morag’s bad dream

Jack’s directions to the block are a strange mixture of precise and vague.
‘We’re the one with the flapping green canopy,’ he says. ‘The last brick building on the right as you head up from the sea. No – wait a minute. What am I saying? Second to last. But hang on – there are lots of brick buildings between us and the top road. But anyway. Flapping green canopy. Look for that.’

He’s right about the canopy. I can only think that all the recent bad weather has partially torn it from its fixings. I locate Jack and Morag’s flat among the forty or so others, press the buzzer, and wait – for so long I wonder if it’s working. Just before I press it again a voice crackles on the speaker.
‘Hello, Jack,’ I say, leaning in, struggling to be heard over the wind and the canopy. ‘It’s Jim. From the hospital.’
‘Right you are, Jim. Come on up.’
He buzzes the door and I push through.

Just as I turn to close it I see a woman walking up the path. She’s zippered to the chin in a metallic blue anorak with just her face showing from the hood of it, carrying a cat patterned shopping bag in one hand and a Cornish pasty in the other. I hold the door for her and wait. She doesn’t acknowledge me at all, just walks and eats, walks and eats, dividing her attention equally between the pasty and the pavement. She’s so methodical about the whole thing she reminds me of a cartoon robot, analysing a sample of human food whilst she makes her way back to the mothership.
‘There you go!’ I say, as she plods through the door. ‘I can see you’ve got your hands full.’
She walks past me without making the slightest acknowledgement – so ruthlessly I imagine she would have simply smashed through the door if I hadn’t been standing there to open it – scattering pastry crumbs as she heads for the lift, which happens to be  ready waiting. By the time I’ve picked all my bags up, both robot pasty woman and lift have gone.

I walk up.

Jack looks exactly as he sounds: pressed trousers, green cardigan, small check shirt and tie, silvery hair flowing backwards like the ripples in a crinkle cut chip.
‘Found us alright?’ he says, silently closing the door. ‘Morag’s in the sitting room. Last door on the left. Sorry – my left. As you look at the window.’

You would absolutely match them if they were playing cards. Morag is a watchful, bird-like woman, perfectly turned out in a silk blouse and tartan skirt, with crinkly hair that goes side to side rather than straight back.
‘Who is it, Jack…?’ she says, gripping the arms of the armchair.
‘Just a nurse from the hospital, darling,’ he says. ‘No need to be alarmed.’
She turns her clear blue eyes on me and waits to see what I’ll do.

‘So – how are you feeling, Morag?’
‘How am I feeling?’
‘Yes. In yourself.’
She frowns at me, as if that’s the most extraordinary thing anyone’s ever asked her.
‘I know you’ve had quite a day of it,’ I say.
‘Have I?’
‘Well – coming home from the hospital. After a long stay. Must be nice to be home.’
She shakes her head, sharing her bewilderment between me and Jack.
‘It’s alright, darling,’ he says. ‘Nothing to worry about. You’re home now.’
‘I am, aren’t I?’
‘Yes. And it’s lovely to have you back.’
Jack smiles at me with a level of control as perfect as his hair.
‘I’ve been sent by the hospital just to make sure you have everything you need, Morag,’ I say. ‘And to see what we can to do help. By way of equipment, physiotherapy, nursing – anything really. We want to make sure you’re safe, that’s all.’
‘I have everything, thank you,’ she says, with great caution.

Whilst the laptop warms up, and to keep the conversation going, I ask Morag if there’s anything troubling her.
‘There is, actually.’
‘Oh yes? What’s that?’
‘I’ve been having bad dreams.’
‘I’m sorry to hear that, Morag. What kind of bad dreams?’
‘There are these people. Young people. And they keep wandering in and out. Sometimes they look at me. Sometimes they don’t. Sometime they walk straight past, carrying things. Pushing things. And I haven’t the faintest idea who they are or what they want.’
‘That was the hospital, darling,’ says Jack, patting her on the hand. ‘That was the hospital.’

carp in a cap

Bill is standing so close to me I can feel his breath. With his thick, downturned mouth and straggling beard, he looks like a specimen of ancient carp, navigating the river by use of feelers.
‘D’you know what this badge is?’ he says, rolling his eyes upwards, directing me to his cap.
I have to pull away to focus. Right in the middle above the brim is a tiny enamel pin badge, two flags leaning out either side of a date.
‘I don’t know. A civil war thing?’
‘Nine eleven,’ he says. ‘The day the towers came down.’
‘Ah!’ I say, frowning a bit closer. ‘Of course.’
‘We used to sit up there, me and Rita. They had chairs and tables and everything. You could look out, right across the city. The Empire State. You could look down on it.’
‘Was that on the North tower or the South?’
‘I don’t know,’ he says. ‘One of them.’

