Saturday, February 25, 2006

The Carer's Allowance

My mother, Maureen Walsh, died of complications of an Alzheimer's-like illness on 27th October, 2001. She was 77 years of age.

Maureen (my mother) was in Respite Care towards the end of September, 2001, in Bellevista House on South Circular Road, Dublin. When I left her there for two weeks she was distressed, confused, not remembering her earlier stay in February after which she didn’t want to come home. She shared a room with five others, right in front of the Nurse’s Station in the Primrose Ward. The walls were painted that colour; the other ward was the Lilac.

I’d resisted applying for the Carer’s Allowance because of work I did on the computer. Teaching people how to use it brought in more money than was allowed under the means test, and so I was stuck between trying to make enough to keep up the car repayments and the rest and trying to provide a proper tuition service while keeping one ear cocked for Maureen in the other room. This fortnight “off” was something to look forward to and I was NOT going to feel guilty like I’d done in February.

How I’d wept when I came home that first time. I just hoped she wasn’t lonely because she’d never been away from my father and from me before.

But September was promising more. I had the Allowance, and under the new rules I could keep up the computer work and use a free travel card on the buses. King for a day, every day! I took her empty suitcase home with me on the number 65 to Tallaght and stopped off in the Penny Black to buy my dinner.

Then my father’s brother died on a weekend trip to Wales. John had had heart trouble before, but he’d kept himself active. His main interest throughout his life was in cars, car engines, vintage cars especially. He, his son Damien and another brother, Jim, went to a car show and on the way back he fell ill and died.

The day of his funeral I was sick with a heavy cold. It was raining, and I decided not to go. But that afternoon I got a call from the Nursing Home to go see my mother, who’d taken a fall.

Maureen had banged her head and though it looked bad (the nurse said) she hadn't fractured anything. I had the pleasure of Mom’s company for a number of hours in the X-Ray Department of the nearby Saint James's Hospital, in Dublin while we waited for the offical all-clear. Ten minutes in, I wanted to strangle the woman. She didn't have a doorkey, she complained, over and over and over again. The fact that we wouldn't be going home afterwards hadn't dawned on her, but her levels of suspicion were high. Finally, I walked her from the taxi to the Lilac Ward again. "Don't you leave me here" she wailed in anger and in grief as I parked her back into the care of the nurses. In a few minutes time, she'd believe she'd always lived there, but for me it was a heartbreak. You wouldn't leave a dog at the vet's without a bit of guilt. Leaving your mother in the care of strangers felt so much worse. So much for resolutions.

Anyway, the two weeks went by quickly, as they had on the previous time, and she was in bed and refusing to stir when I called back for her. "It's nice that you came to visit," she said. "But I'm going to die here." She closed her eyes. The nurses struggled with her to get her up and dressed. She didn't understand she was going home, cursed them, fought with then, but home we went. She was distracted by the traffic, wondering where we were going.

It was obvious that her health gone downhill in the fortnight away. She needed to be led, and she resented being led. She struck out, kicking, slapping, pinching. She became incontinent and had difficulty eating. I thought she might have had another small stroke while she was away.

I wasn’t worried. Somehow when you’re caring for someone who’s taken all the pills, seen all the doctors and who still is on the slippery slope, you switch off all the conscious worries and bury your daily grief. When she came home I almost felt the big switch trip in my head. There was a job to do on this and every day and I was the one doing it.

My father also had to make adjustments, which for him, I think were harder. No matter how I spent my day, washing her, feeding her, trying to get her moving, bringing her on fruitless journeys to the toilet, I at least walked out that door at 7:30 pm. Then it was the “night-shift”, and Tom had to lie half awake, to listen for her. At night, despite the sleeping pills, she’d get out of the bed and wander. Dad hung an iron gate at the top of the stairs to fence her in on the landing. But he didn’t sleep. He couldn’t. Even so, he had to leap from the bed sometimes in the small hours to pick her up from off her bedroom floor. Sometimes she could stand, but she couldn’t always walk at night.

