help

We wondered if you’d help us out on a slightly strange one. We took a call from an elderly female in a nursing home. She was obviously in a great deal of distress – in fact, the call taker said it sounded like she was being murdered. Then he said someone else came on the phone - a care worker or something - said everything was fine, not to worry, thank you very much, the line went dead. Obviously the call taker wasn’t happy with the way it ended, and didn’t feel a call-back would get to the bottom of it, so he said he’d be grateful if you wouldn’t mind swinging by and taking a look.

We’ve been to this nursing home any number of times. It’s a warm, well-managed place, comfy sofas in the lounge, bright artwork on the walls, a brisk and sunlit feel to all the rooms and corridors. Everyone who works there, from the cleaners and caterers to the nurses and health care assistants – they’ve always been friendly and helpful. If there was one nursing home in all the county less likely to be the scene of a grisly murder, it was this one.

We pull up outside, the driveway as empty and neatly swept as ever.

No police tape, CSI boiler suits, reporters.

Gus, the manager, is standing chatting to a nurse in the hallway.

‘Hello,’ I say as we step through the automatic doors. I wave a hand up in the air. Smiling. Slouching. The Peter Falk school of interrogation.

‘Sorry to trouble you. I wonder if I could have a word?’

Gus excuses himself to the nurse, unlocks his office.

‘I think I know what this might be about,’ he says, leading us inside.

‘Absolutely. I’m sorry to bother you.’

‘Not at all.’

He closes the door behind us and leans back against the desk.

‘How can I help?’

‘Our Control room took a call from one of your residents just a half hour ago or so. Apparently there was a lot of screaming and shouting, it didn’t seem to make a lot of sense, and then someone else came on the phone, said everything was fine, don’t worry, and hung up.’

Gus nods.

‘Yes. I thought so. What it is, you see, we have a woman of eighty-four who’s behaviour is extremely – erm – problematic. She’s come to us from her home address ...’

He mentions the flat number, the block, and before he’s even finished, a name pops out of my mouth.

‘Vera.’

Gus raises his eyebrows.

‘You know her?’

‘Too well. I couldn’t even begin to tell you how many times an ambulance has been out to Vera.’

‘I’m not surprised. She’s quite a handful.’ His glasses shine.

‘Vera came to us for a little respite, and almost immediately tried to self-discharge. I was concerned because she wanted to push her rolator down the road without adequate clothing, without showing any insight into her overall condition, personal safety etcetera, etcetera. So we enacted DOLS and ...’

‘Sorry – what’s that?’

‘DOLS. Deprivation of Liberty Safeguards. It’s an aspect of the Mental Capacity Act. You’ve not heard of it?’

‘No. But it sounds – great!’

‘Yes, well. It’s designed to help us give the care we need when the patient isn’t in a position to make the best choice for themselves, for whatever reason. Vera’s an odd case because she’s not been diagnosed with dementia, for example, which is often what this DOLS is brought in to cover, but she’s been assessed according to the guidelines and consequently detained here against her will for the last two months or so.’

It suddenly strikes me that it’s been quiet on the Vera front for some time. I could hug Gus. If I did, I’m sure he wouldn’t mind. He’d find a way to disengage at exactly the right moment, and everything would be properly documented.

‘Vera’s a challenging proposition, without question,’ he continues. ‘She spends an awful lot of time screaming for help, abusing my staff, making phone calls when she can, generally uncooperative, disruptive behaviour. And when she’s not doing that, she’s putting herself on the floor feigning injury, throwing things – you name it, really. I feel that our facility here is probably just an interim measure, but that’s in process.’ He adjusts his glasses. ‘You’ve never heard of the Deprivation of Liberty Safeguards?’

‘No. But I’ll definitely look them up.’

He turns and taps a password into the laptop behind him; with a few brisk keystrokes he brings up a Department of Health website.

‘A useful piece of legislation,’ he says.

‘I’ll read about it later, Gus. Thanks for your time. And good luck with Vera.’

‘She’ll be fine,’ he says, opening the door.

There’s a commotion in the lobby. A nurse is standing just in front of a tidily-dressed old woman in a red crocheted jacket and speckly brown skirt, who in turn is repeatedly ramming the front wheel of her rolator into the glass door and shouting Help! Help! in a plaintively thin voice I’ve come to know so well over the years.

‘Vera!’ I say, going over and touching her on the shoulder. ‘Vera! You’re looking so well!’

And she is. If you can ignore the fact that she’s shouting for help, she actually looks great, well-fed, her hair nicely cut.

She stops shouting and slowly turns to face me. She narrows her eyes a moment, then says in the lower, rasping voice she uses as an alternative to the scream: Do I know you?

‘Don’t you recognise me, Vera? I’ve been out to you hundreds of times.’

After a moment to think about that, she uses voice number three, the childlike whisper: Please help me! I have to get out of here. I have to get home.

‘But Vera – they’re obviously taking excellent care of you. I think you should stay here a while, rest up and get your strength back.’

Vera looks between all of us, then with a raise of her shoulders to build up her strength, charges her rolator at the door again, screaming Help! Help!

As the nurse tries to quieten her down, a young family emerges from one of the rooms behind us,  a man and his two young daughters, putting on their coats, ready to go. They stand in the background, unable to leave because of Vera at the door. The man puts his arms around the girls; they peer over his sleeves appalled, fascinated.

Help! Help!

‘Vera? Come on – you’re frightening those poor children.’

She stops. There’s a pause, then she starts to turn her rolator round to get a fix on them. But before she is even half-way through the manoeuvre, Gus has already politely and efficiently led them away to an alternative exit.