I feel a little cornered by Bill, if I’m honest. I’m waiting to bring the hoist back in whilst the physio and another carer make Bill’s wife Rita ready for the return journey from the armchair to bed. Rita has advanced dementia. When we hoisted her from the bed she held the straps as lightly and happily as a child in a fairy story being carried off by a balloon.
As soon as there was room, Bill had shuffled in from the kitchen.
‘I travelled a lot, y’know.’
‘Did you?’
‘The Far East. Russia. United States. Everywhere.’
‘What were you? A spy?’
‘No. I was a courier. I took the job when I retired. They paid me to carry important letters round the world. I don’t know what was in ‘em. Could have been anything. Egypt. Japan. You name it. All the security people got to know me. They’d see me coming and they’d be like…’ He nods slowly and raises a finger in the air.
‘Sounds great,’ I say.
We both watch as the physio and carer make a few final adjustments to the sling.
‘Sixty years we’ve been here,’ says Bill, thrusting his hands deep into his pockets and leaning in to speak directly into my ear, as if this was a thing as confidential as any of the letters he carried. I’m tempted to say: what – leaning on this hoist, d’you mean? but instead say: ‘Have you really? I bet you’ve seen some changes.’
He leans back.
‘There used to be an abattoir next door.’
‘Oh yes? How was that – living next door to an abattoir?’
‘They killed pigs. Cows. Mostly pigs.’
‘Oh.’
‘You could hear them screaming. They used a fixed bolt, y’know? Through the head.’
‘And if that didn’t work I suppose they let them off,’ I say, nodding at the physio who’s waving me over.
‘Oh but it did work, though,’ says Bill, taking off his cap and slowly pushing his fingers backwards through his greying hair. ‘It worked a treat.’

diving in

‘Just do what you can,’ Michaela the co-ordinator said. ‘It’s a tricky situation. Jeremy’s wife Serena has got dementia, Jeremy’s the main carer. The doctor says Jeremy has to go to hospital in the next few hours, something about his breathing. Apparently none of the rest of the family can step in, and Serena’s too volatile to go to a respite bed, so what they’re saying is she’ll just have to go to hospital with him in the ambulance. Which is a terrible idea, obviously. If you could just go there and try and sort something out that’d be great. You’ve got a couple of hours before the ambulance arrives. Good luck.’

* * *

When I lived in London I used to go swimming in the ponds on Hampstead heath. I’d try to keep it up as late as I could through the year, not just in the easy summer days, but on into October, November, December, when the weather drew down, and the crowds thinned, and the whole thing started to feel like a wanton act of madness to take my clothes off and walk outside the changing rooms into the frosty air, let alone walk to the end of the jetty and throw myself in the water. It didn’t matter how many times I stood there with my toes curling and flexing over the edge of the concrete, staring down into the dark green water; it didn’t matter that I’d done it only a few days before, and everything had turned out okay, I hadn’t drowned or frozen to death, and I’d even started to enjoy it, that electric buzz around my body when I climbed out and hurried back inside. Despite all that, the seconds before I dived in, I would still be gripped by the same sickening feeling that this was crazy, tantamount to suicide, and what I really needed was for someone to rush out, grab hold of me, and save me from myself.

* * *

I’m reminded of that end-of-jetty feeling as I reach out to ring Jeremy’s bell.

