I went in to see Isobel at 5pm. She was soundly asleep when I arrived and had been deeply asleep most of the day. She ate half of her porridge for breakfast but all of a pot of balanced supplement after. She ate the main course of her dinner, but only a few spoonfuls of her dessert as she was falling asleep. Later in the afternoon she ate another pot of balanced supplement. In the brief periods when she was awake she had several drinks.

Late last night she had two more drinks after I had gone home; we are watching her drinking carefully but for much of the time it is no problem, the difficulties arise when she loses fluid through vomiting on days when she eats and drinks little, one day is bearable but a lot of effort must be made the next day to get fluid into her. In the final stages it is likely she will be on a drip for hydration.

Isobel was not difficult to wake. I began giving her a beaker of blackcurrant squash but tea arrived almost at once. Isobel ate the main course without difficulty although she was clearly very tired. She also finished the blackcurrant squash. We talked for a few minutes in order to give her a respite from swallowing. Isobel was not able to make any replies today. I slightly over-thickened the yogurt dessert but it was still very easy for Isobel to eat.

After another break, Isobel tried to have a glass of pineapple juice, but she was very tired and although she finished the juice it took forty minutes to drink. Immediately after she fell very deeply asleep. After washing her face I left at about a quarter past seven. Yesterday the Micra had petrol put into it for the first time since 2008.