I went in to see Isobel at mid-day. She did not have a good morning, eating part of her breakfast and nothing else. It had not been possible to get her to take her morning medication - this is mixed with water and thickened and provides 200ml of fluid.

I started to give her the medication but it was very slow. Isobel could not speak today. She was fairly unresponsive in all ways. Her lunch arrived after a few minutes and I begun alternating spoonfuls of the strawberry flavoured medication with the main course. Over the course of an hour Isobel took about half of her medication and three quarters of the meat, half of the swede, half of the mashed potato and a quarter of the Brussels sprouts (all puréed of course) amounting to half of the main course altogether. It was a very difficult job to get Isobel to eat this as she was having great difficulty swallowing.

After an hour I abandoned any hope of getting Isobel to eat more of her main course. We concentrated on getting her to finish the medication, which she eventually did. Then I began to give her some high energy drink. She drank half of this in less than half an hour but then fell very soundly asleep. It was clear she would take nothing more in the near future.

I left at two twenty, taking with me the Kalanchoe plant which has almost finished its second burst of flowering and needs re-potting. This sort of day, when all the time with Isobel trying to ge food or drink down her, is very depressing.