The Greg Conference

I thought the decision to have Greg home (or not) was an option I was being given by the hospital. The way the question had been put to me sounded like the choice was mine. If I decided not to have him home, the hospital would instigate a series of occupational rehabilitation or convalescence to try to get him walking and mobile again. This might or might not result in him returning home eventually. If his mental state did not improve, I thought they might consider some sort of long-term residential care. I had been perfectly happy to accept him home if there were a degree of physical disability (although it would be difficult in a multi-level house full of stairs). But I had eventually declined to take him back, if, as it seemed, he had some form of dementia as well AND would return to smoking and drinking. Anyway, I assumed these decisions were a long way off - until time had shown us the full extent of his limitations. He was still far from well.

It was a week after that question was put to me and already late September. when I was invited along to a case conference at the hospital to discuss Greg's future. By then he had been in hospital for over three weeks. Fortunately at this point Greg's sister, Jill, had come down for a few days to visit Greg, as well as to help me pin down the doctors, get some answers as to what was actually wrong with him and discuss what the prognosis was. She is an ex-nurse and was disgusted at the lack of answers we were getting from the staff. We tried several times to make an appointment with the doctors but each time were fobbed off with promises that they would see us when they did a ward round. The staff knew my sister-in-law was only down for a few days and had to return to the Midlands, but we waited six hours on the ward on the day they were due and they did not turn up. We were told they had been diverted to another ward. We were by now getting very angry. I asked Jill to come with me to the case conference, as I knew she would have questions to ask too and would give me moral support.

The day of the case conference arrived. I was amazed at the number of people who were in the conference room. Apart from myself, Jill and Greg (who had been brought along in a wheelchair), there was the ward clerk who had originally asked me for my decision, one of the doctors, a physiotherapist, an occupational therapist and a social worker. Eight of us in all. We all sat around a square conference table with Greg and me at opposing corners. A bit like the start of a boxing match, I thought.

The ward clerk started with the opening sentence that we were there to discuss Greg's future, that he was physically getting over the pneumonia and there was now nothing more the hospital could do for him, but that his wife did not want him home. Ouch! Greg shot a glance over at me. It was the first he had heard of it. I felt a pang of guilt. He looked so thin and gaunt after three weeks' battle with the pneumonia. How could I do this to him? The social worker immediately retaliated on his behalf by saying I could not ban my husband from his own home... something I had already conceded again and again in my own mind over the last few days. (When I had Kay at the ripe old age of 40, we had BOTH agreed that it made sense for me to give up work to stay at home and look after her, as Greg worked highly irregular shifts in the media including weekends. At least I would be the lynch pin at home around which everyone else revolved and we would all see more of one another, than if I were at work too and having to employ a childminder. He had paid most of the bills for 17 years. How could I NOT have him home?) I certainly did not disagree with that, but I countered that I was unhappy for him to return to drinking and smoking, particularly if he had some form of dementia. The doctor said that a recent psychiatric test made them think he might not have Korsakoff syndrome after all. They were still doing a few more tests, but it now looked unlikely and that he had merely been confused because of the delirium from the pneumonia. When I pointed out that he had also been confused at home before the onset of pneumonia, they argued that the confusion then was probably caused by the alcohol.

The physiotherapist went on to say that physically he was improving and had managed to get around over the last day or so quite well with a zimmer frame and was even managing to go up and down a few stairs. They therefore considered he would be able to cope well at home. Greg emphasised that he was beginning to get his strength back and felt he would fare much better in his own home surroundings rather than prolonging his agony in hospital. The occupational therapist said she would need to assess the home environment to see if any special facilities needed to be installed. She could look at the stairs situation and see whether he needed aids in the bathroom, or chairs to be raised etc. Greg repeated that he wanted to get home as soon as possible. Tomorrow if possible. All eyes turned to me for a reply.

I repeated that I was unhappy about him returning to drinking and smoking. I would need reassurances that he would not do that again. I could not go through with the nightmare again. It was not fair to Kay or me. I explained the depths we had been in when I could not get any professional help in the midst of his drinking bouts. Greg promised he would never drink again. He said he had not missed the drink at all while in hospital. The social worker backed him up and said he had said that to her too. I argued that I had heard all that before..... in 2006 when he had been in hospital after his gastric bleed and again in February this year when he had come out of the detox clinic. On both occasions he had said "never again" but had returned to drinking again after a short while. In fact, it had only taken six weeks for him to return to drinking after his detox in February. Jill, bless her, supported me and said that Greg would say whatever people wanted to hear to get himself home again. But he would go back to drinking as soon as he was out. The social worker promised she would stay on the case and make sure he kept to his promises and set up some sort of rehabilitation. Greg said he needed time to think about rehab, but would promise me he would do something. Different ones - they were becoming a blur through my tears - said I should not be so negative and give him the benefit of the doubt. I repeated that I had seen and heard it all before. They were not the ones who would have to live with the nightmare and be unable to get a professional to help when the going got tough again.

In the end, we were going round in circles and it was evident that I had no choice at all. All the professionals were pressing me to have him back home. It was a fact that I could not ban him from his own home without good cause. He had promised to stop drinking and smoking. Every professional in that room believed him. At the end of the day, they wanted his bed for someone else, so of course they were going to believe him. He promised in front of them to consider some form of rehabilitation, although he did make it clear he would not go into residential rehab, as he could not bear to be away from home. But he would consider something like drop-in counselling from home. All eyes turned on me again. I felt cornered. I was in an awkward situation. I heard myself saying that I would agree to take him back. The case conference was formally closed. It had lasted nearly two hours.