Welcome Home

A grand old house, maybe a century old, maybe even older, stands at the top of the long, dark road. Balloons and a Welcome Home sign hang over the front door, but once inside, more traditional decorations greet visitors walking into what looked from the outside like a stately manor, but inside was yet another nursing home. A tree in the corner, tinsel around the door handles and frames, cards strung from one side of the dining room to the other. The staff were all in a jovial mood, some wearing festive hats, many wearing badges and gimmicky trinkets on their uniforms. Even the dozen or so residents seemed to be enjoying themselves.

A carer meets us by the door and shows us to Mr Hella's room.

"He is unconscious. He's diabetic and his sugar is low. We've tried to give him glucose tablets and that gel stuff, but nothing is working, so we've had to call you."

"No problem. That's what we're here for." We notice the spotless carpets, the freshly painted walls and the furniture that looked either brand new or just very well cared for. "Nice to see a home where people actually take time to look after the place! Have you had it done up just for Christmas?"

"Something like that. We're trying to keep it that way and hopefully it will last." He points to the room at the end of the corridor and tells us that the nurse is there to help us further.

"Oh, good. You're here. We've tried everything to bring him round, but nothing's working. Hope this isn't a waste of your time."

Mr Hella's blood sugar has dropped so far, that the machine won't even give us a reading. A digital "LO" flashes up on the screen, although we didn't really need to check it. All the classic signs were there. A thready, rapid pulse, sweat pouring off him in buckets and an odd sounding snore when he breathed.

"We've only known him three days, he's a lovely chap and nearly ninety, but this is the second time he's done this to us in two days. Last time we managed to bring him round. He's not on insulin, just tablets, but they must be too strong for him."

"Good work!"

As we find a vein and draw up some glucose to feed his blood with some much needed sugar, we have time to talk to the nurse, complimenting her and the staff again for keeping the care home so clean, making the effort, and especially for being helpful to ambulance crews. Too often when we're called to care homes we're met more by apathy and resignation than by helpful, knowledgeable staff. Assuming, that is, that we're met at all. Sometimes we have to guess which of the rooms is hiding our patient, often having stood outside the building for some time before anyone let us in. 

This place was a timely reminder that not all care homes are the same. 

"Good to see that you seem to have a system that works well when you call an ambulance." 

"You think it works?" 

"Well, we were met at the front door, given a brief idea of what's going on, shown the way to our patient, and had a handover from someone who knows the patient and their condition. I'd say that's a pretty good system." 

"Isn't it the same in all these places?" 

"You're kidding, aren't you?" 

"Well, I'm glad you think it works. You're our first ambulance." 

"Today?" 

"No." 

"This week?" 

"No. First ambulance ever." 

"What? You've never had to call an ambulance before?" 

"No. Never." An amazingly rare feat for any care home, and a record to be proud of.

Mr Hella starts to come round, the sugary water coursing through his blood and up into his brain. 

"Who are you?" 

"Ambulance service, sir. It seems you gave these people a bit of a fright." 

"Oh, I'm so sorry. Did my sugar level drop again?" It seems that he's more used to his condition than the staff who are looking after him. 

"Just a little. They seem to take good care of you here." 

"They are truly amazing. I only wish I could have moved here sooner." 

"When did you move here?" 

"Three days ago. My family have been trying to convince me either to move in with one of them or move into a home ever since my wife died. I needed someone to care for me when I pulled these sorts of tricks." 

"So what took you so long?" 

"First, I'm a stubborn old fool, and proud of it. Secondly, all the places I looked at were awful. Or worse. But I had a look around here when they were just putting it together and when they opened, I jumped at the chance!" 

"Jumped?" asked the nurse with an amused grin.

"Well, gently moved in a positive direction." 

We all laughed. "I think, since this is your second attempt at being difficult in as many days, we should probably get you checked at hospital. Just to make sure you're going to behave." 

"Hospital already? I've only been here five minutes!" 

"But," said the nurse, "you do have the distinct honour of being our first ever ambulance patient." 

"Well, that's no surprise, is it?" 

Confused, I had to ask the obvious question. "Why isn't that surprising?" 

"Well, they've only been open for three days. I was their first ever customer!" 

No amount of pleading would convince him to take a seat on our wheelchair out to the ambulance. "I'll walk, thanks. Just get me my frame. I might be old, but I'm not that elderly. And you," he said, looking back to the nurse, "make sure you look after the place until I get back. Can't have my new home going to ruin whilst I'm away." 

"Don't worry. We'll keep the sign up just for you, Mr Hella." 

