I got carried away while painting today and when I checked whether it was half four, found out it had just turned five o'clock, as a result I did not get in to see Isobel until half past five. Isobel was asleep when I arrived. She had eaten her breakfast and a pot of balanced supplement at the same time. She slept through lunch and only had a couple of spoonfuls from a pot of balanced supplement when she woke. She had not drunk much during the day.

Tea arrived a few minutes after I did. Isobel was rather difficult to wake and was very sleepy. She eventually ate all the main course. She was very slow but did not have any particular problems. She was unable to keep awake when trying to drink a glass of high energy drink. When she had drunk about a third of it very slowly I decided she might do better after a rest and let her sleep for an hour and a quarter. Isobel was difficult to awake and again very slow to drink, but she eventually finished all the drink - if she had drunk more earlier in the day I would not have persisted with this drink.

Isobel was unable to speak today. She seemed generally weak and tired, but at the same time relaxed. For some time she has had minor tremors of the left arm and leg, these were more noticeable today. Her right arm, which has been no problem for some weeks was swollen like a balloon again today. There was a small red mark on the skin at the elbow, although she has a pillow underneath the arm - possibly she has rested the arm with the elbow in contact with the wall. The nurse agreed that there was no explanation for the erratic swelling behavior of the arm. I manipulated and massaged the arm for about a quarter of an hour. Isobel went to sleep again and I went home just after 9pm.