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So after carefully negotiating with 2son that he will see the doctor if I arrange a precious home visit it is with trepidation that I put in the request for one. I had spoken to the doctor about his situation and have kept her updated, but there was never really any reason or value in having a home visit.

Naturally the doctor then proved unobtainable and it took 10 days to make the appointment. Not her fault; she’s the nicest doctor within the practice and the only one who actually listens to what you are saying.

So she came round on Friday. She was supposed to come on Thursday, but as 2son was resolutely fast asleep I thought I’d trick him and delay her for 24 hours. It didn’t work. He was asleep through her visit on Friday as well although he did hear what was said as he repeated it to his brothers.

He wouldn’t let her touch him, but I showed her his hands and she saw his hair. The marks on his hands that do seem to be diminishing are nit bites; I didn’t know they bit. She talked to him, saying that we were worried about his physical state and that he needed help. We also mentioned that he was Vitamin D deficient. Whether he would take supplements or not is another question. She was nice and sympathetic to him which is what I’d told him she would be.

We went back downstairs and had a little chat. Her first question was how do I cope with it which I appreciated. She said she’s seen scalps in worse condition but that the only option she sees is forcing him into hospital, for a short visit and assessment, including getting his hair sorted. She will talk to our consultant psychiatrist to see what’s possible.

The practical difficulties are at what point, legally speaking, does his personal neglect trump his rights to make his own decisions; at what point can social services step in and move him to hospital. In our team meeting after Christmas we decided it wasn’t yet.

The other issue of course is that if he is forced into hospital, kicking and screaming, what does that do to him? It may make him realise that he can’t do this for ever and he needs to decide to make changes in his life, or it may push him over the edge and take away his last safe refuge. It’s a horrible decision that we will have to make and the doctor did ask me whether I wanted that choice taken away from me. I said no. I’m very uneasy about the outcome of this and need to know more before I can make a decision, let alone anyone else. So another meeting is probably the next step.

I just don’t know at what point you say enough is enough and try forcing the issue. Two years is a long time to be out of circulation. He’s 14 now and missing out on so much life.