A Woman of Ninety

When I go into her living-room, the heat and the smell hit me simultaneously. The heat is from the small electric fire, which is always on, making the centre of the room a furnace, whilst icy blasts from the winter outside creep in at the edges, around windows and under the ill-fitting door to the unheated kitchen beyond. The smell is that of stale urine and faeces, radiating from her, almost palpable in the sudden fetid warmth of the air in the tiny room, strong enough to make one gasp and mouth-breathe involuntarily.

She sits in front of the fire, her body angled slightly towards the large television in the corner, its sleek lines and modern look entirely at odds with the net curtains, the threadbare carpet and the few pieces of 1950s furniture. The volume is turned high and she fixes her unseeing gaze on the flickering screen, her face registering no emotion whatsoever as a toothless man on The Jeremy Kyle Show is booed by the studio audience for leaving his wife for her younger, thinner sister and a punch-up ensues. There is one card on the mantelpiece, wishing her a happy 90th birthday, from the care agency engaged by the Council to deliver basic care to her. Her birthday was several months ago and this appears to be the only card she got.

She is wearing a long, summery skirt in mid-winter, with an old, food-stained, hand-knitted jumper and her feet, with long, yellow toenails and fissured heels, are bare, toasting in the heat of the fire. I see a new looking pair of fur-lined slippers in the corner of the room and bring them to her, trying to guide her feet into them. It is no good – on closer examination, her swollen lower legs and feet, so unexpected given her otherwise emaciated appearance, are of variegated hue and the purpled flesh bulges painfully over the sides of the slippers. She starts to get cross and I put them back in the corner.

A carer – a cheerful, breezy, strong-looking woman who comes every morning – lets herself in. I excuse myself and stand in the icy kitchen whilst the carer expertly hoists her charge to her feet and changes her incontinence pad. The carer then bustles briefly into the kitchen, emerging shortly afterwards with tray containing a bowl of microwaved porridge, a small sugar bowl and a cup of tea. The tray is balanced precariously on an upturned wastepaper basket in front of the old woman, the stained carpet at her feet bearing testament to the apparent inadequacy of this dining arrangement.   With shaking hand, she takes a heaped spoonful of sugar and sprinkles it liberally over the porridge, returning again and again to the sugar bowl, repeating the sweetening multiple times, until her breakfast is more sugar than oats.   Then she starts to eat, lifting the spoon to her mouth, a good deal of porridge soaking into the wool of her jumper as it drips from the spoon. Without attempting to help further, the carer announces brightly that she is finished and will call back at lunchtime. She has been there only twelve minutes.

I ask her if I can turn the television down, so that I can try to talk to her about something important. She does not answer me, so I do it anyway. I ask her if she will talk to me about whether she will accept more help and whether she would like to move to somewhere she can be taken care of. I tell her that it seems that she is sleeping on her couch (she has some blankets to one side which she may or may not pull over herself) and, with her last care call being tea time, is not changing her clothes, her incontinence pads or even her seating position through the night. The morning carer reports that she is always sitting in her usual position on the couch when she arrives, wearing the same clothes as the day before. She becomes upset and shouts that this is her house and no-one can force her out of it.

I come back to visit her again, and again, to see whether I am able to communicate with her and understand what she wants. She always sits in the same place, staring unblinkingly at whatever is showing on the television. Sometimes she smiles at me, sometimes she shouts from her own, private world which I cannot gain access to. She claims that she is climbing the stairs daily to air the bedrooms, that she is walking out to the local library with her father and that she is cooking good plain food for herself.

She has advanced dementia. She has no friends and no family. Apart from the scheduled care calls three times a day, and occasional professionals’ checks, she has no visitors. She is a million miles away from someone else who has recently had a 90th birthday.

I find the loneliness and vulnerability of her old age almost unbearable.

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Animals

I hate how their smells linger

In cars and houses, on clothes and fingers.

I hate their dribble, drool, sniffs and licks,

Their nips and bites, barks and kicks.

I hate the way they scamper and scuttle

And mortifyingly crotch-snuffle.

 

I loathe how their fur covers my clothes,

Gets into my hair, creeps up my nose

Giving me outbreaks of hives, a fear of fleas

Swollen eyes, a frightening wheeze.

I loathe how encountering their dander

Makes me tear my skin asunder.

 

And yet I love them when outside,

Seeing them flying free, running wild

Or on a screen, when a documentary

Makes me gasp, wonder, laugh involuntarily.

