I am shown into the ‘quiet lounge’ when I arrive at the care home and told by a cheerful young girl, who hands me Alice’s file*, that she will go and bring her to me. The room is quiet in name only, so I turn off Jeremy Kyle, ranting at high volume in the corner to an empty room, and settle down to read the paperwork. I know the salient points already: Alice has dementia, she is subject to a ‘deprivation of liberty’ authorisation, she has no family and has been in the home for three years. As I start checking through the daily records the door swings open, Alice is wheeled in and we are left alone.
She is not sitting in a normal wheelchair, but is reclining in a large, cushioned, wheeled armchair (she has had to buy this herself, at huge cost, as this sort of expense is no longer funded). She is thin – very thin – and she is sleeping, her head slumped to one side, her open mouth showing only gums, no teeth. I try to wake her, holding her blue-veined hand in mine and calling her name, at first softly and then more loudly, but I am unable to rouse her. I decide to go through more of the paperwork while she sleeps in front of me, hoping that she will wake soon, and discover that she does have family – a daughter- but that they fell out some years ago and have not seen each other since. Her daughter has never visited the home.
Alice is no longer weight-bearing I read, and cannot change position herself, so needs to be repositioned in her cushioned chair every few hours and turned throughout the night in bed, to stop her developing pressure sores. Alice is non-verbal now and on a pureed diet, but shows preference for sweet food over savoury.
And then, buried in a ‘previous history’ section, the following sentence leaps out at me:
‘she used to sit on gentlemen’s knees at parties’.
There are two photos of the younger Alice: one is a head shot of a smiling, plump-faced woman, taken perhaps ten years ago at a guess; the other shows Alice in the foreground of an older, faded group shot with a grinning, raucous looking bunch of people. It might be Christmas – they are wearing paper hats at any rate, drunkenly askew, and their glasses are raised towards the camera in a silent ‘cheers’ from yesteryear. Alice is indeed sitting on a man’s knee, as is another woman; they are bunched up to get in the photo. The picture raises a myriad of questions in me – who are all these people, and where have they gone? Why has Alice lived here for three years with no visitors whatsoever? What was said between mother and daughter to cause such irreparable damage? Why would it be salaciously recorded that she used to like to sit on men’s knees, if the only discernible evidence is one photo of one party? Alice cannot tell anyone anymore and there is no one else here to complete her story, to remember her before she turned into the unresponsive woman in front of me now.
Further attempts to wake Alice are fruitless and so I enlist the help of another carer, who has been doing the rounds of the home with a trolley for mid-morning tea break. She comes in holding a plastic, spouted beaker holding thickened lukewarm, sugared tea. She shouts ‘time for your brew!’ next to Alice’s ear and holds the beaker to her lips. Alice’s eyes do not open, but her lips close briefly around the spout and she swallows a few sips, as insipid, beige rivulets dribble down her chin and are soaked up by the wool of her cardigan.
The carer then wheels her back into the main lounge, parking her enormous chair in its usual spot and tucking the blanket around the buckle which stops Alice from slipping out of it altogether. During my time with Alice in the quiet lounge, the once-a-fortnight activities co-ordinator has arrived and is doing ‘armchair aerobics’ with the more able residents. The music is loud, but Alice sleeps on. Then one of the girls on duty brings over a large baby doll, almost toddler sized – the type with a realistic crying function. She places her in the crook of Alice’s arm, with the crying noise on and calls out ‘your baby needs you Alice’. Alice’s eyes flutter briefly and she turns her head, her mouth puckering into a reflexive kiss against the plastic head. As the carer pushes a dummy into the doll’s mouth – its mechanism to stop the noise – Alice mutters ‘aw, sh’ and closes her eyes again as she sleeps on holding the doll and the carer turns her around once more in her chair.
*not her name