Last Wednesday, at their weekly assessment meeting, the rehab team at Wauchope District Hospital, deemed Barry not to be making sufficient progress to warrant staying in rehab. He had been there three weeks, and the improvement was minimal. So the Aged-Care-Assessment-Team (ACAT) was called in. Today, the ACAT team 'interviewed' Baz, having interviewed me yesterday over the phone.
The ACAT team wants to assess Barry as requiring Low-Care or Hostel Care. They are going to discuss with the Aged-Care facility of our choice, Bundaleer, whether they have space for him, whether they will take him, and whether they can support the specific care-plan that he requires. Bundaleer is the only aged-care facility in Wauchope. It has a 55+ area, a 100-bed Hostel, and a 40-bed Nursing home. I had discussed availabiltiy of a Nursing HOme place for Barry and one was being held for him. However, I had not organised a Hostel place for him.
However, later this afternoon, I received a phone call from the Rehab Unit. They are convinced that Barry should go into High Care, not Low Care. So, we have a bit of a stand-off. However, the professionals are going to sort it out. The Rehab Unit has been with Barry for three weeks, the ACAT team for less than an hour. Rehab is concerned that at night, a Hostel only has two staff rostered on. Barry wanders at night and gets lost and confused and can wander into wrong rooms. This is when he becomes incontinent. During the day, he cannot be left alone for longer than an hour. Issues arise otherwise, and he becomes anxious. Today, he was anxious because a toaster was hot. It had been used to make a sandwich. Cleaned and turned off. But Barry was anxious because it was still hot. He did go and get someone though.
One of the issues, is that Barry has no physical impairment. He is not paralysed down either side, nor anywhere on his face. He knows that something is wrong with his head, but not what. He tries to respond but cannot find what he needs for the grey that envelopes his mind. He is sympathetic to the others in rehab because they are 'worse' than he is. The very injury that he has suffers, stops him from understanding the injury he has suffered.
What I understood from the initial CT-scan is different from what Ross understood from it. Ross maintains that Dr Crighton did not say that the LHS of the brain was destroyed. We were shown a scan with abou 7 slices through the brain. Each slice was nearly totally grey with just a thin line of non-grey around the extremity of the hemisphere (immediately below the skull). A bit like a cowlick in the hair, and about at the apex of a hair-part there was a large blotch of white which we were told was the haemhorrage. This was not the same size in all seven slices, this blotch. Ross thinks that synapses and pathways will be repaired with time. With the second scan last Thursday, we were told that the haemhorrage had shrunk a little, but was still there and still as dense. The stroke was Thursday 27th October, which was 34 days ago. Ross is much more hopeful than I.
There are flashes of interesting insights, though. Today, being shown on a card 7 + 4, Barry wrote down 11. He could not say 'seven plus four equals eleven', but he could compute it in his brain. I told the rehab nurse that Barry is a sudoku fanatic, and they are going to try him on those tomorrow. If all goes to plan or whatever, I will get him a build-yer-own morse code set. He was a radio-technician by trade, in the pre-computer days.
So whilst I would like to see him in a Hostel, I do not really think that is appropriate for him just yet. He would get lost among 100 people, and the care would not be as targetted as may be necessary. The rehab nurse said that his incontinence is improving, now just to control the wandering, and to work out what he CAN do with his brain. Maybe, he will be able to move into a Hostel somewhere down the track.
What I am convinced of, though, is that I can not take him on. I had a long talk with Rehab about this today. They think there is a good chance that he will always have to be monitored by the hour. He is not a physical chore, as long as the incontinence improves. However, he is a mental and emotional chore. And my younger brother and I have both agreed that our families come before Barry. Our families and our own health. That is tough to write, but I acknowledge that it is true.
Top photo taken in Mark Foys Liverpool Street store at Christmas in 1952, making Barry 7, Julie 4 and Ross 2. The bottom photo was taken in the yard of our Hornsby home in 1950, making Barry 5 and Julie 2.