Audrey and Joan are both in their nineties, both have dementia and have both recently moved into residential care homes, after living alone in their own homes for longer than perhaps they should have done. Audrey was widowed a few years ago and Joan lived alone in the house she grew up in after her parents, whom she cared for, died within twelve months of each other.
Both are also now ‘unbefriended’ – meaning they are without family or friends willing or able to represent them in important decisions about their health or welfare now that their dementia means they are no longer able to speak up for themselves.
Both have recently been the subject of difficult discussions: Joan’s residential home decided they could no longer cope with her behaviour and approached social services to have her moved on; Audrey’s son, himself a pensioner with complicated health needs living at the other end of the country, decided he did not want to go through with the original plan of having his mother move near to him after all. He instructed social workers to find her a permanent place in residential care locally and to leave him completely out of the decisions.
I have met each woman a few times and when I arrive and sit with them, there is a blankness to their expressions as they search my features and, when I remind them who I am and that I have met them before, sometimes a slight panic as they try to place me. ‘I think I might know your face…’ they have both said to me, playing for time, although Audrey gives me a sweet, wan smile as she acknowledges that she does not remember me at all.
Audrey remembers her son, John, only when she is reminded about him. She says she does not think she has seen him for a while but she cannot remember (she has not). She recalls a couple of anecdotes about his school days and a small dog they used to have. Audrey remembers that she was married but she cannot remember her late husband’s name. Last week, equable, easy-going, smiling Audrey unexpectedly became teary-eyed and flustered, putting her hand on mine and saying urgently ‘I think there was another one… I think I might have had another one, I think there wasn’t just John. But I can’t remember’.
Joan, on the other hand, is rarely equable. She often cries inconsolably and shouts out. This is the main reason the residential home is trying to evict her – they say her distress upsets the other residents. Most upsettingly, if she sees a male resident she shakes and screams, cowers in her wheelchair and shouts accusations at him about the nature of his intentions towards her. She asks staff repeatedly and with escalating anguish to promise that they will not make her marry anyone or be alone with a man. Even with constant reassurances, Joan is never placated until she cannot see a man – any man. Although men are greatly outnumbered by women in the residential home, it is nevertheless a difficult feat for the staff to pull off, to ensure Joan feels safe.
I do not know the truth about these women’s histories, and they cannot really tell me. Their feelings are real, but their memories are confused snatches of moments, the briefest of brief episodes of lucidity. I do not know what they are remembering and I do not know what really happened.
But I do know just a little bit about them now.
Joan, when calm, is a great mimic with a fine singing voice. She can adopt a variety of different accents at will. She knows a few dirty jokes and laughs uproariously when she tells them. She likes a brightly coloured, soft cardigan by day and, by night, as her care plan records, she likes ‘the duvet pulled right up and tucked up under her chin and she likes to wear a fresh nighty’.
Audrey relishes her food and particularly likes custard creams and milky coffee. She is proud of having all her own teeth and she bares them at people in mock aggression with a jokey growl when inviting people to inspect them. She is unfailingly polite to all care staff. And she likes to sit with a Tiny Tears doll dressed in a blue Babygro on her knee, exhorting others to notice ‘the perfect bloom on his little cheeks’.