Like a country that declares war on its neighbours over a mountain ridge, Mrs Alderman has gone to war over her back.

It’s been the cause of a great many problems and pain for her over the years, and lots of clinicians of one sort or another have been involved. But there are some degenerative diseases that can’t be cured with medication or fixed with surgery, and the best you can do is try to ease the symptoms and find a way of organising your life in a more accommodating way. Unfortunately, Mrs Alderman’s response has been to declare war on everyone who has tried to help. Top of her list are the orthopods, who – according to Mrs Alderman – are a bunch of clowns with chainsaws. The orthopods are followed by everyone else who works in the hospital, Consultant to Cleaner, then the ambulance service, Community health teams, doctors, their reception staff, and really anyone who happens to be driving past, and then her neighbours, of course, and most of all, her family.

Her grandson Joey has been staying with her a few days since this latest discharge from hospital. His main contribution has been to restock the fridge freezer with ready meals. Much further than that he’s unwilling to go, and it’s hard to blame him, really. The flat is an absolute mess, and even if you brought in a team to straighten the place out, Mrs Alderman would have it back in its current state before they’d posed for photos and shut the door behind them.

This sprawling sense of chaos and complaint seems to attach itself to any contact with Mrs Alderman. I’d been sent in to conduct the initial assessment, which is essentially a fact-finding mission, to see how she is and what she needs from us. We’d had a frank conversation about emergency care support, what she could and couldn’t do for herself. She’d agreed that one care call in the morning might be helpful to get her washed and dressed; everything else – taking her medication, putting a ready meal in the microwave – she could do for herself. She could get out the chair by herself and take her four-wheeled walker out of the flat, down the corridor and back, so she was by no means immobile. And it was important to take regular exercise, however limited.

What happens next is that Mrs Alderman is on the phone that evening complaining that the carers hadn’t shown up, that the morning carer had done nothing but stand in front of a photograph of a dog she used to own called Rusty saying how nice ginger dogs were, for fack’s sake, and then pulled off her support stockings and took them down to the laundry room.

‘They’re in the dryer,’ she says.
‘Who put them in the dryer for you?’
‘How the fack would I know?’
‘Can’t Joey fetch them up?’
‘Why should he? He’s seventeen! And anyway, even if he did he can’t put them on for me, can he? And I can’t. Not with my back. I thought you were supposed to be facking helping…’

The carer isn’t around to ask about any of this. My suspicion is that Mrs Alderman removed her own stockings and took them to the laundry room herself, but the Coordinator is worried.

‘It might be easiest if you just go there tonight and sort her out,’ she says. ‘And try to clarify the situation whilst you’re there.’

* * *

There’s just one person in the laundry room, an ancient woman bent over a broken plastic trug, busy shovelling the contents into a machine. She looks up when I come in, supporting herself on one arm so precariously she looks in imminent danger of pitching head-first into the washing machine.
‘Hello,’ I say. ‘I’m Jim, from the community health team at the hospital. I’ve just come to pick up Mrs Alderman’s washing and take it up to her. I think she left it in the dryer.’
The woman straightens.
‘Oh! She’s got you running around now, has she?’
I smile and shrug.
‘That’s her lot, there,’ she says, nodding at another plastic trug, piled up with dressing gowns and throws and things and two blue support stockings artfully draped on top.
‘She puts too much in’ says the woman, tightening the scarf round her head, then leaning back in to her load.

* * *

When I knock and struggle through into Mrs Alderman’s flat, the TV is on full volume. She’s watching a film – marines fighting alien invaders or something. A helicopter gets blown to bits and there’s a close up of Aaron Eckhart looking worried.
‘Put it down there,’ shouts Mrs Alderman to me, as if we were under fire, too, pointing the remote at an undifferentiated heap of crap in the middle of the room.
‘Fack me, I don’t know,’ she says, muting the TV. ‘One minute it’s Sense and Sensibility, the next it’s facking aliens.’