Jean slipped off the sofa and couldn’t get up again. Even though she’s ninety-four, she’s been pretty mobile and independent, but just lately she’s been feeling a little off-colour, weaker in the legs, slightly nauseated. She tried everything to get back up, different angles, improvising with furniture, any object she could think of to help. Nothing worked, so she sat there, marooned on the rug, stroking the cat, wondering what to do. The phone was within reach, thank God, so that was some comfort. It was midnight, though, too late to call her grandson, she thought. He’s got work in the morning. He needs his rest. It wouldn’t be fair. So she made herself as comfortable as she could and stayed there until mid-morning, when he happened to pop round during break.
The doctor was called. She couldn’t find anything wrong particularly, although it would have been useful to get a sample of urine, to screen for UTI. Jean was adamant she didn’t want to go to hospital, and to be honest, the doctor didn’t think it was entirely necessary. She would make a referral to The Rapid Response Team, who’d come in and blitz the place with equipment. They could set up a micro-environment downstairs, with grab rails, a commode, zimmer frame and what have you. Take blood. Maybe get that urine specimen. And start on a course of physiotherapy to get things working again.
Jean was anxious, but the doctor said there was every reason to be optimistic.
‘I don’t want to go into a home,’ said Jean.
‘We’re not there yet,’ said the doctor, closing her bag. ‘Nowhere near.’
Jean’s daughter Ruth caught the next train down. She’d be there to look after her and superintend all the comings and goings.
‘We can get a wet room installed downstairs,’ she said. ‘Plenty of room to move about, a shower, raised toilet. It’ll be fine, mummy.’
‘Don’t let them put me in a home, Ruth.’
‘No-one’s thinking of that. All we’ll do is change things round a bit. Get a bed put in downstairs, so you can look out into the garden and see all the birds.’
‘That’ll be nice.’
My visit happens to coincide with Jackie, the OT. Jackie has been working in the community for a good many years. It’s always a treat to see her car outside.
I was worried about her the other day, though. When I came into the office she was being comforted by one of the nurses. As a senior practitioner, Jackie’s expected to act as department co-ordinator now and again – a hellishly stressful role, especially at a time of increased workload, decreased budget, a perpetual fog of re-organisation blowing through the department.
‘The director was here first thing,’ she said, ‘striding through like the Master of the bloody Universe.’ She blew her nose on a hankie. ‘Everything all right? Good! Good! I can’t remember the last time I saw him down here. Can you? I mean, can you?’
The nurse rubs her shoulder.
‘What’s the use?’ she said. ‘If I have to go, fine. I’ve got nothing to lose. But this? This is crazy.’
It’s a worrying development. When practitioners as valuable as Jackie are threatening to quit, you wonder how tenable the system is.
Out of the office, though, Jackie quickly recovers. The community is where she belongs, where she thrives. Like the best community health practitioners, she has a highly developed sense of where people are, what they need, and how best to give it to them. Her skill is so natural that in using it she heals herself as much as the patient.
After she’s introduced herself to Jean and Ruth she settles onto a stool to get the whole story, clarifying points when she needs to, making sure she knows exactly what happened, and what might be needed. Jean is a little guarded at first. Ruth explains her mum’s anxiety about losing her independence.
‘She’s lived here sixty years,’ she says. ‘She doesn’t want to go anywhere else’
‘Of course not,’ says Jackie. ‘Why would you? A lovely house like this. But you know what? There’s so much we can do to make it so you don’t have to move. That’s why we’re here. To help you stay at home.’
It’s reassuring stuff, but even I can tell that Jean isn’t entirely convinced. All those hours on the floor have dented her confidence as much as anything.
Suddenly, Jean’s cat, Arthur jumps up on Jackie’s lap. She immediately makes a fuss of it.
‘You’re gorgeous!’ she says. ‘Aren’t you? What a sweetie?’
‘He certainly rules the roost,’ says Jean.
‘I bet you do!’ says Jackie, tickling it under the chin. ‘I’ve got a cat,’ she says, reaching into her pocket. ‘D’you want to see?’
She gets out her phone and scrolls through to a stout tortoiseshell-and-white in a red, diamante collar. ‘Say hello to Marilyn!’ says Jackie.
‘Oh!’ says Jean.
Arthur reaches up and rubs his chin on the corner of the phone.
‘Arthur and Marilyn!’ says Jackie, turning the phone to show him. ‘A perfect match!’
By the end of the consultation Jean and her daughter are as relaxed as Arthur. Once again I’m struck by how great Jackie is. As an occupational therapist she knows the trade as well as anyone. She can size a mopstick rail or a bathboard without even thinking. She knows how to turn the most unprepossessing living space into a workable therapeutic environment. But beyond the technical limits of the role there’s something else, something warmer and even more useful, perhaps. And that’s her ability to align herself with the patient and their family, to show them she’s not just some official person descending from who-knows-where to make changes they may not understand or even want. She’s a human being, like them. She’s on their side. And when that’s understood, anything’s possible.
I tell Jean what I’m going to do next, shake her hand and say goodbye.
‘See you back at the office’ I say to Jackie.
She smiles and waves, but her expression darkens a little. Ruth comes in with a cup of tea. The moment passes.
‘I’ve got a dog as well as a cat,’ says Jackie, brightening. ‘Wanna see?’
‘Ooh – what sort?’
I leave them to it.