies type Alzheimer (au stade de déambulation) ou toute autre personne présentant des risques de fugue liés à d’autres pathologies (vasculaires, dégénératives, psychoses déficitaires…)

Sounds pretty gloomy, eh? This was confirmed for me this afternoon when I overheard a visitor complaining that her relative was getting very confused and perhaps he would be better off moving on to Sumènes. Oh, he’s not ready for that yet, replied the nurse.

I asked Didier if Michel, the guy who comes down with his zimmer to drink coffee in the physio room (and who complained about the lack of homosexual partners here), would end up in Sumènes. He replied no, he had already been there and for some reason (perhaps I can guess what) was referred back to le Vigan. Didier found him wasting away in a bed on the second floor, unable to use one leg and insisted he be allowed to come down for physio. He is clearly proud of the result: Michel walks with alarming rapidity with his zimmer and has as much autonomy as an apparently permanent resident here can have.

If Sumènes sounds bad,there is apparently another grimmer one in St Hippolyte, Deborah claims. Her former doctor, who went off the rails and attempted suicide after a series of awful events, now lives there.

What happens to all these poor souls in other countries, and in particular in Britain, I wonder. I have to hope that things have improved since my childhood, when my friend Christine and I played with a classmate called Denis, whose parents ran the old people’s home in a vast old Victorian building nearby. I vaguely remember playing hide and seek, running through a long ward lined with the beds of old people.

More surreal patient events

Today we said goodbye to Mme Lacombe, a quiet but very pleasant woman, who was born in Serres but now lives near Ganges. She is the one who was visibly shocked by the guy who complained there were no homosexuals to be found in the hospital (post three days ago). Well, she had a worse shock two nights ago. A male patient (at that time in the bedroom opposite hers) entered her room and said, in an aggressive way: “I know you. Why are you not at home looking after your children rather than lying in bed here?” And he then wet his pants standing in front of her bed. Mme Lacombe freaked out, rang for help and couldnt be reassured that he would not come back, and had a difficult night awaiting more dramas. Deborah’s advice to her was to brandish her crutch at him and shout for help – and she would come to the rescue (her room is next door). But I somehow don’t think this is quite Mme Lacombe’s style.

The patient was in fact moved to a bedroom at the other end of our floor, far from her room. And later, an aide explained to her that this man, who suffers from confusion (I love the French phrase ‘il n’a pas la tête’) was in fact looking for a loo, not realising there was one in his own bedroom. His family were apparently away for a few days and he gets dumped in the hospital on these occasions. Not usually on the orthopaedic side!

Another patient who arrived confused (see four days ago), disappeared back to Ganges, and is back with us, almost as confused as before, but no longer aggressive. Yesterday she sat in the salle de kiné (the physio room) and said, to nobody in particular: “Je cherche……” A young man who works mainly with the old in the retirement home asked what she was looking for. “Je cherche…… un gendarme.” Why, he asked. Because somebody has taken my handbag and all my possessions, she replied. The young man sat down beside her and gently explained she had broken her shoulder, had had an operation and was now in this hospital to help get her shoulder better, and that all her belongings were safe in her room upstairs.

How often over the past two days I have heard her lost, asking where she is and why, and I have heard people patiently explain the same story to her again and again. Today she was sitting next to Deborah and me and she asked us – most politely – if we could kindly tell her if there was a good hotel nearby where she might find a room.

12th November is THE day

In the morning I will go to the scanner in Ganges, at lunch-time I will see the surgeon in Montpellier and at tea-time the ambulance will take me home!

I had the weekly review with the doctor here today. She is pleased with the mobility of the hip and agrees that from Monday I will be able to put 100% weight on it. That means I no longer need to use the crutches to take part of the weight, which will greatly help my shoulders. I aim to be walking with just a stick (as a safety measure) before I leave.

