To a stranger, she was a small frail elderly woman sitting on a chair in a nursing home. To me, she was a woman I had known for many years – fiercely independent, living life to the full and a very infrequent attender at the surgery. She was a member of the “I didn’t want to bother you Doctor, sure I knew if I gave it a bit of time it would heal itself” brigade. She was usually right. Recently, she had been admitted to a nursing home due to a series of ‘small things’. There was no one major issue, just a gradual onset of the frailty of mind and body that comes with advanced old age.

Having greeted me, she said with a twinkle in her eye “my son said I was only coming in here for a couple of weeks but we both know that’s not true”. Her children had been and continued to be very supportive of her and she was confident in that support.

Her son was concerned that her memory was getting progressively worse to the point that he thought it was unsafe to leave her continuing to live alone.

I had been summoned to do the “memory test” to confirm his suspicions and to breach the subject of staying in the nursing home long term.

I began by asking how she felt her memory was. “Oh not as good as it used to be,” she replied cheerily, “but at my age what can you expect!”. She readily agreed to answer the memory test questions and tasks. In response to being asked to write a sentence, she wrote in beautiful copper plated script “I am happy here”.

She was way ahead of me as usual!

I had preconceived ideas of how difficult it was going to be breaching the subject of staying in the nursing home long term. Knowing how independent she had been all her life, I thought this would be a major source of sadness and disappointment for her.

Instead she was embracing the change. She was enjoying having her food prepared for her, the helpful friendly staff and, most of all, a feeling of being safe and secure. She had also decided that she would go for overnight stays and maybe even mini holidays with her children when she felt like it – she just hadn’t broken this news to them yet!

I had a spring in my step as I left for home. A difficult task unexpectedly converted to a pleasant one. This is one of the joys of being a GP!

Addendum – This took place before the advent of Covid 19 and its horrendous impact on nursing home residents and staff. It makes me wonder if the same response would be forthcoming in the current environment. While instinct might say it would be different now I have learnt from this woman and many other patients that you should never pre judge how someone else sees the world and what feels right for them.