Rose

Age at interview: 65

Brief Outline: Rose was diagnosed with heart failure after a heart attack 14 years ago. She has an implanted defibrillator to regulate her heart beat, which is monitored by a machine at her bedside. She is visited at home by a specialist nurse once a month.

Background: Rose is widowed with four grown up children. She used to work as a mailing hand encloser but was forced to retire eight years ago because her poor health prevented her from climbing stairs and lifting heavy boxes. Ethnic background: White British.

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Rose learned that she had heart failure fourteen years ago when she was hospitalised after a heart attack and had a stent inserted. She was told that the left ventricle of her heart wasn’t working properly. She has had two mild heart attacks since then, one of which she was unaware of. About four years ago she had a defibrillator put in her chest to regulate her heart beat. Sometime later it was not working properly and had to be replaced. 

Rose experiences breathlessness and tiredness, which seem to be worsening as time goes on. The breathlessness limits what she can do. She goes out less often and no longer travels abroad. She uses a stick to walk outdoors and hires a mobility scooter when out with a friend. She cannot play with her grandchildren outdoors. She has to walk slowly and uses oxygen when doing hoovering or ironing. She sleeps on her side propped up with three pillows to prevent breathlessness at night but sometimes needs her oxygen. Family members help her with some household tasks and take her shopping, as well as providing emotional support when she feels down. 

Rose was very disappointed to have to give up work when she could no longer climb stairs or lift heavy boxes, and would love to return to some sort of work. She moved from a three bedroomed house to a bungalow when stairs became difficult for her. 

Rose also has back trouble and osteoarthritis in her left shoulder but cannot have an operation for it as the risks of a general anaesthetic are too great for her heart. She has a lump behind one of her knees which further restricts her movement. Restless leg syndrome interferes with her sleep unless she takes a medicine for it. She sometimes feels sick, which she attributes to stress. She could not drive for eight weeks recently while suffering from dizziness, but this has now been cured with medicines. A duodenal ulcer was also successfully treated in the past. She is currently waiting for tests to find out whether she also has COPD (chronic obstructive pulmonary disease).

Rose’s heart condition is monitored by specialist heart nurses who visit her at home about once a month. Rose checks her own weight before each visit and occasionally measures her blood pressure with a home monitor. She also has a general check-up once a year with a nurse at her GP’s surgery. Her defibrillator is monitored by a machine at her bedside and the readings sent automatically to the hospital; she also has it checked at the hospital twice a year. She takes lots of different medicines for her heart plus painkillers for her arthritis and an anti-sickness medicine when necessary. Rose is very happy with the way she is looked after and feels reassured that the professionals are keeping an eye on her. She gave up smoking after her first heart attack and tries to eat relatively healthily.

Rose uses oxygen during the day when needing more energy to do things, and sometimes at night; she has portable cylinders delivered to her when she is away on holiday.

Tell me about, you know, how long each day you use that for, and when and how, and that sort of thing?

Well it depends what I am doing, the oxygen. From hoovering and dusting in here, or anywhere else except for the kitchen, because I can’t use it in the kitchen in case I’ve got the cooker on.

Oh, okay.

It’d go boom.

Right.

That’s when I use it. And the ironing—I get a bit puffy doing my ironing. That’s when I use it. And I find, you know, sometimes in the evening I’m a bit breathless, so I use it then.

[uh huh]

Cos I’ve got a home oxygen and I’ve also got bottled ones.

Oh okay. So is the home oxygen thing that generates…

It’s in my bedroom.

…that generates it’s own oxygen?

Yeah.

But it’s not something you can carry about, is it?

No [laugh].

No.

No it’s about that wide, about that high, but I have got bottles as well.

Right.

That you can carry about.

Okay they can’t be terribly…

But they’re a bit heavy.

Yeah, they can’t be awfully big if you can carry it around.

No, no, but they are heavy all the same.

Yes. So do you have those delivered regularly?

When I need them.

How do you go about ordering them then?

Just phone them up. I’ve got, I’ve got the oxygen lady number. 

Right.

So just phone them up and say, ‘Could I…’, you know.

Okay.

And I find if I want to go away, which I did do last year with my friend, I find that the oxygen people will deliver it wherever I am going.

Fantastic.

So that’s handy.

Yeah. 

Rose used a box with just one compartment per day and said she knew which pills to take in the morning and which at night by their appearance.

Do you have any clever ways of remembering to take all those tablets at the right times? Do you ever forget?

No. [Points to dosette box]

[ah ha] Lovely. Very pretty dosette box.

Yes. And there is only one that I have to take at night, well two. There’s amitriptyline and another one I have to take at night. There’s only two I have to take at night.

Ok, the rest in the morning.

And the rest in the morning.

Yeah. So those compartments are just one per day, yeah, one compartment per day?

Yeah.

So how do you know which ones to take at night?

Because there’s only the one left in it.

Ok, so you know when you look at them, by what they look like, which ones are the morning ones and which ones are the evening ones.

Yeah. I take them all, all in the morning and just one at night. And I know which one I’ve got to take at night, so I leaves it in there.

Yeah

And my amitriptyline I take.

Rose weighs herself just before her monthly visit from the community heart failure nurse so she can tell her the measurement.

Does she [community heart failure nurse] weigh you? 

No, she leaves me to tell her what my weight is.

Oh ok, so how often do you weigh yourself? 

Oh about once a month.

So just before her visit?

Yeah [laugh]

Yeah.

Then we work out whether it is going up or whether it is going down.

And is it fairly stable or…?

Yeah, yeah. 

Rose and her friend pay to hire mobility scooters to get around the local town; she thinks she may need one of her own in future.

You know, at least I can get out when I’m on a good day I go to my friend’s. We go to [town] and we hire these motor scooters and we get around town like that ‘cos there is no way I could walk around the town and nor could she. You know.

They are free though aren’t they?

No.

No?

No you have to pay £15 for a year and then on top of that every time you use one you pay a pound.

Oh, ok.

That’s, that’s in [town] a proper mobility.

Right

They all act different ways, you know. In [another town] you can go in and have one and pay whatever you like.

Oh really?

Yeah, so lots of difference between them.

I think later on in life I might need a scooter, mobility scooter, but I think that’s a bit further on yet.

Yeah.

Cos I don’t want to get one now because it’d like make me lazy.

Right

And I don’t want to do that. You know, if I can walk I’ll walk even if I have to stop half a dozen times wherever I am going.

Yeah

You know.