Anna, Serena’s tearful, middle-aged daughter, comes to the door, barely stopping long enough to hear me introduce myself before turning around and hurrying back into the living room. I stand in the oak panelled hallway and tried to get my bearings. A substantial house, with a large number of doors leading off into various rooms, and a forbidding staircase rising in the middle of it all. Elderly people are busy coming and going through the doors or walking up or down the staircase, each one of them preoccupied, mumbling or cursing to themselves, holding bits of paper or bags, a shirt, an overcoat, bumping into each other, shouting out – so many of them I’m suspicious, and wonder if it this isn’t some kind of set-up, and they’re swapping jackets or hats backstage, finding a different door or staircase to walk through or down again, like a manically paced but well choreographed West End farce.

Bracing myself, I go through to the kitchen where some of the relatives have gathered round the table with Serena at the head end. Serena has the quick movements and filmy white eyes of a large, albino crow, hopping from the table to the cabinets and back, randomly picking up bits of paper, blinking down at them uncomprehendingly, then carrying them back again.
‘Try to settle yourself, Serena’ says one relative.
‘Come on. Drink your tea,’ says another.
But Serena sees me approach and hops up to speak, as fluently as if we’d only broken off a moment before.
‘…you see, I can’t be bothered with all of this!’ she says, looking up into my face, tipping her head from side to side and blinking rapidly, as if she can’t decide whether to talk to me or peck me up like a worm. ‘It’s such a nuisance! I’ve got so much to do today. D’you see?’
‘Yes. I can imagine it must be pretty stressful.’
The relatives fix me with a collective frown.
‘Sorry! Hello! I’m Jim, from the hospital response team. They’ve asked me to come and see if there’s anything I can do.’
‘Well unless you’ve got a magic wand in that bag I’d say no,’ says one elderly man.
‘Or a tranquiliser dart,’ says another. ‘Welcome to the madhouse.’
Just then Jeremy wanders in. He’s a morose, red-faced man in pyjamas and dressing gown, trailing the cord of it behind him like a tail.
‘They’ll be here in a minute,’ he says. ‘What have you done with my medications?’
One of the relatives sighs and pushes himself up from the table. Another one appears briefly behind me in the doorway, then disappears just as quickly.
‘Come in to my study and we’ll chat there,’ says Jeremy.
I follow him, avoiding the tail.

Jeremy’s study is a plush room, like something out of a gentleman’s club, with brass fittings, spot-lit paintings, and antique rifles and muskets on display along the walls. Jeremy goes to sit behind an enormous desk, complete with green velvet pad and a crystal glass ink and pen stand.
‘You know the situation I take it?’ he says, putting some half-glasses onto the end of his nose and then tipping his back to look at me. ‘Hmm?’
‘Essentially – you have to go to hospital, but you’re Serena’s main carer and there’s no-one else to step in and look after her.’
‘And I mean no-one,’ he says. ‘She gets very distressed by any change, so it’s out of the question for her to go to a nursing home. I’ve told them this. Out of the question! And neither can she be left on her own. She’d burn the house down in a matter of minutes.’
‘How about arranging for a twenty-four hour carer?’
‘No,’ he says. ‘Any strangers in the house and she reacts. She’s very difficult. I’ve had years of it.’
‘The trouble is, Jeremy, going to hospital with you is the worst thing that can happen. You’ve been to A and E before. You know what it’s like.’
‘I know exactly what it’s like. It’s hell on earth.’
‘They do get very busy there, that’s for sure. And that’s why Serena can’t really go with you. She’ll be sitting in a chair for hours and hours whilst you’re on a trolley, surrounded by potentially distressing scenes. And there’ll always be the chance she might wander off…’
‘Well that’s it! I’m not going, then!’
‘The doctor thinks you should go, though. It won’t help Serena if you get worse, will it? So what I suggest is you look at getting a twenty-four hour carer to stay whilst you’re in hospital. They’re trained to look after difficult patients. She’ll be happiest and safest that way. It’s the best solution, Jeremy. I’m just being perfectly frank with you here.’
I can see him weakening.
‘But where would they sleep?’ he says.
‘I’m sure you could squeeze them in somewhere.’
‘And how much would it cost?’
‘I think it’s about twelve hundred for the week.’
‘One thousand two hundred pounds?’
‘I think so. It’s just a little more than a residential home would be – but you’ve got the benefit of Serena being at home in familiar surroundings, so she’ll find it much less stressful…’
He huffs and grumbles, pushing papers around on the desk a moment, then shoots me a look as directly as if he’d rammed the words into the muzzle of one of those muskets and fired them at me.
‘And who pays for all this? Me, I presume!’
‘I think it’s worth it. For peace of mind. And hopefully you won’t be in hospital long.’
‘Hmm. Well. Get me some actual figures, would you?’
‘Certainly.’

