Betty

Age at interview: 89

Brief Outline: Betty cannot recall being told about any kidney impairment and has no symptoms of it as far as she knows. She has occasional blood and urine tests but is not told the results unless action is needed. She has multiple health problems and limited mobility.

Background: Betty is divorced with three adult children. She has been a housewife and mother. Ethnic background: White English.

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Betty has a variety of health problems that impact on her daily life. Her mobility is limited due to pain in her back and weakness and cellulitis in her legs. She uses walking aids and a stair lift and can no longer do things she enjoys that involve standing, such as cooking. She has carers to help with personal care twice a day and is dependent on them and other people to take her out shopping or for medical appointments. She takes tablets to treat a hiatus hernia and diverticulitis and has to watch what she eats. She is also on blood pressure pills and an anti-coagulant since having a minor stroke. She takes about eight pills each morning but doesn’t mind as it has become part of her daily routine.

Betty cannot remember ever being told there was anything wrong with her kidneys and has no symptoms of kidney disease as far as she is aware. She has occasional blood and urine tests done, as well as having her blood pressure checked annually. She is never told the results but assumes that if anything was seriously wrong the doctor would call her in. She is happy not to know as long as there is nothing seriously wrong. Her most recent blood test was about two months ago, when the practice nurse told her she was overweight. Betty believes she eats relatively healthily and cannot see how she could reduce the amount she eats, and that her weight gain is due to her limited mobility, which prevents her from being active.

Betty tries to avoid going to the GP unless it is really necessary. In the past she has found it difficult to organise appointments at her surgery because she was expected to phone on the day she wanted the appointment but had to book a carer in advance to take her there. However, she has since been told that she can book ahead because of this. She used to be able to call a doctor out to see her at home using an alarm button that she wears on her wrist, but the service has now been reduced to responding to emergencies only and she has been told to phone 111 if she wants advice from a doctor.

Betty likes cooking for herself but doesn’t do it much these days because of pain from a back problem when she stands for any length of time.

Then I had the trouble, as I say, with my spine, and that was, that was about, can I say six years ago, about six years ago. And I had to have an operation and, oh I can’t say, can’t say the name of the doctor. I was operated on by a neurosurgeon and he removed all the pressure from my, from two of the lobes of my spine and he hid a lot of nerves and things like that. But it, I was told it wouldn’t last forever and he couldn’t do any more. But it has been very good but now it’s starting to feel really bad again. I can’t, if I stand for a while, I can’t, I used to like making cooking and doing cakes, if I stand for more than like, I get this terrible pain and I have to, it’s like , it’s like somebody jabs your teeth when you’ve got a bad tooth, somebody jabbed. I have to suddenly go like that and sit down. It goes. It does go and then it’s okay again, so it’s that sort of thing I’ve got. I have good days and bad days with all of those sort of things.

Yes and she weighed me and I eat, as I say, very little and I can’t cut down on what I eat because I really choose what I eat, you know, and I always have porridge in the morning. I must admit I have a little brown sugar on it, I mean I know that. I have, try and, midday I have, I used to have it in the evening but it’s, I couldn’t cope with it in the evening, after a while, so I have it at lunchtime, you know, and I always have something. A lot of chicken. I have fish. I like those packs, do you know, do you know the ones? They’ve got all the chopped up green stuff and everything in.

You know, I have that. I like that with perhaps some chicken or something like that. If I make, I make a soup, I do it, I make my own soup, like, you know, I just shove everything in. I do like cooking and everything, you know, but, as I say, with my back, I have to have to keep sitting down, so I don’t do much these days.
 

A nurse told Betty that she is overweight, but as she is relatively inactive because of mobility problems and already eats healthy food in small quantities, Betty doesn’t know what else she can do.

Let me ask you…

Yeah.

…when the doctor said to you recently that you were overweight…

Yes.

Was she suggesting…

No, it wasn’t a doctor. It was the nurse.

Oh was it?

She said, “You you’re getting quite obese.”

She used that word?

Yes.

Really?

Yes and I said to her, “I’m very sorry but it isn’t what I eat.” I said, “It’s because I can’t walk or do anything.” I’ve always been so active, you see, and I’ve always walked and walked and walked. Well, of course, stopping that and, as I say, I just can’t cut down any more on my food. Sometimes I, as I say, I’ll have some lunch and then afterwards I won’t , sometimes I don’t even have anything else. I might have just a , sometimes I have a small sandwich about tea time but sometimes I just have a sort of small slice of cake, and that’s it. That that’s what I eat, you know…

…it’s well, my carer, when, you know, when she comes and, she knows what I eat, you know, so it’s no good me trying to bluff because, and say I don’t eat this and that and the other, she knows exactly what I eat and she said to me, “Betty, you can’t cut you can’t cut down anymore.” So….

Was the practice nurse suggesting that you should change your diet in some way?

No, she didn’t say. She just said I was overweight and getting on towards being obese.

So, but she wasn’t suggesting you should do anything?

No, no. Well, I, but the food I eat is the healthy food.

Chicken, you see. Make my, sometimes I have soup. I buy a tin of soup for an emergency. I have a couple of tins in the cupboard. But usually, I make my own soup and, as I say, it’s a lot of, I like green stuff and I like, well, I do have potatoes, I must admit, I do have potatoes, but I don’t know what else I, you know, I can do.