Six o’clock in the evening, half an hour before the end of a long and complicated car shift. Things haven’t worked out well. I’ve ended up the wrong side of town, there are calls going out on the radio for jobs with no vehicles to assign, and the shadow of a late-finish is lying across me, scythe & cloak.
I’ve been to this particular address once before – Rachel, a woman in her seventies, equivocal diagnosis somewhere on the scale between dementia and mental health, the result being the same – carers four times a day, keeps to her bed, poor levels of self-care despite all the help.
I can hear her TV from outside. She likes it loud.
I retrieve the keys from the keysafe and let myself in.
‘Rachel? Hello? It’s the ambulance.’
She’s in bed.
‘Do you mind if I turn the TV off? I can’t hear myself think.’
The carers do their best to arrange things so she stays reasonably neat between calls, but Rachel always manages to get in a state. The remains of her sandwiches are scattered around, the lid has come off her beaker and spilled tea on the bedclothes, the little table with her things on – remote control, box of tissues, magazine and so on – is lying on its side.
‘Help me,’ she says.
She holds her hands out. They’re caked in faeces. I pull the duvet aside. Her incontinence pads are half-way down her legs, spilling over.
Rachel’s outstretched hands speak eloquently to me of the predicament I’m in. The fourth carer won’t be in till eight. There’s no prospect of any crews to help me on this one, at least until the half-sixers book on, and anyway, the likelihood is they’ll be sent out on any of the high priority calls currently stacking. I either wait it out and finish horribly late, or I take care of things myself.
‘Let’s get you cleaned up,’ I say.
I take my jacket off and hang it safely out of reach in the lobby.
I put on some gloves.
I fill a basin with soapy water, take a roll of toilet paper, a flannel and a towel and carry it all through.
I put it out of the way whilst I strip the duvet, carefully cut off Rachel’s pants, scoop the worst of it up with wads of tissue, bundle everything up with the inco pad and stuff it all in the bin by the TV.
I put another inco pad underneath Rachel (who doesn’t seem able to help at all by pushing down with her feet and lifting her bottom), and soap her as clean as best I can.
I change the water and do it again, along with her hands, although the intricate tucks of her rings need a brush to clean properly. I leave that for someone else.
Once she’s as clean as I can make her I dry her off, put on some clean pants, strip the damp bottom sheet and remake the bed. I help her to stand up whilst I secure the main inco sheet, then settle her back.
I dispose of the filthy water, dump the dirty sheets in the bath. I can’t find a new duvet cover so I leave that for the eight o’clock carer.
I right the table and restore her things to their position.
I turn the TV back on for her whilst I go into the front room and write down everything I’ve done.
I ring the son to let him know we’ve been out.
‘Thanks,’ he says. ‘I don’t know what we’re going to do about this. It’s all getting out of hand.’
I make sympathetic noises, but actually I’m still writing stuff down so I’m not paying too much attention. All I want to do is finish and get home.
I leave the paperwork somewhere obvious, then go back in to the bedroom.
‘The carer will be in soon,’ I tell Rachel. She’s staring at a game show on TV and doesn’t respond. The audience laughter is as grotesque and highly-coloured as the studio. I keep my back to it as I tell her that I’ll be putting the key back in the keysafe.
I shut the door and hurry down the steps.
The interior of the car feels beautifully snug and quiet.
I take my radio off and throw it on the seat next to me. I’m not going to speak to anyone on that thing again tonight. I’m not even going to look at it.
Incredibly, I’m not that late. Just quarter of an hour. I can’t believe I’ve done so much in such a short time.
I tap the screen clear.
My feet and hands drive me back.