This is the situation. Deidre is a ninety year old woman blessed with good health, for the most part, living independently in a warden controlled flat, with only a domestic to run the vacuum over and have a bit of a tidy up on a Monday, and one or other of her sons to go shopping with her every Wednesday and the occasional days out. Unfortunately, Deidre suffered a series of falls over the last few weeks, the first almost inevitably leading to the second, and then a third, and although she escaped with nothing more serious than extensive bruising, her confidence is shot. She’s taken to her chair. There’s been something of a decline.
Deidre’s been referred to us by her GP for the usual interventions, the physiotherapy to get her strength back, the equipment to help with mobility, pharmacist to review meds, social worker to look at care needs and even a mental health nurse to test her cognitive function and chat about how she’s feeling. It’s all pretty comprehensive.
The trouble is, if the patient doesn’t want any of these things, and they’ve got the mental capacity to make that decision, there’s not much you can do about it.
And of course, Deidre doesn’t want any of these things. She won’t even consider changing her chair.
I’m not saying Deidre’s chair doesn’t look comfortable. It’s a low, luxurious, thickly-padded affair, more like a giant baseball glove than a piece of furniture. It’s the kind of chair you drop back into from a height, and land in a fixed position, and then face as much of a struggle to get out again as a breech-birth baby lamb.
Deidre’s two sons, Derek and Ian, are both here. We’ve all tried to persuade Deidre to sit somewhere more suitable. There are sensitive and subtle issues at stake, though. I’m sure it’s less about a chair and more about what it stands for, a loss of self-determination, increased vulnerability and dependence – even just an acceptance of her own mortality. It would be easy to make the chair into a symbol and lose the battle, like those stories you hear about regiments being sacrificed just to hold on to a tattered flag.
I retreat, and let the sons have a go.
Watching them, you’d never guess they were brothers.
Derek is thin, measured, quietly economical. He moves like an ascetic community monk in jeans and sweater, patiently hearing what everyone has to say, and then considering his response, hugging his knee, gently rocking backwards and forwards.
Ian is red-faced. I want to put my hands on his shoulders, take a breath, and then undo the top button of his red checked shirt, because otherwise I’m worried his head will explode. He’s so hot his glasses keep steaming up, and he wipes them clear with a handkerchief he whips out of his pocket. He even has angry feet. For some reason Ian’s not wearing any socks, and I have to say I’ve never seen such wild and livid toes, the kind you might expect to see on the feet of a devil, stomping about the cinders in Hell’s front room.
‘Will you listen to the guy?’ he says, shoving his glasses back on and then waving the hankie in my general direction. ‘That’s why he’s here, Mum! To help get you better.’
‘I’m not getting rid of this chair!’
‘But it’s not suitable, Mum! I wouldn’t be able to get out of that thing, and I’m not ninety.’
‘No. You’re not.’
‘Why won’t you sit in the other chair?’
‘Because it’s not mine.’
‘You can’t spend your whole life down there.’
He storms off into the kitchen.
Derek considers for a moment.
‘It mightn’t be for long, you know,’ he says. ‘Just until you get the strength back in your legs.’
‘I’m not getting rid of this chair.’
‘No-one’s suggesting you get rid of it, Mum. We’re just saying it’s a good idea if you use Dad’s old chair for a while. It’s easier to get in and out of.’
‘This is my chair.’
Derek smiles at me.
‘Mum’s always been very – how shall I put it? – sure of her own mind,’ he says.
‘I can see that.’
It’s always interesting to see the differences between siblings, the roles they’ve been allotted to play. Derek the calm, Ian the furious. I wonder if it’s conditioning, or simply down to genetic luck. Was there a point back in time when the young Deidre and her husband decided in some unconscious and unspoken way, that Derek was fundamentally like this, and Ian essentially like that? Or is it all down to the pull of a handle on a genetic fruit machine? The spinning of ancestral drums, the lining up of chromosomes, flashing lights, oohs, aahs, and a baby with angry feet spilling out.
‘I’m amazed you can keep your cool!’ says Ian when I go into the kitchen to ask him something.
‘It’s easier when it’s work,’ I say. ‘You should see me with my mum.’