I adore their galloping majesty,

Love stories sentimental of canine loyalty.

 

And when one of them looks at me,

I feel our similarities.

A life lives, a heart beats.

I cannot eat their meat,

Cannot stomach flesh, sinews, veins

Minced and chopped, served up as my main.

 

 

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Time-keeper

refNo.1 son stood with head respectfully bowed. But I could tell he was looking at his watch, counting down the seconds before he would have to blow his whistle. His very first task as a trainee referee was to supervise two minutes silence on Remembrance Sunday. A weedy peep, betraying his anxiety, barely audible on a wind-buffeted playing field, signaled the end of the silence and that play could get under way.

The role of the time-keeper is essential to sports. From timing races to determine winners on land and water, to careful marshaling of the playing duration of rugby, hockey, netball and football matches, to clocks that limit breaks in tennis, constrain routines in gymnastics and force attacking play in basketball. Even cricket’s colonisation of whole days is prey to the clock, with lunch, tea and drinks breaks to be timed and enforced.

How well suited would my older son be to the task of time-keeper? All the evidence from home-life is that he would not be playing to a known strength.

The morning of one of his football matches typically involves him having to be woken up. He may even have to be woken a second time. “We need to leave in 45 minutes”, Mother in the Middle or I will specify. A little later, as he takes a leisurely breakfast, irritation ill-concealed, “Can you get dressed now. We’re going in 20 minutes.”

This prompts a move to the shower. The argument that he should wash after, not before, a game was made, won and ignored long ago.

“Five minute warning!” we yell, which may disturb him from his social networking activity.

When we’re kicking our heels at the front door, already swaddled in jumpers and coats, glancing at our time pieces, there will be a flurry of activity. “Where’s my socks? Which kit are we playing in? Who’s had my shin-pads?” Frantic searches, allegations, cross words enliven the house. Whatever’s lost will be found stuffed in a school bag or buried beneath clothes heading to or returning from the washing machine.

“Are we going to be late?” no.1 son will ask urgently, accusingly as he stumbles out of the front door, feet not properly in boots, coat dragging on the ground. Some days I resist the impulse to set out how any degree of organisation or time-awareness could have negated the need for this rushed, bothered exit; and some days I don’t. This, with age appropriate adjustments, has been going on for years. And my contribution truly sits among that list of futile things parents do (and should stop doing, but somehow don’t).

Once, when no.1 son was only nine or ten, I decided not to nag. Having told him the time we would be leaving the house, I left it up to him to get himself ready promptly. Half an hour after we should have left home, he was sat watching TV. We arrived barely before the match started. My stand had achieved nothing but inconvenience his coach and teammates.

Therefore, alongside the referees, umpires, scorers and judges, as time-keepers critical to junior sport, we should recognise the parents. Not equipped with high-tech chronometers, or backed by rule books, it’s mums and dads persuading, chivvying and marching their offspring out of the door that ensure junior sports fixtures start promptly. 

Watching the first half of no.1 son’s first match as referee, I started to become anxious. His nerves before the game were overt as he questioned me about various aspects of under 12 football: the duration, substitutions, off-side, identity of linesmen. With all that uncertainty in his mind, I began to worry that he might have forgotten to time the half. I tried to work out how long the game had been going. An even bigger puzzle was how I was going to gain his attention when, by my estimate, the first half would be over. I paced circuits around the pitch, trying to work out if he seemed aware of the passage of time.

Then suddenly and with impeccable timing, two loud blasts on the whistle, as no.1 son brought the first half of the first game of his refereeing career to an end.

 

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Leaving Home

Pristinely presented, impeccably dressed

She receives me from next to her hospital bed,

Casts disparaging glances at fellow inmates,

With their gaping nighties and matted hair,

Still disgracefully abed, not up in their chairs,

‘I’m not like these women, I don’t belong here.

I want to go home’.

 

I tell her about professionals’ concerns

That she can’t manage alone, she shouldn’t go home.

There’s nothing wrong’ she repeated stoutly,

Except being terribly old – I’m well past ninety –

I forget some words, I’m very deaf

And I’ll be gone soon, I don’t have long left.

I want to go home’.

 

‘Can you make your own food, brew a cup of tea?’

I go out every day with my trolley on wheels,

Buy enough just for me, prepare my own meals’.

‘But they say you’ve lost weight, you’ve been wasting away,

Your cupboards were bare, your food was rotten,

That, perhaps, you had simply forgotten?’

