Earlier this year much of my time and head space was consumed by supporting an elderly family friend who fell, sustained a fracture and was admitted to hospital. I use the word consumed because that is how it has felt. Many hours of travelling, making phone calls, waiting for phone calls.
I know this story is nothing new or earth shattering. It is being played out day in, day out. But, this happened to me and I know, from discussions I’ve had with colleagues, there is something different when, as a health professional, you find yourself adrift and struggling in a system you have been a part of, you value greatly and want to champion with all your heart.
There is something different about navigating a course through the terrain of being a health professional and a carer. Putting different hats on when you need to and trying to judge which hat you should be wearing at which particular moment. Something different about trying to make sense of a system which you know is buckling at the knees. Trying to be understanding of the pressure that everyone is working under whilst keeping a lid on your exasperation with how you know things should be.
One of the ways in which I dealt with the situation I found myself in was to journal. I am a writer and it is my way of making sense of things. What I am offering here are excerpts from my journal, the things I wrote in moments of quiet to work through everything that was happening.
Over many years as a researcher I have collected other people’s stories. As a researcher I know that if I were to interview the other people involved there would be multiple narratives of what I describe, each offering a different perspective and interpretation. However this is my narrative, my perspective. It’s called, ‘Hanging by a thread’ because that is what we have both been doing in our own ways.
Monday night Pilates finished with relaxation, a few moments to slow down, ease off and be still. Into the car, check the phone, missed call from an unknown number. Your neighbour has been trying to contact me to let me know that you fell on your way to the shops this afternoon. You’ve broken your arm and are in hospital. For some unknown reason you were transferred to somewhere quite a long way from where you live.
I track you down in A&E, explain that you have no direct family who are regularly in contact with you, and that we’ve know each other for over 40 years. I’m the person you ask people to call if you need anything serious I visit you most months and phone each week to make sure you’re ok. I’m also the person your neighbours call when anything goes wrong. So, I’m not sure what that makes me – a family friend or something more? At this moment in time no-one else is claiming responsibility for you, the hospital doesn’t have a number for anyone to call and so I think, ‘I’m it’.
I’m told you’ve had an x-ray and they are waiting for the results before they put a cast on. That could take another couple of hours but, ‘can anyone come and pick you up?’ At 1am? Are they serious? A 91yr old who lives alone – is there really no room at the inn tonight?
I look out at the darkness and contemplate the two hundred mile drive. Don’t even think about it. For a moment I think about trying to ring round your neighbours to see if anyone could drive to pick you up but then remember the distance they would need to travel. So it’s agreed. You’ll have an overnight stay with an assessment in the morning to check that you’re OK to go home.
I phone the next morning to see how you are and am told the referral for the assessment has been made but it could be another day before you are assessed. Why is it taking so long? I want to push my foot hard on the accelerator, every instinct in my body says to get you home asap. I know what might happen if you’re out of your own environment for very long.
Then another call later that afternoon. Your behaviour has changed quite suddenly. You’ve become aggressive and are refusing to let them take blood or get near you. You want to go home and as far as you are concerned they are keeping you there. There is concern that you may have sustained a head injury when you fell and they want to scan you. The reason for the call is to tell me that they are placing a DOL order on you. A DOL? Did I catch that right? I have an inkling I should know what this stands for, but I haven’t a clue.
Three letters disguised as something harmless and playful, a girls’ best friend. But not today. No Siree. Today your best friend is a deprivation of liberty order designed to protect you from yourself. Of course this is the right thing to do. They are worried that you might have a cerebral bleed. This is serious. So now, when your years of playing with dolls are long past, you are once again the owner of a DOL. I’m told to phone back the next day to see how you are.
I call the next morning and have to navigate the system again, this time the ward. Of course it’s the correct thing to have to do but when you’re not family but the person who, in the absence of family, has been supporting someone it’s so hard to explain who you are. I hear myself telling a rambling convoluted story.
I get to talk to your lead nurse and she tells me that you’re much better but still a bit muddled and you won’t be going home today. I decide I need to be there. You need to see someone you know and I think it might help if you have some things that are familiar with you, i.e. your own clothes, washing things, slippers etc. All you have with you are the clothes you fell down in.
Are you taking me home?
I call onto the ward to see you before I drive to your home to pick up your things. You recognise me straight away, your eyes light up and you smile. The first words you speak, ‘have you come to take me home?’ You’re a bit confused about what has happened and why you’re in hospital. You ask me, with a total disregard of the plaster cast wrapped around your arm, ‘why are they keeping me here? I don’t understand. I just want to go home.’ When I point to the plaster cast you look at it with curiosity and stroke the little sausage fingers poking out of the end. We inspect the marvellous purple bruise spreading above your elbow.
I drive to your home and let myself if. When you set off yesterday you had no idea that anyone would be coming into your home. It is spotless and puts mine to shame. Nothing is out of place, not even a dirty mug on the draining board. I feel like, and indeed am, an intruder as I go through your draws to find some clothes and your wash things. Everything is so neat and ordered. A draw for gloves and scarves, one for jumpers, beautifully white pants and vests neatly folded in pairs. I turn round and feel a lurch in the pit of my stomach as I look at your bed and see, fold so precisely on the pillow next to yours, one of your husband’s handkerchiefs with his initial embroidered on it. He died several years ago and you must place it there everyday when you make the bed. Before I left the hospital I asked if you’d like me to bring a picture of him back with me but you said you couldn’t bear it, it would upset you too much.
When I get back to the ward your named nurse comes over to say ‘hello’. She smiles and says how nice it is to see you a little more like yourself because, ‘yesterday you hit me in the face.’ We both look at you and wait. You look straight into the very face you hit just hours ago and, without missing a beat, your response? ‘Well, at least I didn’t break your glasses.’ Not what either of us was expecting and definitely not the response I was willing you to give. I know this is your sense of humour, you are trying to make light of something in your straight talking way, you are embarrassed, but would it have cost you so very much just to have said, ‘sorry’. AND THEN you draw breath and with a classic one two say, “I didn’t pull your curls out either did I” and, like the trooper she is, she takes it on the chin.
What’s the password? Before I leave you I’m told I need to set one up so that when I phone the ward I can talk to people in more detail about you. I’m now part of the inner circle, those granted priviledged access to information about you. But what I really want to know is what is the REAL password? The one I need to get you home asap?
Pictures by Danielle MacInnes via Unspalsh