Tuesday, January 06, 2009


I push past a ragged budleia that’s growing out across the steps, and press an old bakelite bell. A sonorous buzz sounds deep inside. I step back. The house is dark and quiet.
‘Get ready,’ says Rae. ‘Assume the position.’
We shouldn’t be here. Man attacking woman with walking stick. The police should go in and secure the scene first. But this is an over-run, and we can’t afford to hang around. The police are busy tonight, it’s so cold even the moon seems frosted over. We need to wrap this one up quickly. I need to be home, sliding into a snug bed and cuddling up to my wife. Such an absurdly rich vision of paradise. Am I that lucky? I stamp my feet and rub my hands to hurry things along.
A light goes on above the heavy black door.
Our breath hangs on the air.
A chain comes off the door and it opens.
‘Hello. Ambulance.’
An elderly woman stands there. From the dim overhead hall light she seems okay. No great gashes, no clumps of matted hair. She stands holding aside the heavy curtain that hangs just behind the door, smiling like an indulgent grandma, short and rounded out with layers of clothing, finished off by an apron whose string tie cuts into her middle and makes her upper half seem independent of the lower. When she turns around I expect her to swivel, those hefty legs to follow later.
‘I can’t go on like this,’ she says. ‘I don’t know what to do.’
She tells us that her husband, John, has Alzheimer’s but doesn’t know it. She tells us he hit her with his walking stick.
‘Not badly. Just on my lower leg. And I’m ashamed to say I slapped his face.’
‘Are either of you hurt?’
‘No. But I can’t go on like this. I packed my bag. I was going to leave tonight. But I couldn’t think where to go.’
‘Shall we come in and see what we can do?’
‘Yes. Please.’
She turns round and we step inside.
Another curtain hangs across the bottom of the stairs. We follow her up the treads which creak alarmingly. The house is utterly quiet, heavy with it. The thick brown paint on the stair panels and skirting boards, and the candy-striped, board-like wallpaper, yellowing and sliding off in places, gives the place a cloying, weighty feel. It’s like walking through an enormous old chocolate cake.
‘He’s in there,’ she says puffing slightly and pointing to another curtain that hangs across the entrance to the living room.
I pull it aside and go in.
Over the other side of the room an elderly man is standing in front of an armchair, his arms straight down by his sides. He has an intensely watchful expression, accentuated by great tufts of grey hair that sprout from his ears and a pair of wiry grey eyebrows that grow down over his eyes and make me think of the budleia outside.
‘Hello, John. I’m Spence and this is Rae.’
‘Yes,’ he says, glittering.
The woman wheezes past me and lowers herself into the armchair that faces his. She straightens her glasses, and then holds on to the armrests as if she thinks it’s going to take off any minute.
‘What do you want? Who are you people?’ he says.
‘We’re with the ambulance, John. Your wife…’
‘Your wife Vera is worried about you. She says you’ve been quite upset tonight. She says you’re not yourself and she’d like you to see a doctor at the hospital.’
‘Why would I need to see a doctor?’
‘Just for a check-up. To make sure everything’s okay. Will you come with us, John?’
My bed may as well be on the moon for how soon I’m likely to find myself in it. It feels as if we’ll be trapped in this room for hours, as motionless as those vast cream underpants drying by the fire, as fixed and foxed as that dog picture on the opposite wall. I look at John and he looks at me.
‘What doctor?’ he sneers.
Rae steps up to him.
‘Shall I get your coat, John? And you’d better wear a hat or something ‘cos it’s bitterly cold out tonight. In fact, I’d go as far as to say it's taters.’
‘Coat? Oh – yes – it’s over there on the chair.’
Vera struggles up again. ‘I’ve got his hat.’ She places it on his head. ‘There. I’ll come up and see you in the morning, darling.’ They both fuss around him. Vera gives him a kiss on the cheek; Rae helps him on with his coat. ‘You’ve got your good slippers on, they’ll be fine.’
‘There. What a picture!’
Rae offers him her arm. He takes it. She looks at me.
‘Oh. Right. Yep. Let’s go then.’
I get the door.

When John is safely stowed on the back of the ambulance, Rae gives me a wink, slams the door and we set off.
We haven’t far to go. John studies me as I race through the paperwork.
‘What do you do, then?’ he asks.
‘Good question. One I ask myself a lot.’
He frowns.
‘I had five brothers. Five. Count them. All went in the army. All through the war. All came out. Imagine that. Not easy places, neither. Egypt. Libya. Terrible.’
‘My uncle’s the same age as you. He was in Italy.’
‘Italy? Oh.’
He frowns at me again.
‘Where are we going?’
‘To the hospital?’
‘To the hospital? Why’s that, then?’
‘To get you checked up.’
He folds his arms. ‘We used to go to school through a hedge at the bottom of the garden. Out onto the lane, just a little way, and there it was.’
He smiles at me. ‘Handy, eh?’


