Date of birth: 25 September 1931
Primary condition: Old age
My dear sweet Nancy. This lady was the first client to break my heart. I was the first carer to visit her. She lived in a large detached house in a quiet cul-de-sac. Her front door was unlocked. I knocked and entered. She sat on the sofa with her neighbour and friend. She was small and slight, birdlike, frail. Her skin was dark and looked bruised. She had an air of defiance. She didn’t look at me. Her friend smiled and looked embarrassed. “Hello,” I said. Nancy didn’t respond, but looked to her neighbour and asked, “Who is she?”. “My name is Julie,” I said. “I’m here to help.” Again, she turned to her neighbour: “But I don’t need these people!” Her neighbour turned to me and apologised. “I’m so sorry,” she said. “Nancy has never needed carers before, but they wouldn’t let her come out of the hospital without you. She’s been incredibly independent her whole life. Never needed help before. She’s struggling to come to terms with the situation she’s now in.”
And there we have it. I don’t know Nancy from Adam. I’ve never set foot in her home before, and yet here I am. I have let myself in, just shouting “Hello” as I enter her hallway. This is my workplace, but it’s also Nancy’s home, a place where she feels safe and secure. She’s always been able to dictate who comes through her door, until now.
Nancy wasn’t happy I was there – a stranger in her home. I hadn’t been invited. She, like many older people (but not all), was resisting the ageing process with every fibre of her being. Yes, this was going to prove challenging, but her failure to acknowledge she was old and her utter determination to fight the ageing process, ignore it, turn a blind eye to it, whatever term you use, was in itself inspiring. As time went on, I began to admire that fighting spirit. In her mind, she was still youthful, beautiful, spirited and I loved her for it.
I didn’t do much on that first call. I don’t think Nancy once made eye contact with me, but as I left, I turned to her and said quietly, “I understand why you don’t want me here, I honestly do, but one day, maybe you will look forward to my visits.” I didn’t know it at the time, but those words turned out to be more accurate than I could possibly have imagined.
My first few visits to Nancy were stilted. I had an hour for her tea call and an hour for her bed call and there wasn’t a great deal to do. It was difficult to fill the time. I did what I had to do. I never pushed her to open up to me, though I desperately wanted her to. It started slowly, little snippets of her life, which she delivered while I was doing something else – cleaning, cooking. She was from Oxford and had one child, a son. When he was eight years old, she discovered he was diabetic. This was a story she told me many times. How in those days it was much more difficult to give him injections. She said she did it every day for him until he could do it himself. At this point she would demonstrate how it’s done today by tapping her arm gently. “In those days it was a huge great needle and you did this!” She would thump her fist against her arm from a distance to demonstrate just how big and painful that needle was! She bruised her arm many times doing this.
Her son went to Nottingham University, where he met his future wife. They had two children – a girl and a boy. Nancy’s husband decided it would be a good idea to move to Nottingham to be closer to them, so they did. She hated it. Another story she regularly relayed to me was how that very first day in Nottingham, while her husband was out, she left the house and got into her car. It was, she told me, a top-of-the-range sports car. As I got to know Nancy better, I realised that she liked to have the best of everything and she wanted everyone to know it! She drove around Nottingham, she told me. She had no idea where she was going, she just drove, for miles, along unfamiliar roads. As she drove, she began to cry. “Damn that husband of mine,” she said to herself. “Why am I here? I have no friends here, this place is alien to me.” She drove for hours and hours and got utterly lost. She decided she was not going to stay. She was going back to Oxford.
Nancy is now 96. She’s still in Nottingham and I am her carer. Her son brings bottles of white wine. He hides them in a cupboard. I should get one out on a Friday evening, he tells me, for her to have over the weekend. If we don’t hide it, she would drink a bottle a day. I smile and look at his wife, who smiles back. Is she thinking the same as me? She’s 96! I think if I were 96, I would probably do whatever I damn well liked, and if that meant drinking a bottle of wine every day, then that’s exactly what I would do. Obviously her son doesn’t think so, but what her son doesn’t know, although he’ll find out soon enough, is that Nancy knows exactly where he hides that wine!
