Mr Cooper looks dead, hunched over in his armchair, his dressing gown gaping, his wasted chest waxy in the meagre light filtering through the curtains.
‘Mr Cooper?’
I flip the bakelite switch on the wall, which fizzes and snits with blue sparks.
‘Shit.’
I flip it off again.
Mr Cooper makes no movement. The only sound in the room is from the gas fire, purring gently next to him.
‘Hello?’
I go over to him and crouch down, placing a hand on his arm.
‘Mr Cooper?’
He nods, and opens one eye.
‘What is it? Why don’t you go back to sleep?’
‘Mr Cooper – it’s Jim, from the hospital. I’ve come to see how you are.’
He closes his eye again.
‘Mr Cooper…?’

Even if I hadn’t been here several times in the last few months, I’d know he’d been on our books before. There’s a perching stool over in the corner, buried beneath a pile of junk; a pressure relieving cushion and a walking frame dumped on the unused bed along with a mountain of discarded clothes and bags of assorted creams and bandages, and through the open door to the adjoining bathroom, a bath-board acting as an extemporary shelf for a stack of buckets, boxes and blister packs of medication. There’s been a marked deterioration, though. The flat was always a mess, but in the six months since I was last here it has slumped into something worse. The only signs of clarity, of humanity, are an emergency shop in a cleared space in his filthy little kitchen, the barest essentials to keep a person going, and by the side of his armchair, a green drugs bag with his TTOs, discharge summary, and a DNACPR in a clear plastic folder, neatly signed and dated.

Because, of course, the difficulty with Mr Cooper is, well, Mr Cooper.

It had always been an uphill struggle to get him to agree to anything. A little shopping from time to time, the barest minimum of wound care, the occasional knock on the door – these were only ever achieved in the face of his unrelenting refusal to accept help. The dangers had been explained, of course, with sufficient checks to show that yes, Mr Cooper did have mental capacity to make these decisions. And the result was that despite everyone’s best efforts, over the months and years the scenario had played out with a cruelly inevitable decline. The best any of us could ever do was try not to lose touch completely.

Like a sly, slow-moving, community health chameleon, I try to persuade Mr Cooper to let me take a few observations. Still, it’s more a testament to his failing health than any social skill of mine that he agrees to the barest minimum, and lets me put some barrier cream on his sore areas.
‘There!’ I say, peeling off my gloves. ‘That’ll be a little more comfortable.’
The readings aren’t good, though. And my luck certainly doesn’t stretch to an ambulance.
‘Hmm. I must admit I’m worried about you, Mr Cooper.’
He starts in the chair, as if someone had given his wasted shoulders a gentle shake, then he slumps back into his mausoleum-grade torpor.
‘Just go to sleep,’ he says.
It sounds as if he’s talking to a naughty child, and for a minute I wonder if it’s a sign of increased confusion. If it was, his capacity would be compromised and I could get him forcibly admitted. But as soon as I explore that option, it becomes apparent that it’s just a figure of speech. He’s referring to himself in the third person. He knows exactly what he’s about.
I explain to him as clearly as I can why I’m worried, why I’d like to re-admit him to hospital, and what might happen if he doesn’t go.
‘No,’ he says. ‘Thank you.’
There’s nothing more to be done.
I put some food and water by his chair, move the commode a little closer, and let myself out.
After I’ve put the key back in the keysafe, I phone the office and let them know how things stand, my concerns about the faulty light switch, the gas fire, the environment, the whole dismal scenario.
‘Sounds depressingly familiar,’ says Michaela. ‘I’ll get the council on to the electrics. In the meantime – Jim – I’ve got another job for you…’

*

Later that day I’m asked to go back to Mr Cooper for a welfare check.
It’s completely dark when I let myself into the flat. I don’t want to use any of the light switches, so get out my torch.
‘Hello? Mr Cooper…?’
I train the beam on his armchair.
Empty.
‘Hello…?’
It’s strange, how different the place is by torch light. I hadn’t noticed that behind his armchair is a workbench, with vices, a scattering of fine tools, and a dismantled model train.
‘Mr Cooper…? It’s Jim, from the hospital…’
Two rooms I’d not been in before. One filled floor to ceiling with books, the other with metal shelving, neatly lined with old glass storage jars, their yellowing contents indistinguishable behind a coating of dust.
‘Mr Cooper…?’
But the flat is empty.

Going back to the front room, I notice for the first time that Mr Cooper’s emergency button has been unfastened and draped neatly over the back of his chair. Seeing it there, isolated like that, in the direct light of the torch, that precise circle of red in its plastic ellipse, talismanic, an upturned eye, it’s easy to think that after all those years of resisting and signing forms and saying no and just go to sleep and please leave – the very instant Mr Cooper gave in and pressed the magic button, without any further hesitation or debate about the matter, he completely and instantly vanished.
And that was the end of the matter.