Diary of a busy practitioner, juggling work and family somewhere in England. This week: tackling public speaking


6.30am Tuesday morning as I am trying to get dressed. DALC1 runs in with a list. 'Mum, this is what I want to do to my room!' The list reads as follows:

Trieangler shelf
Ifle tower beding
Ifle tower light
Ifle tower pichers
Red hart cooson
Striepy lamp
Ifle tower cretens
Move bed

After tactfully asking and finding out that the penultimate item on the list should actually read 'curtains' and being grateful, at least, that she doesn’t want a bunch of Parisian cretins in her room (it’s 6.30 in the morning for goodness’ sake, I haven’t got a clue what’s going on- she’s literally never mentioned the Eiffel Tower before) I am dragged to her room where she proceeds to start to strip her bed. 'What are you doing?!' I gasp. 'Changing my room!' she replies. My phone beeps - Julie wants to know if she should leave frozen mince for tonight’s spaghetti on the worktop or in the fridge today- and there is the longest wail I’ve ever heard coming from downstairs. I race downstairs to discover that the wail is (still) coming from DALC2 who is refusing to take off her soaking wet pyjamas having made it through the night but not quite to the toilet this morning. Quite attached to the wet pyjamas, apparently.

Today I am speaking at a seminar run by the firm. I still can’t bear public speaking- one of a number of things I am expected to do that I haven’t had any training for- but as the years go on it does get easier. Nevertheless, I have bought a new dress and not eaten carbs for a week. I remind myself that these people are being given a free cup of tea, a biscuit and legal advice. They are not going to start heckling or walking out because I can’t work the powerpoint buttons as slickly as I would like. And, I’m fairly sure my boss (who is also speaking) won’t have bought a new suit or done anything, really, except maybe comb his hair this morning.

Amongst other things, I will be talking about NHS Continuing Healthcare. Last time I did a talk on this subject people were waiting outside the toilet to speak to me afterwards. It is a very popular subject, with few people really wanting to pay for their own care. Except me. I have been to enough care homes to know that if I have financial security in my old age I will be spending it on a care home that has good food, a movie room, and doesn’t smell of what my younger child probably smells of today.

In my talk I will use examples of clients I have got funding for, including one whose main issue was constantly trying to- and often succeeding at- absconding from the nursing home, another who was so physically aggressive they would often punch and bite the carers. As I am waiting for my turn to speak I glance through my notes and at the 12 care domains in the Decision Support Tool. It all suddenly seems extra familiar.

‘Challenging behaviour that poses a risk to themselves and others’.

‘Cognitive levels that lead to little awareness of risk, and dependence on others to assess basic needs’.


‘High risk of falls’.

‘Periods of distress that do not respond to prompts and reassurance’.

‘Needs feeding to ensure an adequate intake of food’.

You only have to look at the number of tubs of Sudocreme we’ve got through to know there is a ‘risk of skin breakdown which requires preventative treatment’, and the calpol stains on the wall to see there is a definite ‘non-concordance with medication’. I think of my friends who have had to deal with febrile convulsions which are, you know, really normal and common and nothing to worry about.

Without wishing to make light of anyone else’s situation, I am pretty sure that if those bundles of joy many of us have at home were actually elderly relatives we would be able to apply for CHC funding.

I survive the seminar, although like some kind of trauma victim I have no recollection of speaking at all, apart from the fact that one of my arms was gesticulating wildly the whole time without me being able to stop it. It wasn’t mentioned on the feedback forms though, so that’s something.