More good news, the doctor reckons I can drive shortly after – whenever I feel up to it. Luckily as it is the left hip, I only need it for the clutch. At the worst I can crawl down to the supermarket using just second and third gears!

At first I was disappointed that somehow my departure is taking a week longer than I expected, but actually it is probably a good thing in the long run. I’ll have just over a week to improve my walking, get my knee into a better state and generally get fitter with daily sessions on the pulleys and exercise bike.

Escape date recedes

November 3rd is the magic date when I have the right to put 100% on the left side, so I should be able to start reducing dependence on crutches. I was expecting the trip to Ganges for the scans and then to Montpellier to get the all clear from the surgeon a couple of days after. But on asking about dates yesterday I was told these two trips are set for the 12th November!

Can I hang on for yet another week? On the plus side this gives me time to do the kinds of muscle strengthening exercises that people usually do on arrival, and I can practise going up stairs, which I may not do at present, and discuss practical household needs with the ergonomic staff. But Deborah leaves on the 5th, so I will have no company, and it prolongs evven further the time Margaret and Hans spend dealing with my laundry and shopping requests. I suppose one possibility is to leave on Friday 7th and then get an ambulance to take me to Ganges and Montpellier the following week, but I’m not sure if I have the right to leave before the surgeon sees me. I’ll discuss all this with the hospital doctor on Wednesday.

I suspect the delay is not only because somebody probably didn’t ring up soon enough (the scanner is apparently very busy) but also that this is half-term time here, plus Toussaint next Monday, so lots of people are on holiday.

Am I in a dream?

On several occasions I have reflected that this bizarre world I find myself in is like a theatre – but am I a spectator or in the cast? I said this to Rosalyn, the physio assistant and she laughed and agreed, and said she often wondered if she was in a dream and would suddenly wake up.

The cast is constantly changing: various characters get better (well, enough to boot them out, or send them across the garden to the retirement home), others unfortunately disappear back to Ganges or another hospital for further treatment. I suspect this is what happened to the old woman opposite, who kept tearing off her arm bandages. Some remain only too audibly present, like 95-year-old Mme Héron, Gael (the poor handicapped woman) a man who has had a stroke which makes it hard for anyone to understand him, and a drug/alcohol befuddled younger woman.

New performers make their entrance. Deborah and I escaped down a quiet corridor on the ground floor this morning. From another corridor at the end we heard religious music (all around us on Sundays) and a woman singing along with the recording. Then we spotted the singer, a black woman, marching past – and back, and forth. EVentually she turned off her recorder and passed into our corridor and we got talking. She was a Camerounian who worked for a French boss (as housekeeper, I think) and when he retired to France came with him. At the last moment she discovered that her visa did not include her four-year-old son. Her friends advised her to go ahead and fight for his visa here. I couldnt make out whether she knew she would end up in hospital in Montpellier before she left the Cameroons. but she has had a (repeat) slipped disk operation and returns to Montpellier tomorrow to get the surgeon’s verdict. Her distress at being parted from her son was evident and heartbreaking. I’ll find out her name soon,as she has ended up in the room opposite me after having to share with a poor old blind woman who cried all night and just wants to die. Our new Camerounian friend muttered it makes you think of euthanasia.

Some people find more practical ways of escaping. We were sitting in the garden yesterday when we heard an aide menage rushing towards an elderly patient, complete with bandages,marching towards the exit to the hospital. “Non, non, Madame. Vous n’avez pas le droit de sortir”. That’s the second time we have witnessed a patient being rescued at the last moment.

Perhaps the worst fate I can imagine is to end up in the “deuxième” – the second floor. This is the ward upstairs, with combination lock entrance, for the very, very sick, dying or – I imagine- insane. Curious because sometimes people do come out. There is a batty 59-year-old who pushes his zimmer at great speed down to physio at coffee time in the morning, has his glasses of juice and coffee, and departs. He is seen occasionally in the afternoons, playing scrabble with Mme 114 (she who is constantly asking where is her room 114). We know he is 59 because a couple of days ago he suddenly broke his silence, and in a deep (mainly,to me, incomprehensible) voice recounted his life history. Unless I have got completely the wrong end of the stick, this included the fact that he is homosexual and it is difficult to find partners in hospital. I think I am right because Deborah saw the good Protestant woman lying on the treatment couch next to her raise her eyebrows to her hairline.

