I went in to see Isobel at just before five o'clock. The bed was in the same position and Isobel had a towel over the bed, she was half awake. The nurse explained that there had been two major vomiting episodes in the late morning and lunchtime. Isobel had ate her porridge for breakfast normally but had missed lunch altogether as she had shown signs of possibly vomiting again until well into the afternoon. I had noticed as soon as I arrived that Isobel's left foot and calf had slid out of the bed. The carer said that since this morning the kind of foot first sliding out of the bed which I had warned them to look out for when Isobel first arrived had taken place a number of times; so far it had not resulted in a complete fall from the bed. Owing to the risk of Isobel falling out of the bed the re-orientation of the bed agreed yesterday had not been implemented: I agreed.

Isobel's neck and arm were less swollen. She seemed rather tired and listless. I read to her for about twenty minutes. At first the left leg was constantly sliding out of the bed, this had been a major problem at home in the summer and early autumn. Normally this would be countered by the simple expedient of a cot side on the bed, but this has in the past always caused a violent reaction from Isobel with attempts to climb over the side; this is why the special low bed has been used for her. At first she was sitting up in the bed, as a precaution against vomiting. After a few minutes I decided there did not seem much risk of this and lowered the head of the bed partly, this immediately stopped the sliding leg problem. Isobel seemed to relax a lot over the course of just a couple of minutes and at the same time her speech improved and she used short sentences instead of single words.

When tea arrived at about twenty past five, I had to raise the head of the bed again, this caused the sliding leg problem to start again, although not so badly as before. I fed Isobel four egg sandwiches, she ate these with no problems and did not need to be reminded to swallow. Compared to the half hour spent on chips and corned beef yesterday, the sandwiches took ten minutes and the jelly and cream afterwards only took five minutes. There were a few little problems with her beaker of tea, as a result of teeth being clamped together while drinking, but it was better than yesterday.

After tea we watched television for a while and then I read some more of her book to her. Once again the sliding leg problem was stopped by lowering the head of the bed. During this period Isobel was happy and relaxed; with no apparent consequences of the difficulties earlier. The reason for the vomiting remains unclear. We agreed to try soft foods tomorrow and see if that helps, although all the food she had today was soft. I did not give Isobel any fruit today in case it was rough on her digestion. I stayed until about twenty past seven, Isobel was so happy and relaxed that I forgot to manipulate her fingers!