The family gathered for my parents’ 50th Wedding Anniversary at the end of September 2001, none of us telling her, of course, that there was going to be a party, as she would have flatly refused to go. In the event it went very well indeed. Maureen didn't know where she was or much about who she was with but she was good-humoured, if baffled. We had a good meal in good company in the Black Forge Inn and the party resumed at the house. One of the last photos I have of her was taken then. Her grand-daughter, Elaine, who’ll be married herself in September 2002, sat beside her smiling. My mother peered suspiciously at the camera lens.

Next day, we siblings had the long-planned chat about her immediate future. Naturally, those who hadn't seen her on a daily basis expressed shock at her deterioration. I estimated that she had about a month to live. (In the end, she didn't quite have that). But even so we said that it was time that we looked for a permanent solution in the form of a nursing home.

Maureen beat us to the punch. Towards the end of October I couldn’t feed her any more and I sent for the doctor to ask his advice about hospital care. He phoned for an ambulance. I washed and dressed her through the blows and the curses. Two burly Dublin Fire Brigade men wrapped her in a green blanket and my father kissed her goodbye. He’d never see her alive again. We went through the motions in the Outpatients Department of Tallaght Hospital. “This is Willie’s way of getting rid of his mother,” she said to me, lying on a trolley in the corridor. I think it was the only thing she ever said in her life to me that cut me through and through. I could only flip a few more switches in my head, ones I didn’t know were there. Nurses came and went. She was moved to an examination cubicle where she slept fitfully all day. At times, she tried to struggle off the bed, or remove the drip from her arm. She beat the nurses and a young, black woman doctor. I was perversely amused that they couldn’t handle her. Sometimes I helped them examine her; other times surveyed their technique critically. It felt good that someone else was on the receiving end for a while.

I couldn’t fault the hospital staff, who did everything they could. It was a Friday and we arrived about 1:30 in the afternoon. They took tests all day. Brig arrived after work in the evening. It was 9:30 pm when a doctor other than the A&E junior had time to see her. She was young and confident, but unable for my mother, who slapped her as soon as she came near. I was tired, but I crooned something soothing into my mother’s ear until she calmed a little. Finally, they agreed to hospitalise her. My last words to her were: “Well, Mother… I’m off now. Remember, if you have to hit somebody, make sure and ball your hand into a fist beforehand!” The young doctor said a wry “Thanks a lot,” and I left. It was about 10:00 pm.

I stayed away all week, with the exception of telephone calls. She was very ill, unable to swallow food, drink, or medication. She beat the hospital staff and refused treatment. They were able to rehydrate her, but things were not looking good, they said. Dad and I would see her on Saturday. On Friday night, I went to bed and was awoken in the early hours of Saturday by a telephone call. Would I come to the hospital? Maureen had suffered a heart attack and had had to have the resuscitation team. I asked was she still on the ward. The moment’s hesitation in the nurse’s voice before she said yes told me she had died.

I’d never seen Tallaght Hospital at night before. Like a small city within its walls, it bustles with people coming and going. It has its own shops, even a bank, in the lobby. Tonight, only the porter was about. He let me in and watched as I walked over to the lifts. The John Osbourne Ward was near the back of the hospital along a curving corridor. “You’ll remember this walk for a while,” I said to myself as I passed by closed and darkened storerooms, offices, following the arrows on the hanging signs. I was met by a young nurse, wringing her hands. She was trying to find words to tell me the worst possible news. I told her it was okay, and not unexpected. She kept telling me how sorry she was. Would I like tea? To talk to the Hospital Chaplain? There was a nun of some kind hovering about. She offered me condolences. Unsure of Mom’s religion, the Catholic Chaplain had given her the Last Rites. They hoped I wasn’t offended. I told them she wouldn’t have minded. Finally, I got to see her.

She lay peacefully in bed near the door of the ward, her hands folded outside the bedsheet. “Well, Mom,” I said. “You’ve gone on ahead then.” I touched her face. It was still warm. I sighed, and went back out. Prayers were never my thing.

The night wore on as it had to. My sister and brother-in-law arrived and we contacted those in England who needed to hear; broke the news to my father and faced into a new day. Saturday. Eva, my sister, hugged me. “We’ve done this before,” she said. “This will be your first time.”

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