 

I don’t remember that’.

 

‘Can you manage your money, pay your own bills?’

After my husband died, in ‘88…’

(My entire adult life, I swiftly calculate)

‘…I had to cope, I learned the drill’.

‘But they say you’ve been giving money away,

Five hundred a month to a ‘friend’ you don’t see,

And thousands more, unaccounted for…’

 

‘I don’t remember that’.

 

‘Can you manage at night, do you ever feel scared?’

I’m not fussed about that! I’m very strong,

I’ve managed alone for ever so long’.

But they say you bang on the neighbours’ doors,

Distressed, undressed, at all hours

And they ring the police to report on your plight,

Concerned for your safety, especially at night’.

‘I don’t remember that.’

 

But I remember my son, he was born in the house

And died there too, a terrible waste –

Just seventeen. And my husband’s gone,

I’ve outlived them all, there’s nobody left,

I don’t have long,

I’ll remember them there, I want to go home’.

 

 

 

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What Visiting Care Homes has Taught Me

I have spent a lot of time in the past few years visiting people in care homes – usually frail, elderly people, often with dementia and, in the main, those who lack any (suitable) friends or family who visit them. I sometimes come away saddened, sometimes uplifted, occasionally entertained but nearly always pretty emotional one way or another, so I wanted to spend some time reflecting on that and why it was making me feel the way I do.
I intended to write a piece, along the lines of ‘ten things I have learned from going to care homes…’ – the way people do – but it seemed too trite, too reductive, for something so complex and individual. Many people have their own view on care homes – particularly if they have had a relative in one – but there are some popular perceptions about residential care that you hear a lot, which I wanted to think about, such as:

‘Don’t let me end up in a place like that; shoot me first’
It’s true, I’ve yet to meet anyone who actively looks forward to going into residential care and there are certainly plenty of people who are not happy to be in a care home, as well as plenty who are pretty happy with their lot. However, a lot of people say this type of thing when they are fit, well, young(ish). What I have seen is that there is a hidden group of extremely vulnerable people whose only alternative to residential care may be living alone and who are really very lonely, with three or four brief calls a day from an ever-changing roll call of carers; people who may crave more companionship; people who cannot get out by themselves but whose care package, cut back to its very barest bones by cash-strapped local authorities, will only fund someone to come and defrost a frozen meal in the microwave and change their incontinence pad. In fifteen minutes flat.

‘It’s just God’s waiting room’
Well, yes, pretty much, I suppose it is. For the very frail, the very old, the incapacitated, the vulnerable, the abused, who are in residential care, there are certainly a depressing number of homes where the residents are stationed in a hot living room, arranged in a traditional semi-circle around a large, very loud TV most of the day, every day.
I have also seen some homes with more innovative ideas: for example, chests of drawers placed randomly in corridors, stuffed with scarves, necklaces, dolls and handbags, with hooks on nearby walls, to enable dementia sufferers with a compulsion to rearrange, to carry things around, to nurture, to have some sort of focus to their walking. Some also have chickens or dogs, for residents to stroke and feed or café stations, where they can work to retain whatever skills they have remaining.

However, what I think sometimes people don’t see is that ‘God’s waiting room’ can just as easily be one’s own living room if you’re old, infirm and on your own. Take Lilian for example: she lives alone in the same house she has lived in for sixty years. She has advanced dementia and is doubly incontinent. Lilian does not speak much these days but has always been adamant that she wants to stay in her own home. Now, however, she cannot go upstairs at all and she barely moves from the couch, where she also sleeps, in her clothes, sitting up. Lilian refuses to wear nightclothes or even have a bed. The television has always been on when I have visited. The carers come three times a day, for twenty minutes in the morning; fifteen minutes at lunch and fifteen minutes at tea. Between these times and for the long stretch from 5pm to 9.30am, Lilian is on her own, sitting on the sofa, staring at the TV. The channel is never changed; her expression never varies, whether the screen is showing Jeremy Kyle punch ups, a game show or the news or if it goes off-air. At 9.30am, the carer comes, attempts to give her a wash standing up in her living room (logistically very difficult due to her frailty and often not possible due to her resistance), changes her pad (which is often soiled overnight) and makes her porridge in the microwave. At lunchtime, the carer comes back and leaves Lilian a cheese sandwich and a cup of tea. At teatime, a frozen meal is heated up for her. Once a week, a carer cleans her house and shops for her food, but Lilian never leaves the house. Lilian recently turned 90 and received only one card, from the agency that her carers are employed by.

