I went in to see Isobel at five o'clock. She was wide awake and watching television (in a rather casual fashion).

There was a slight gap between the bed and the wall, she had managed to push Rocky down in the bed and drop her right arm down in the gap. Inevitably it was very swollen as the hand and forearm had been below the level of her body. I spent a few minutes holding the arm up and massaging it, without any significant result. I propped it up using the pillow and two bears so that the hand was above the level of most of the body in the hope that fluid would drain out.

I read a little more to her from her book - we passed the halfway stage yesterday, the progress has speeded up in the past three weeks. For tea Isobel had scrambled eggs and liquidised tomatoes followed by yogurt. She ate this slowly and steadily with no problems. I asked for the mug of tea to be provided without thickening, as it could always be thickened using the tub of thickener in the room. I gave Isobel the tea in fairly large mouthfuls and she handled these without any problem. I have suggested to the carers that they can try unthickened drinks, and thicken them if they have difficulty. All of us have had some difficulty with thickened drink in the past few days.

After tea Isobel watched television until half past six while I massaged her hand and forearm, straightening all the fingers except the second. Then I read her book to her until almost seven o'clock. Isobel watched television while I very slowly managed to straighten the second finger completely and flex it backwards and forwards for a few minutes. This does cause Isobel some discomfort and has to be done very slowly and gently. Isobel had no other pain today and was a little bit livelier than earlier in the week.

Before I left Isobel had another beaker of unthickened tea which she again drank without any difficulty. Today Isobel's speech was patchy, but good at times. Once again there were a lot of complete sentences, sometimes said very clearly. However there were also a lot of one word responses and a lot of mumbling and slurring. The quality of speech varied during the visit, with about four periods of clear speech separated by longer periods of limited speech. I made sure there was no gap at the right hand side of the bed before going home at twenty to eight. Isobel was still awake and watching television.