Jenny said...

For some reason stories of older people touch my heart more than those of young children. Although the way they make me feel, i think i should say break my heart rather than touch my heart.

i pray my grandparents don't develop alzheimers or dementia that really would truely break my heart.

i've been trying to work out whether to look at a few hours voluntary with either children or older people, and i think this has made me think about which group to look for.

Spence Kennedy said...

Hi Jenny

It is such a devastating illness to suffer, losing your life-long partner by increments. I know of so many similar situations - both at work and in my own family & friends - it's amazing the courage people show under such duress.

I hardly know what to say about these things, it's so tough. But if there's one - awful - generalisation to be made, it's that life is sometimes very difficult, at any stage, early or late. We're all vulnerable. The fantastic and saving thought is that people come up with coping strategies, they adapt and cope, and find help in lots of unexpected places.

I think it's brilliant that you're thinking of doing this voluntary work. I hope you find something that suits.

BTW - thanks for reading the blog!


Unknown said...

I used to work as a domestic in a geriatric hospital (sorry, thats what they were called then, hope its not un-PC now) and it was the dementia patients who always broke my heart. There was one woman who had no clue who her husband of 50 odd years was and would shout abuse at him. And he used to come in and sit and hold her hand and talk to her every single day. When she kicked off he'd just shrug and say "She's my wife. I love her". It was twenty years ago now and reading this made me see him in my mind's eye like it was yesterday.

Thanks Spence.

Anonymous said...

Bless him. I love patients like John but then I get to go home for some R&R after a shift. I can only imagine how heartbreakingly difficult it must be to share a life with somebody, and then witness them deteriorating into a stranger. Emotional stuff

Spence Kennedy said...

Thanks, K & CN.

I suppose this case was particularly resonant for me because it mirrors what's happening at the moment to my uncle & aunt. He's in his nineties, Alzheimers, living at home, violent sometimes. The fact that he went through the war and came home to her (after being listed as Killed in Action). Big and funny guy - ran a pub for years. Used to drive a big old Zephyr Zodiac with whitewalled tyres. Lovely dog Rusty. It's all so horrible, such a protracted withdrawal from life, an assault by death on the very memory of someone.


Anonymous said...

What happens to cases like this gentleman? From an outsiders viewpoint I can't see what is going to happen at A&E.

Will they give him a drug to calm him down a bit?
I cant see a psych unit taking him as he is not extreme enough...apart from three hours 59 minutes in A&E before being sent back to his wife what can be done?

Spence Kennedy said...

Hi Anon

The main thing is that his wife was given some breathing space. The home situation had reached crisis point. She was so traumatised, she was seriously prepared to drag a bag of clothes out of the door in the early hours of a freezing morning rather than stay any longer with her husband - a man who she obviously loves, but who has become dangerous.

Taking John to hospital meant she could stay put and get some rest, John would be in a safe place, an assessment could be made re. the domestic situation. Maybe he'll go into an EMI unit - it depends. Maybe she just needs more help at home (it looked like she'd been trying to cope to an unacceptable level).

We acted as a fire break!

Quite often the help we give falls more into the social than the medical bracket.

uphilldowndale said...

So sad and thank you for caring

Anonymous said...

To answer Anon, John will have been checked out for any physical complaints in A&E, including things that could be causing an exacerbation of his dementia symptoms, such as a urinary tract infection. He'd then be admitted to an Elderly Care ward, and it would be up to the multi-disciplinary team (incl. social workers, doctors, nurses, occupational therapists... the list is endless) to decide what care he'll need, and where it is best delivered, then arrange it all before discharge from hospital.

PS, another great one Spence x

Spence Kennedy said...

Thanks for that, Mree - a good summary of that whole assessment process. I hope John & Vera get the help they need...

Anonymous said...

My neighbour here in northern Italy (the German-speaking bit for those aware of such niceties) is married to a former German teacher who has had Parkinsons for about 15years. He now has the associated dementia and has recently started hallucinating - he keeps telling her to talk to her friends. When she asks which ones he says "That one, and that one, the ones with no clothes on." She pays for him to go to a local care centre 4 x 1/2 days a week - she goes walking in the mountains in the summer and skiing at this time of year! I can hear her in the evenings sometimes when he's being really stubborn. I mentioned the German teacher bit because that is the sad part for me - I can't help her at all as he has forgetten all his German, he's lived here for many many years although he was born in Sicily, and I don't yet speak Italian enough to communicae with someone as ill as he is.
I hope it never happens to me - she deals with the whole situation so much better than I know I could.

Spence Kennedy said...

I can't imagine how tough it must be for your poor neighbour. The thing about dementia that's so awful must be the fact that you lose the essential person even though physically they're still there. It would be like a protracted bereavement, I imagine.

Even though you can't speak Italian, the fact that you're a friendly face and there to help must be quite a considerable comfort to her.

Thanks for your comment, and for reading the blog!