References to the deuxieme make me think of that awful scene in “All quiet on the Western Front” when the young men lying wounded in a French hospital are told the rumour that the bandages room at the end of the ward is in fact the dying room – and you don’t return.

On the positive side, today is yet another cloudless sunny day and I’m about to bully Deborah to go outside, which involves waiting for a young(ish) passerby to help push her wheelchair down the precipitous slope just outside the main doors. And I am sitting in a very comfortable armchair which the staff making my bed this morning suddenly thought I needed. Somebody is bringing in some dvds later in the week, so I plan to start watching movies.

Ella’s fifth birthday party

My oldest granddaughter Ella, will be five on Monday. She has been as high as a kite for a week now, waiting for today’s birthday party. She will be wearing the fairy costume (theoretically) my present. I still get angry that thanks to the incompetent management here I couldnt watch her unwrap the present this morning. (I have still not had a reply to my letter, sent to the directeur over a week ago.)

This made me remember my first birthday party (either my fifth or sixth birthday). I was not present. As so often in my childhood I was ill and, that being before everybody had a phone, the party was not cancelled. I can remember hearing the children downstairs, presumably eating something simple like jelly, as this was in the Forties. The next two birthdays were spent in hospital.

French health system creaking

There is no way I would have got the care I am receiving here in Britain. Instead of spending the last two months in hospital or clinics I would probably have been discharged after a week or two and left with presumaby some sort of daily visit to deal with the post op medical care, give me medication, make my bed and wash me and horrible meals on wheels. I certainly remember that after my first hip replacement I was discharged after two weeks with no physio prescribed until I demanded some – and then only got six poor sessions. Perhaps the low quality of operation and after care 14 years ago accounts for why that hip replacement never worked properly and did such damage to the bone of my pelvis.

So, I am grateful for the French health system, but also deeply concerned at the signs I see that it is inevitably crumbling. This is only a little local cottage hospital, caring mostly for the very old, confused or dying. But it also has a small rehabilitation side, with about 20 beds assigned to people like me, and a surprisingly well equipped physo room, albeit cramped, with two physios and an assistant (there is a third physio vacancy which never gets filled because of the shortage of physios and the fact that people don’t want to come and work in the sticks).

I have written before about how much I have appreciated the care of the kinés, Mireille, Marthine (the sadly departed replacement) and Didier (less so…) and their lovely assistant, Rosalyn. Mireille and Rosalyn go round all day long dealing with moaning, difficult, handicapped, deaf, blind – or deaf and blind patients with non-stop kindness, smiles and gentle compassion as well as professionalism. But how do two people cope with a roomful of patients needing help or simply in danger of falling over when doing their exercises? Thursday was a particularly taxing day, when all the patients most in need of help seemed to need it at the same time. It was the day when Madame Héron, who is almost completely deaf and blind, suddenly started to work with determination at walking between the bars and then demanding more attention (loudly, because she lives in her own little world), when new patients arrived who found it almost impossible to move from wheelchair to treatment bed without being virtually manhandled by these two women. At one stage I said to Mireille, who had her usual smile, but I thought it was a little fixed, that she must be very tired. She replied she was ready to keel over – rare for her to admit personal struggles.

There are simply not enough kines and this is a cryng shame. But the same applies to nurses, aides soignantes, and the assistants. At every level the staff here are incredibly cheery and patient. Yet the better I get to know them and the more I eavesdrop, the more I realise the system is only just holding together. The staff have to race to get through their morning tasks, on top of responding to the demands of people ringing for help. Sickness and holidays mean they are stretched so much that sometimes they finish an afternoon shift, only to start immediately on a morning shift the next day, without a break. (The storms didn’t help of course, as several staff could not get to work those weeks.)