There are more Lilians out there than it is comfortable to contemplate.

‘All care homes smell!’
Yes. In my experience they mostly do. Of urine and faeces. I’ve never been in one that doesn’t, at least some of the time. Some are worse than others. What’s important is how quickly the staff change the residents and how respectfully they do it.

‘All carers are angels/devils’
I have seen some fantastic carers, who are endlessly patient and wonderfully kind. This is sometimes despite the verbal and physical assaults sent their way by the people they care for: answering the same questions many times a shift, day after day; finding out and honouring the little things that matter to a person; getting to know a person properly and being alert to physical cues, respecting that someone has a right to exceptional physical care even when they cannot tell anybody what’s wrong.
I have seen some shocking carers, who are thoughtless, lazy and occasionally deliberately unkind: meeting frustrating behaviour with raised voices and rough hands; not changing someone’s incontinence pads when they have had a bowel movement; taking the path of least resistance; not noticing or caring that someone’s wheelchair is parked at an angle that means they can’t see the television; neglecting personal care interventions, like cutting nails or washing hair; and numerous tiny acts of thoughtlessness or neglect that rob someone who can no longer speak up for themselves of their dignity.
What I see most of the time, however, is overworked, underpaid, well-meaning people, the majority of whom are women working shifts for one reason or another, struggling in a massively under-funded industry, in a society that does not respect them or what they do, doing the work that is so necessary, so difficult and which most people could not do.

‘They just take all your money and I want to leave it to my kids’
They won’t take all of it, but they will take most of it. If you’re on benefits, you’re currently left with about £25 per week for yourself and the rest is your contribution to your care. If you have savings above a certain level, you pay a lot more and at a different rate than the council pays. It’s complicated. It’s expensive. If you try to leave it to your kids you may well be pursued for deliberate deprivation of capital. Funding elderly care is a ticking time bomb for our ageing population.

 

So what has visiting care homes taught me? (Apart from the fact that extreme old age can be immensely sobering and that life is unfair). In my opinion, it boils down to just one thing – ultimately, it is compassion and respect that matter.
I sincerely hope that I have the opportunity to live to a ripe old age, surrounded by people who love me and that I am as healthy as possible for as long as possible. But I have seen many people who are, unfortunately, alone at the end of their lives and do not have anyone they love or who loves them. Perhaps their partner went first. Or they never had a partner or children. Or they have fallen out with their children. A lot of people towards the end of their lives are difficult, intractable, rude, vulnerable, difficult to like let alone love. You can’t always give love to people, but to have a meaningful society, to make life worthwhile, you don’t just house and feed the vulnerable, you also give compassion, respect and dignity – to the cared-for and their carers. I think it really, really matters.

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What a performance

tline concertThe car park is busy. The young players spilling from their parents’ vehicles and away to warm-up. It’s a big day – the grand show – a cup final, of sorts.

The parents follow their off-spring to the arena and just like the players they split into two groups: strings and pianists. Above the noise of the warm-up, snatches of the parents’ conversation are heard:

“Lovely day for it. Wouldn’t mind playing myself.”

“I’d be up there in a flash, if it wasn’t for this elbow.”

….

“Have you seen what that Nigel Kennedy is up to? It’s a disgrace.”

“It’s all about the money. And these foreign conductors coming over and running our orchestras. Can’t they find a local to wave the baton?”

….

“If I don’t hear a bit more melody from my lad this afternoon, I’ve told him it’s over. I’m not coming here just to listen to him plonking away again.”

….

The audience is asked to take their seats. The host reminds everyone that the aim is for the young musicians and their families to have some fun. A few grown-ups in the front row nod earnestly while the majority of parents take a sudden interest in the ceiling or their copy of the programme.

The show begins with a pianist, propped up on cushions to reach the instrument. There’s plenty of sighs and chuckles as the youngster completes her piece, vaults from her seat, grins at the crowd and scuttles off-stage.

Next up is the opening violinist. His first notes are shrill and dissonant. The noise of the instrument is abruptly drowned by a shout from the strings teacher, “Straighten your wrist! Keep it straight!” The boy struggles to the end of his piece. He stands, averting his eyes from those of his family and friends in the audience. His shuffle to the wings is speeded by his teacher, clasping his shoulder, pushing him out of sight.