Head Injury

Barely a cupboard under the stairs, the tiny top-floor room in the residential care home had no more than a bed, a two-door bedside cabinet and a tiny sink. The floor space was almost entirely taken up by Jasmine, and she was no bigger than a ten-year-old. As I walked in through the door, the sloped ceiling made me tilt my head to the right a little, just to make sure I walked in unscathed. 

From the look of her, Jasmine looked like she weighed no more than a wet tea-bag, and even then after the water had been squeezed out. Her skin was dry and fragile, veins spidering up arms so thin they seemed as though they would snap like sun-dried twigs. The red tinge to her thinning white hair gave away a secret, as yet unseen, cut to her head. She lay there confused and a little disorientated, but a winning smile crossed her face. 

"I'm not too sure how I ended up here, but I think I'm alright. Just get me up and I'll get right back on that gin that must have floored me in the first place!" 

"Now, Jasmine, if you'd have said whisky, I'm your man, but not gin. Might have to leave you on the floor until you can choose a proper drink."

The care home staff looked horrified, but Jasmine saw the funny side. 

"You'll do as you're told, young man! Now get me up so I can see exactly who I'm telling off." 

With the help of one of the carers, Jasmine was lifted off the floor and helped to a chair. It was the first we saw of the damage she'd done to her head. 

"You're going to need a trip up the hospital, I'm afraid. That's quite a nasty cut you've got on your head." 

"I'm not going anywhere, but back to bed." 

"Jasmine, your scalp looks like you've put a cat-flap in it - it needs sticking back together again. It's that impressive, that I can almost read your thoughts!" 

"I'm NOT going to hospital!" 

"See! I knew you were going to say that!" Jasmine eyed me suspiciously, a small, half-smile giving away her amusement. 

I tried to replace the flap of skin back in place and hold it all together with some bandaging. The carer who helped me lift Jasmine off the floor started to feel faint at the sight of the injury, so I sent him to get something completely irrelevant, allowing him to get some fresh air and maintain some dignity. 

As he left, the ambulance crew arrived, the two-wheeled carry-chair in hand. Having spent a few minutes explaining, cajoling and joking with Jasmine about her injury and the need to have it treated, she finally agreed. We helped her into the wheelchair, wrapped her in a blanket and secured her with the belt.

"At least I managed to arrange a blanket that matches your new hair colour. Anyway, I'll leave you with the  friendly ambulance crew, I'm sure they'll be nicer to you than I was." 

As they turned the chair around, Jasmine said a polite "Thank you", and I turned back to sort out all my bags. 

"I'll check on you a bit later at the hospital if I get the chance, make sure you're behaving yourself." 

"You do that. I look forward to it. And make sure you don't forget that gin!" 

"Whisky!"

"Oh. Alright then. Make it a whisky." 

With that, Jasmine was wheeled into the lift and taken down to the ambulance for the short journey to the hospital. I tidied up the mess of packaging, wrapped some of the blood-stained bandages in an inside-out glove, picked up all my luggage, turned to leave the room, and without looking up properly, walked head-first into the low sloped ceiling.

Armchair

"Oh - it's you again". Sometimes it's a phrase said with genuine affection. Sometimes relief. Sometimes it's just downright disdain.

*****

"Armchair", you grunt, as an afterthought to the opening phrase.

Well, yes. It is me again. And again. And again. I keep coming back here when you've had enough of another one of your clients. But this time, I can bite my tongue no longer.

This time, you left her in the armchair, in front of all the other residents, for a whole day. And night. And most of another day. Almost 36 hours, and none of you thought to check on her.

You just "assumed".

You just thought "she doesn't do much usually".

You just presumed "she was in one of those moods".

None of you thought that it was unusual that she hadn't asked for help to get to meals.

Or back to bed.

Or even to the toilet.

Three shifts went by, and she was still sat in the armchair.

When you finally took a look, you saw she was barely breathing.

You saw she was covered in vomit.

You smelt the strong smell of urine.

So you told her off. Like she was some sort of small child.

Like it was her fault that she'd possibly been unconscious for the best part of two days.

Like it was her fault you ignored her.

Well you know what? It's your fault. Your job is to care, to pay attention, to tend to needs. That's why she was there, so you could look after her. That's what you have chosen to do. That's what you're paid for. So don't tell me that you're "not paid to think, just to clean them". The "them" you refer to are people. Not animals or the cages that they're kept in.

You were charged with her welfare, when she had no where else to look, and no one else to turn to. And you failed.

And I hate to say it - I get the feeling you're almost glad.

Glad that she's taken off your hands.

Glad that you're no longer responsible.

Glad that she'll probably never return to that armchair.