The building, furniture and equipment show further evidence of needing an urgent cash flow. The entrance is so makeshift it is positively impossible for someone in a wheelchair to go out to the garden alone, the physio room badly needs more électrode systems – and space, the bedrooms are shabby with paint peeling and scuffed doors (I have contributed to this trying to manoeuvre my wheelchair into the tiny bathroom, and things like the control to raise and lower my bed don’t work.

Sometimes, I have to admit, it is not lack of cash but lack of imagination that creates unnecessary problems. For example, it would cost nothing to move one of the chairs with arms to near the lift, rather than the useless showy, too low for patients, seats. I often see people on walking frames struggling back to their room, badly needing a half-way halt. And the two nice aides who made my bed this morning, propped my crutches up tidily beside the table – out of my reach…

Major milestone

Today I swapped my wheelchair for crutches!

It all happened rather quickly, after a night in which, with some trepidation, I slept on my side, with a  pillow between my knees .  Today was the weekly review by the doctor, Docteur Commeines. I’ now half way through my four weeks of ‘applied progress if’; I may now put 50% pressure on my left leg.

“I’m tired of seeing you in a wheelchair,” said the doctor.  “Time to see you walking.”  I was handed an ambulateur (walking frame) and tried without enthusiasm, saying I would prefer crutches. So in they brought a pair of cannes anglaises, or beguilles, and away I went, or rather, swayed, back to the kiné room next door. There I walked back and forth, gradually gaining confidence, helped tremendously by Mireille, the kiné, and egged on by Deborah. In fact quite a few people smiled with pleasure at this sudden step forward – literally.

Then, unbelievably (a bit scary) I left my wheelchair behind and walked back to my room. It is somewhat unnerving to see no wheelchair beside my bed after six weeks. Instead just a couple of sticks which I have to concentrate on not knocking over; otherwise I’m stranded.  Whoops. As I said that I moved in bed and knocked one to the ground. Luckily I have my grabber beside me.  I wish I had not lost my old portable grabber, but Deb (sister) is trying to remember where she bought it.

The joy of not having to negotiate the door and cramped space with my wheelchair. And hopefully this transition will relieve the increasing strain on my arthritic right knee and shoulder, caused by manoeuvring my wheelchair, pivoting round on my right leg, and having to lean heavily on my shoulders when walking between the bars.

Poor Deborah has to watch on,somewhat depressed, as she realises she needs more pulley work before her scheduled date for starting to put weight on her leg, in ten days time.  Tomorrow it’s back to the pulleys for me too, to strengthen those damaged or weakened muscles. But at least it looks as if I might be out of here earlier than feared.  Maybe even by the end of the first week of November.

Problems for Monsieur le Directeur – hehe

Well the petition failed to keep Marthine here. All the staff know about it and I have heard various scornful adjectives applied to him. But at least, Mireille told me, that there is now a new policy that there should not be more than 14 reeducation patients per physio. I have noticed one or two empty beds in the corridor sand one of the new arrivals told me yesterday that he was kept in Ganges for an extra week because there was not a bed for him here.

Meanwhile I reckon he has a few security issues to address. I have already worried about the fact that any of the lost souls wandering round the garden could easily wander out of the open gates to the road beyond. A few days ago one patient in my corridor wandered out – and off back home, much to the consternation of the nursing staff who had to haul him back.

Last weekend the nurse and aide soignante alone on night duty were disturbed by the sound of banging on the glass front doors of the hospital (no night grillages). It appeared to be a drug addict, presumably planning to raid the pharmacie. They phoned the pompiers, who arrived 90 minutes later – and the man ran off.