I phone the office to talk to a social worker about it. She rings me back five minutes later with the name and number of an agency who’d be able to step in at short notice.
‘I can’t pay up front,’ says Jeremy. ‘I’m good for the money as you can probably see but I’m waiting on a deal coming through. It’s complicated. A cash flow thing.’
‘Fine. I’ll talk to the manager of the agency and see what he suggests.’

The manager sounds cautious.
‘We want to help,’ he says. ‘Of course we do. But we need at least half up front as a gesture of goodwill. And then a guarantor of some description for the rest. It doesn’t look good for a care agency to be chasing down clients for money, y’know?’
‘No. I can see that.’
I tell him I’ll call him back after I’ve talked to the family. Back in the kitchen, one of them says he’ll stand for the other half. ‘ Anything to get this bloody mess sorted.’
In the study again. Jeremy says he can only manage a cheque for four hundred, and asks if I’ll haggle with the manager over that.
Meanwhile the ambulance arrives; two paramedics crash into the study carrying resus and obs bags and an ECG.
‘Where’s the patient?’ says the first.
Jeremy starts shuffling papers on his desk, avoiding eye contact.
The paramedics turn to look at me, holding the phone in the middle of the room.
Serena hops in, pursued by three relatives, one of them The Guarantor, who frowns at me and holds his hands out, palm up.
The phone starts ringing in my hand. I hold up a finger for silence.
‘Just give me a moment!’ I say. ‘One moment…’

the walkers

Norman and Diane have walked a very long way. They’ve walked the Pennine Way, Glyndwr’s Way, The Pilgrim’s Way and The Ridgeway. They’ve walked Hadrian’s Wall and the coast of Devon & Cornwall. They’ve walked the length of the Thames from Trewsbury Mead to estuary. They’ve walked from Land’s End to the other end, and they’ve got journals filled with watercolours and photographs to prove it. But today Norman faces one of the most challenging journeys he’s ever undertaken – the short ride in a hoist from chair to bed.

‘Don’t worry, darling. It’s okay,’ says Diane, stroking the backs of his hands as the hoist rises up a little and the sling straps tighten. Norman wriggles anxiously from side to side and kicks out his legs. ‘Try just to relax and go with it,’ she says.

It’s a manual handling dilemma. Norman isn’t so debilitated that bed care is the only option – which would lead to further deconditioning, the risk of pressure damage and so on – but then again, after his recent illness, neither can he transfer safely with just a zimmer frame and the assistance of two. A stand-aid would be the only other option, and that’s certainly on our minds as we try to reassure him before we lift him out of the chair. If it fails, we’ll be forced to get him back to bed by some other means, and then try to build up his strength and confidence over time with a home exercise programme. For now, the hoist is the best option.

‘It’ll help when he has regular carers, a routine and so on,’ says Brigit, the Occupational Therapist. ‘They’ll be a lot slicker than us.’
‘I think there’s just been a lot going on today, hasn’t there, darling?’ says Diane. ‘I think you’re just exhausted.’
He looks up at her, his legs sticking out, his hands gripping the brightly-coloured straps in front of him.
‘Where are we off to now?’ he says.

boomerang

Brenda’s daughter Emma shows me in. She’s polite but thin-lipped, pale and precise, like someone with a hundred other things to do and none of them as stressful.

‘Mum has dementia and doesn’t know it,’ she whispers in the kitchen after letting me in the back door. ‘It’s been getting worse this last year. She’s been found wandering in the street a few times, brought back by neighbours and police. She lives with my brother, Tom, but they don’t get on. Tom had a Jack Russell, Billy. Mum used to look after him when Tom was at work, but she kept tripping over it so we…erm… we made other arrangements.’

It sounds ominous, but I don’t get a chance to ask what she means, because Emma turns and walks through into the lounge.
‘The nurse is here, mum.’
‘Nurse? What nurse?’