Nancy’s tea call starts at 3.30pm and ends at 4.30pm. A few minutes before I leave, I can see her eyeing up that cupboard. I know that the moment I’m gone, she will be there rummaging around the back of it for that bottle. When I come back at 8.30pm she’ll be halfway through it. She’s so small and frail that half a bottle of wine is the equivalent of you or I drinking two. She laughs and giggles like a child. She recounts the time she kissed another man behind her husband’s back. He went to his grave not knowing about that one. She has been propositioned more times than I think I’ve had hot meals. She was stunningly beautiful. She believes she still is. Next to her bed on her bedside table is some face powder and lipstick. Every now and then, she reaches for it and applies it while looking into her little handheld mirror. “I look good for 96, don’t I?” she says. “You look amazing,” I tell her. What she actually looks like is a 96-year-old woman applying make up to a little wizened face, but she’s happy in her belief, and if Nancy is happy, then so am I.
It isn’t long before her son realises that hiding the wine is a fruitless endeavour. She will find it no matter where he puts it. She can smell the alcohol from any room in the house. In the end he concedes defeat. “She can have it when she wants it,” he says, so her first glass gets earlier and earlier. She begins to pour herself a glass before I leave her tea call and then she starts pouring it as I walk into her home for her tea call, eventually having a full glass in hand when I get there at 3.30. Sometimes she meets me at the front door, glass in hand. She knows all the young children in the street. They shout “Hello!” when they see her. She presses her small wiry fingers to her lips and blows them all a kiss. “Hello darlings!” she smiles.
I continue to see Nancy regularly. We talk, we laugh, we cry and on one occasion she turns to me and says suddenly, “who are you and why did you start coming here?” “I’m your carer,” I say. “Oh no,” she replies. “You’re not my carer, you’re my friend!”
Of course, Nancy is old, and with or without her wine, she’s getting more and more frail. Although it’s a slow process, I see her deteriorate before my eyes. She just finds it harder and harder to get around, until eventually she is bedridden. A few days before she passes, she’s not really engaging anymore. Her friends and family come more frequently. They’re often here when I visit. They sit next to her bed and hold her hand. She stops eating and eventually stops drinking. Not even the wine can tempt her. On her last evening, I sit on the edge of her bed. As I reach for her hand, she opens her eyes. Smiling sweetly, she simply say,s “hello darling,” and closes her eyes again. The next day, she is gone. She died on the same day as my daughter’s 18th birthday. I won’t forget that day, nor will I forget my dear friend Nancy.
The day after Nancy’s death, the office removed her calls from my rota. In Nancy’s space, there is simply an unpaid gap. We only get paid for our time with clients, nothing in between, not for travel time nor for gaps between calls, so my pay will inevitably go down. I may or may not be able to afford my bills because of this.
When I receive my rota for the following week, there is another call in Nancy’s place. A lady I have never met before, a new client perhaps. I don’t want to go. She is not Nancy. I’m yet to meet her, but I feel I already dislike her for no apparent reason. There is a word, you see, that no one in the office ever cares to use. They are aware of this word, but it’s not in their interest to acknowledge it. They are a business, and their primary objective is to make money. If it isn’t profitable for them, then it isn’t going to happen.
The word I’m talking about is grief. To be an exemplary carer, we must care. Sounds obvious! And yet the companies we work for seem to lack compassion for anyone – their staff, their clients. A client dies. This means the funding this client brings to them ceases. So they simply look for another source of revenue.
Not once did anyone from the office ask if I was OK, if I needed some time to grieve, a couple of days off, a chat, a good cry, or a hug. They don’t want carers to care, they want us to do the tasks set out in each care plan, then move on to the next call. They don’t want us to form bonds. They want to be able to change our rotas when it suits them. Clients we saw every day for years could suddenly be whipped off our runs and allocated to someone else, someone who had no idea of their routines, their needs, their likes and dislikes. This has a detrimental effect on us and the clients we are caring for.
In the end, I had no choice but to accept the change in my rota. I couldn’t take time off as these companies don’t provide sick pay. So you bury your grief. It’s all you can do, but it’s something we all experience, and the lack of support we receive when it happens is just one of the many injustices we experience as care workers.
Julie Sansom has worked in domiciliary care for around seven years. She entered the care sector after being made redundant from a 20-year career in an office-based role. She is a passionate advocate for fair employment practices within the care sector, especially the elimination of zero-hours contracts. She believes these contracts offer no job security or consistency and can often be used exploitatively by employers, silencing workers’ dissent by threatening to reduce their hours.
This article is part of a book Julie is writing about her experiences working in the private care sector. The book seeks to lift the lid on what is really happening from the inside.
Image credit: Chastagner Thierry via Unsplash