The two women were so traumatised by what might have happened if he had broken the door down that they went to their doctors who signed them off with stress, indicating there needed to be reassurance the doors were more solid before their patients were to go on night duty again. So the staff are yet further stretched, and M le Directeur has some problems to address.

Actually he has another little one which landed on his desk on Friday afternoon: my letter requesting he sorted out the firewall which prevents me (and I assume Apple users generally and perhapsothers) from using skype or email on the wifi system. Thank you to Deborah, my neighbour, and yves Jaffrennou, my friend, for improving style and language.

M. le Directeur
Centre Hospitalier
Le Vigan

Monsieur le directeur

Je suis très heureuse d’avoir l’Internet grâce au service wifi. Mais malheureusement je ne peux m’en servir ni pour l’e-mail ni pour Skype (ou son équivalent Apple – FaceTime). Ces deux services sont pourtant essentiels pour moi – et, indépendamment de moi pour tous les pensionnaires qui voudraient en bénéficier. Pour ce qui me concerne, toute ma famille habite à Londres et j’ai beaucoup d’amis loin du Vigan. Je n’ai pu, par exemple, partager avec mes petits- enfants, l’anniversaire de deux d’entre eux.
J’ai deux ordinateurs Apple: un iPad et un MacBook. A l’accueil, j’ai demandé s’il y avait dans l’établissement un pare-feu qui bloquerait ces deux services. On m’a renvoyé à l’informaticien.

L’informaticien m’a informé qu’il n’y avait aucun pare-feu pour le serveur du Centre hospitalier, mais par contre qu’il y en avait un, général pour tous les serveurs de l’hôpital et de la maison de retraite. Quand je lui ai demandé s’il pouvait modifier ce pare-feu pour permettre l’accès à ces services internet (e-mail, Skype) par les ordinateurs d’Apple il m’a répondu que le pare-feu est sous la responsabilité de la direction de l’hôpital et que toute demande de le modifier doit passer par cette instance.

C‘est pourquoi, Monsieur le Directeur, je me permets de solliciter de votre bienveillance de bien vouloir donner l’autorisation de modifier les conditions d’utilisation des services de l’internet dont je viens de parler, y compris pour Apple et ses applications. Vous comprendrez que la communication avec les familles lointaines est essentielle pour le moral – dont dépend pour une part la guérison elle-même des patients.

Bien sûr, il n’y pas encore beaucoup d’utilisateurs d’Internet dans les institutions médicales où séjournent de nombreuses personnes âgées, mais je pense qu’avec la banalisation des moyens électroniques de communication, cette situation va changer rapidement.

Veuillez agréer, Monsieur le Directeur, l’expression de mes sentiments les meilleurs.

Au Vigan, le 16 octobre 2014
Madame Frances Allen

Learning from my elders

As Deborah and I sit it out until our bones or grafts heal, gradually people whose faces have become so familiar move on. Jeanie. the garrulous woman of my age, and Mme Pialot, the gentle lady from the room next to her have gone home, followed shortly by the plucky 89-year-old Mme Cambon. Se told me the day before she left that her only daughter has now gone back to her home in Japan, her son from Bordeaux was collecting her to go straight to a Nimes hospital where her other sone, aged 51, is gravely ill with a smoking related lung disease. In a couple of days her 93 year old neighbour leaves to live with her daughter.

All of these old ladies were silently, uncomplainingly plucky about their recovery and the life ahead. Unlike Mme Héron, whose voice I hear regularly shouting ‘Non’, refusng medication, physio, waiting for physio. But ‘m beginning to feel more tolerant even about her when I reflect that she is very deaf, and therefore isoltated, and 97!

I also have such respect for all the people who help them, invariably patient, smilingly and ready to listen. Above all Mireille the physio and her assistant, Rosalyn, have a genuine compassion for old people which shines through. Rosalyn was telling me the other day that seeing old people suffer or worry about their future was perhaps the most stressful part of her job.