Brenda is still sitting in the chair she was helped into by the ambulance when they brought her back from hospital. She’s resolutely straight-backed, like someone who got delivered to the wrong house by mistake and doesn’t feel able to tell anyone.

The way the seats are arranged means that Emma is on the right and I’m on the left, with Brenda the focus of our attention. It’s an unfortunate set-up, the community health version of good cop / bad cop, with me smiling and nodding and making encouraging noises, tapping away on the laptop, and Emma perched quietly on the opposite side, picking her mother off every time she glosses over the facts, which is all the time, of course. Even though I’ve got every sympathy for Emma, still I’d rather she was in another room. I can’t help glancing at the empty dog crate with a photo pillow of a Jack Russell at one end, Billy transmuted from pet to soft furnishing.
‘Where’s Billy?’ says Brenda. ‘I’ll take him for a walk later.’
‘Billy’s gone,’ says Emma.
‘Gone? Wha’d’ya mean, gone? Gone where?’
‘We talked about this, mum He kept pulling you over.’
‘Don’t be so soft.’
‘Don’t worry about Billy, mum. He’s out of the picture. Okay? When you went into hospital. He’s been taken care of. We’re talking about you now.’
‘I don’t care about me.’
Emma sighs. Zips her fleece higher up her neck. Pushes her hands deep into the belly pockets of it.
‘No,’ she says. ‘And that’s the problem.’
‘I’m sure there’s some way you can get to walk…erm… the dog, Brenda. With someone else, maybe? You know? To hang on to?’
I glance at Emma. She closes her eyes and twitches her head from side to side.
I smile and look back at Brenda.

If she heard any of this she doesn’t let on. She’s switched her attention to an old, dented, dark-wood boomerang that’s hanging from a nail on the opposite wall.
‘D’you know what that is?’ she says.
‘A boomerang! Looks like a proper working one. Not the souvenir type.’
‘My father brought that back for me. He was in the merchant marine.’
‘Was he!’
‘Yes. The merchant marine. And he brought that back for me. A lovely boomerang.’
‘Did you ever take it over the fields and throw it?’
Brenda laughs.
‘What? It’ll take the top of your head orf! Like a boiled egg!’
‘I think you’re supposed to catch it.’
‘Are you? Well I’m sure I don’t know’
Emma sighs. When I look at her she raises her eyebrows.
‘Anyway. Let’s get back to seeing how we can help,’ I say.
Brenda looks sad again.
Stares at the dog crate.
‘I think I’ll take Billy out later,’ she says.

behind the glass

The almshouse cottages are laid out on three sides of an immaculately kept croquet lawn. The white enamel paint is a little chipped on the hoops, showing patches of dark iron underneath. Maybe that’s through being struck with croquet balls over the years, but I’ve never actually seen anyone play. In fact the most life I’ve ever seen on the green is that crow, hopping around in the misty rain like a sexton in a frock coat, his hands under his tails, inspecting the lawn for worms.

Helen won’t be out playing croquet anytime soon, rain or shine. It’s enough of an adventure just making it from the armchair to the bathroom and back. I can imagine she would have been good at it though, sometime before the war, bobbing down to line up the final shot, giving the ball a hearty thwack, snatching off her cap, throwing it in the air, and then jogging over to the judging desk, the croquet mallet balanced on her shoulder. But of course, she wouldn’t have been living in an almshouse then. She would have been in nursing accommodation in London, excitedly practicing the air raid drill, hurrying out to dances, learning her craft.

Seventy years or more have passed since then, and Helen’s world has contracted to the size of a single room. It was small to begin with, but in an effort to stop her from falling the bed has been brought into the living room, leaving just enough room for a commode, a zimmer frame, an armchair and a side table. She still has her shelves of books, of course – one case devoted to Miss Read, whose name is repeated with dizzying regularity up and down the spines – but if you wanted to fetch one out you’d have to move a stack of things first.