The two sides continue alternating. Each string performance met with strong applause from one part of the audience; the piano pieces delighting the other. At the changeover, if a boy enters while another exits, they swap threatening looks and shoulder barges.

A pair of cellists take a while to set up their instruments and to get their chairs and music stands aligned. Impatience in one section of the audience escalates from mutters and tapping to a bellow of, “Gerron with it!” A man in another wing of the audience stands up, bristling and pointing, before he’s pulled back into his seat as the cellists begin their piece.

Each pianist to the stage is a new player, some are complete beginners using just a couple of fingers, others showing mastery of tempo and expression. Their teacher stands quietly, one hand on the piano lid, the other holding a stopwatch, monitoring the seconds, ensuring equal playing time, whatever the experience of the youngster or the quality of their play. One of the most talented of the group is forced to abbreviate a Beethoven concerto to keep within her allotted time.

There are fewer string musicians. The handful of newer and less adept players are given a quick run-out each. The teacher whispers each note they’re expected to play, making the sheets on the music-stand redundant. The pupils pay as much attention to the teacher as they do to their instruments. The more skilled violinists are indulged, playing longer pieces and returning to the stage to play duets. Meanwhile their teacher stands close to them, always in the audience’s eyeline, barely managing not to bow when a particularly tuneful rendition comes to an end.

The final performance of the afternoon features a cellist. A burst of loud, arresting notes subsides into a pianissimo passage. As the audience strains to pick up the nuances of the bowing, a shouted encouragement is heard, “C’mon lad, belt it out!”

The cellist stops and shouts back, “Shut it, Dad!” Then returns, brow furrowed, to his cello. Before the reverberations of the last note have reached the back of the hall, the cellist is up and stomps off the stage.

—————————-

I have seen all of the behaviours described at numerous junior football matches. I’ve seen none at the junior concerts that I have attended.

 

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Mothering a Teenage Son – A Moment

It didn’t happen overnight, him being taller than me. It just felt like it did.

For so long, he was a little, little boy, catching up with me, inch by slow inch, agonising about how long it was taking him to grow, about how all his friends were towering over him. One year, he was under my chin, the next up to my mouth, then my nose, my eyebrows, my hairline; small amounts, year on year.

Then one day, I glanced over at him and realised that my eyes had to adjust upwards, to take in a defined jaw and handsome, long face. I realised that the tiny, incremental, years-long changes had crystallised into a beautiful young man, my teenage son.

……………..

When he was a very little boy, before he learned to speak properly, he would nevertheless make his views perfectly clear, as only toddlers can. ‘Big Up!’ he would command, imperiously holding his pudgy arms aloft in my direction, demanding to be picked up and carried.  ‘Big Up!’ I would repeat, swinging him up to my lofty height, showing him the world from my vantage point as he nestled his smooth cheeks into my neck and clung on to me.

The Big Up phase seemed at the time to last forever, an oft-repeated refrain punctuating my long, stay-at-home-mother days. A demand I found increasingly difficult to obey, as he grew heavier, as my belly swelled and my arms filled with his siblings.

Now, it seems like it went in a flash and I wish I could hear his baby voice lisping the command one more time.

………………

Last week, he came home from school and showed me the work in progress of the muscles in his  biceps whilst I was cooking the children’s tea in the kitchen. ‘Punch me there, Mum’ he exhorted in his deep, deep voice, ‘punch me, so I can see if it hurts’.   I explained, patiently, mother-like, as I carried on cooking, that I was not in the habit of punching my children and I had no intention of starting now.

He was briefly distracted by food, but waged an impressive campaign throughout the evening, continually urging me to punch his upper arm. ‘I don’t want to hurt you’, I repeated and he just raised his eyebrows at me quizzically, dismissing that notion as so self-evidently ludicrous that it did not even require a comment.

So, eventually, I did. I danced around on my feet to try to make him laugh, telling him I was going to float like a butterfly and sting like a bee, as he stood there, bicep clenched in anticipation of the blow.   I didn’t put my back into it, of course. I wasn’t about to try to hurt him deliberately and I like to think I would have punched an assailant with considerably more force. Nevertheless, my pride also made me want to impress him with some modicum of strength.

Is that it?’ he said, with a disarming grin, when I had landed my blow – ‘never mind Mum’ and he ruffled my hair with a devastating smile, adding ‘Is there anything else to eat? I’m still hungry’.

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