People paralysed from a stroke are usually fully aware of what is said, and what is going on around them, and Mrs Doherty wept, great tears that she could not wipe away running down her face.
Maggie did her best. But she had completely underestimated the difficulties involved, which, even for a professional nurse, can be daunting. A district nurse came in for four hours a week, but Mrs Doherty required twenty-four-hour nursing every day, and the only person to do it was Maggie. Feeding, drinking, washing, bathing, help with dressing – all had to be attended to. Soiled underwear and bed linen had to be changed frequently, and even though a bathroom and lavatory, specially designed for invalid use, had been built on to the ground floor room, Maggie found that getting her mother on and off the lavatory was a monstrous task. Mrs Doherty tried desperately to help herself, but early one morning, when she’d managed to get out of bed, her Zimmer frame was just a little too far away, and, in trying to reach it, she slipped and fell, and lay on the floor, wet and cold, for several hours.
Another thing Maggie had not expected was the boredom. Each day was the same – a struggle with physical necessities, until Maggie felt she could scream. Although Mrs Doherty’s speech had improved to the point where she could say a few words, she could not carry on a conversation, and her attempts to do so frequently led to tears of frustration. In the end Maggie gave up trying to speak to her mother. In the winter, when the days grew dark and wet, Maggie wondered how much more she could take.
Mrs Doherty made heroic efforts to do things on her own. She was not a woman who wanted to be a burden to her daughter. She did the exercises advised by the physiotherapist, but progress towards mobility was minimal. Had she been twenty years younger, it might have been different, but she was simply too old to build up new muscular strengths. Every little thing was a labour for her to achieve; frequently, she wept uncontrollably.
Jamie came to see his mother each day, but did not stay for long. It was difficult to communicate and conversation was confined to banalities. He could see the strain imposed on Maggie, and though they both thought often of the scene in the hospital, and Miss Jenner’s rejected advice, neither of them ever mentioned it.
One day Jamie said to his sister, ‘You need a holiday. You can’t carry on like this. You’ll crack up.’
Maggie burst into tears. ‘If only I could. But I don’t see how I can leave her.’
‘Tessa and I could take over.’
‘I don’t think you could. She needs someone with her all the time. You have to go to work, and I doubt if Tessa would do all that I do.’
‘Then she’ll have to go into a nursing home for a while. I will make enquiries and arrange something. You must have a break.’
‘That would be wonderful. Thank you, Jamie.’
He could see her depression and was concerned. Everything about her, her clothes, her hair, her face, her nails, was neglected. Even her body language was so unlike the Maggie they had always known.
‘Do you think you’ll ever go back to writing?’
‘Oh, I don’t know. Can’t see it, somehow. I had a letter from one of my magazines today, telling me that they were taking me off their books. That’s bad news.’
Jamie didn’t say anything but arranged for a nursing home to take his mother. It was not easy. because of his mother’s incapacity. Most nursing homes wanted old people who needed no nursing, he discovered. He found one, eventually, who said they would take her for two weeks, providing she was not incontinent. Jamie assured them that she was not, but would require help in getting to a lavatory, or a bedpan. The expense was colossal, but Priscilla agreed to help pay.
Mrs Doherty was terrified when she was told that she was going to a nursing home for a fortnight. She couldn’t express herself but kept saying ‘No, no, no,’ and shaking her head and crying. She managed to formulate the words ‘Let me stay here’, and then added, ‘Please, please, oh please,’ but no one took any notice. When two men came with a special recumbent chair in which to carry her, she resisted with all the puny strength she could muster – but they took her anyway.
The stress of being moved, and the mental agitation, the new surroundings, strangers taking care of her – it was all too much for the old lady, and she went rapidly downhill in the nursing home. She would not eat or drink, she made no effort to move, but lay inert in her bed. Her time, at long last, had come, and Mrs Doherty died five days later.
A man
half bent over on the sofa, eyes down, asleep or awake.
An assistant puts a mug of tea in his hand
but he can’t hold it or isn’t ready, she puts it gently
on the sideboard next to him, With the cup shakily
in his hand now (I am watching) he raises it slowly
to his .. . But where to go? The cup goes to his glasses,
almost touches them, then slowly down again, up again,
this time halfway to his mouth. The cup (I am watching)
is on the sideboard again. A biscuit has been put
into his hand. Using both hands shaking, and with
tiny movements he tries (I am watching) to break
the biscuit. With a small piece of it he tries to find
his mouth. He fails and lowers his hand again
very slowly. His left hand holds the biscuit half away.
His right hand has gone right down past his knees.
It comes up again. He achieves breaking the biscuit
again and with his right hand reaches his mouth
with a tiny piece (I am watching) and gets it in.
Now he has found the cup of tea on the sideboard
and holding it in his right hand he is drinking from it
very slowly, all the while his head down .. .
He tries to stand
and very slowly turns and is soon
heaped about the end
of the sofa, his weight greater than his power to shift it.
Two assistants help him up and sit him back on the sofa.
One says ‘Stay there’. But he wants to move, so they
help him up and he walks or is walked across the room
and into an armchair. One of the assistants pulls out
the footrest which tips the chair back. (I find myself
swaying). She puts the stool under the footrest
to support it. She adjusts the head rest, pats his chest
and says, ‘There,
have a rest.
He closes his eyes
and is still.
— David Hart
This poem and that on page 145 by David Hart were written when he was Poet in Residence at the South Birmingham Mental Health Trust, 2000—01. A man half bent over was originally written in an Older Adults Assessment Ward as it occurred, very very slowly, the version here being newly made. At the annual conference of the Royal College of Psychiatrists at the Queen Elizabeth II Conference Centre, a Van Gogh self-portrait reproduced as a poster for PR purposes by a drug company led to the writing of Poor Van Gogh. The whole sequence of residency poems with commentary was included in David Hart’s Running Out (Five Seasons Press, 2006).
DEMENTIA
The reality of an ageing population is that many of us will end up in residential care in our final years. Taking only the figures for dementia, one in four people over the age of eighty now suffers from progressive dementia of the Alzheimer’s type, and from ninety onwards that figure rises to one in three. At the time of writing, there are more people over sixty-five in the UK than there are children under sixteen. This is recognised as one of the most serious social problems of the twenty-first century. Who is going to look after these hosts of demented old people? Who will be there when we die?