Helen has been sitting this whole time with her head resting on the open palm of her right hand. She straightens now and again to look between her daughter Karen and me with an anguished look on her face.
‘I simply don’t understand what it is I have to do,’ she says.
‘You don’t have to do anything, mum. We’re just talking about things we can do to help you get better.’
‘Is it money? I think I have enough. But if you need more I can get another job.’
‘No, mummy. Don’t fret. We’ve got enough money. You’re job is to rest and focus on getting better.’
‘But all these people,’ says Helen, frowning at me. ‘I don’t know who they are or what they want. What do they want, Karen?’
‘They want what’s best for you, mummy. Like we all do. Try not to worry.’
‘But I do worry! I can’t stop worrying!’
Karen goes over to give her mum a hug, but Helen irritably pushes her away and then slumps forward again.

It’s an impossible position for Karen. Not only does she have the grindingly practical business of caring for an elderly mother whilst running a family of her own, she has to do it without the one person she’d naturally have turned to for advice and support, as she did all through her childhood, adolescence and beyond, the single parent who’d trained and worked as a nurse, the woman who’d seen things and suffered things and come out the other side with her hands and her uniform clean, who’d always somehow managed to be just as strong and as resourceful as she needed to be, the woman that was somehow in the room and yet out of it at the same time, as remote as that black and white photograph of a newly qualified nurse in a pristine uniform, sitting with a straight back behind the glass.

‘Anything you could do to help would be great,’ says Karen, smiling weakly at me. Then reaches over to squeeze her mum’s shoulder.

little my and the bear

Minton Green is a blandly perfect, municipal kind of heaven. A development for supported living so new and pristine it’s like I’ve been miniaturised and placed in an architect’s model. I wouldn’t be surprised to see the top of the building lift away and a cluster of gigantic faces peer down to see how I interact with the lobby; instead, what happens is an elderly woman wanders over and asks what I’m doing. She’s wearing a black and yellow square pattern dress that flares at the hips like a bell, her silver hair is swept up into a top-knot, and her face is so pale the intricate threads of her veins run in clear blue patterns across her temple like satellite shots of river courses from space. She has a serious expression, but there’s something hazily sweet about her, too, more a girl of five than a woman of eighty. She reminds me of someone, a fictional character, Little My from the Moomin books.
‘I’m waiting for my colleague’ I tell her. ‘She said she’d be about ten minutes.’
‘Well sit down and talk to me instead,’ she says, and without waiting to see what I think about that, marches off into a wide, communal lounge. There’s no-one else there, except for a large, caramel coloured teddy bear in one of the bucket seats in the window.
‘Come on’ says the woman, and she goes and sits next to the bear.
‘I had a lovely day today,’ she says, as I put my bag down and sit with her. ‘Me and my friends went out to lunch.’
‘Well it’s a nice, sunny day for lunch!’ I say. ‘Where did you go?’
‘The high street,’ she says. ‘Near the old pet shop.’
‘Famous’ I tell her. ‘Lovely.’
‘I want to get a parakeet,’ she says.
‘A parakeet! Wow! That’s exotic!’
‘Or maybe the other one. You know. Smaller.’
‘Budgerigar?’
‘Hamster’
I can’t help laughing.
‘What’s funny about hamsters?’ she says.
‘No, no. Nothing. It’s just – I can never see the point of them. They only come out at night. And then they run round in a squeaky wheel and drive you nuts.’
‘Oh – I wouldn’t mind that. I’m a good sleeper. What do you think of my bear?’
She reaches across and grabs the teddy, squeezing it to her. It’s so big she has to lean round to the side to look at me. The bear has an alarmed expression, its arms up left and right and its eyes bulging, as if she’s squeezing too hard.
‘I bought him in a charity shop. I’m going to give him a wash later, as a treat.’
‘He’ll love that. Just don’t put him in the washing machine,’ I say. ‘He’ll come out a cub’
‘Is that your friend?’ she says, suddenly tossing the bear to the side and leaning forwards to get a better view through the window.
‘No. I think that’s a postman.’
‘Oh. Where are they, then?’
‘I don’t know. She said ten minutes.’
‘It’s been longer than ten minutes, hasn’t it? Well – hasn’t it?’
‘Yes. I suppose it has.’
We sit there, staring through the window.
Two carers come into the lounge, each pushing a resident in a wheelchair. I half expect them to say something about me sitting there in the window with Little My and a giant bear, but they just nod and smile as if I’m a resident, too. And for one, dizzying moment I wonder if I am.