Wrinkled Souls

Chapter One: Patricia

Old age is no place for sissies

Bette Davis

I stare down at the remains of what used to be a functioning body. My legs have become two mere appendages lying immobile on the bed mocking me for a lifetime of taking them for granted. Now my legs only move if someone else moves them. In spite of my compulsory confinement I count myself lucky to be able to still force my feeble hands to attend to mindless minute tasks such as turning on the radio or putting food in my mouth, but only if everything has been set up within my reach. My non compliant body aches and my only release is a drug-assisted unconsciousness every night. I do not fear death rather I dread the unmerciful future.

My name is Patricia Cross and I’ve lived for eighty-seven years. Somersby Aged Care Facility will be my final residence, not that I ever had any real choice in the matter. Once the hospital staff had decided that nothing further could be done for me I was promptly assigned to the discharge pile and it was expected that I would accept the first available nursing home bed. The planned one week hospital stay for my second knee replacement extended into months as the inopportune infection ravaged my new titanium joint. The persistent pain and stench of pus put an end to any lingering hope I might have of a cure. My fate was sealed with the removal of the tainted part. Apparently it was no one’s fault. My right knee is criss-crossed with scalpel incisions, its joint function obsolete and compared to its matching left leg it is not only misshapen but six centimeters shorter. Perhaps if I had been ten years younger my body might have adapted, but the months of being bed-ridden and pumped full of antibiotics, eroded my bones and muscles and effectively rendered me an invalid. There was no time permitted to adjust to my disabled status. Once the hospital machine decided that nothing more could be done for me I was removed from its radar as if my presence was an unwelcome statistic. The machine had declared me unfit and I found myself imprisoned in a system that was designed to accommodate facts and figures but not humanity. I was shipped off to the first aged care facility where a bed could be found.

That was three years ago While the brochure promised personalised nursing care the reality is that I am one in a herd of eighty-five residents and my care is dictated by budget and staff constraints and I pay handsomely for the privilege. It took me two and a half years to succumb to Sam’s badgering to sell the cottage in Bowral and the price was never worth the loss of the dream that I might somehow get back there. No one seems bothered that my life had now been reduced to this small room.

I miss the clean air and the trees, the grass and the hills which I could see from my lounge room. Most of all I miss my space. The space to be me, the space for my privacy and the space which others can enter only if invited. There is no space allocated for the life that used to be mine. It was an enforced divorce. All life’s treasures my clothes, my books, my music and even my toiletries had to be downsized to accommodate a room the size of a prison cell. I had instructed Sam as to whom he was to give my jewelry and the special things which Tom and I had bought together. The rest of my belongings were sold or given to charity.

Only my fellow residents can know the deprivation of privacy, the deprivation of personal freedom and the comprehension of being a mere cog in an institutional machine. Sometimes I am scared because I can feel my very presence in this world diminishing. I want to scream out I’m alive, I can think and I still matter. However there are brief interludes in which I become almost content with my limited life of eaves-dropping in the goings-on outside my door, listening to the radio, enjoying a cappuccino when Sam visits or talking to a nurse who has taken the time to get to know me. I know that the staff breathe a sigh of relief when I am compliant with their over-scheduled routine.

I am waiting for death but I cannot let go of the need to know what is going on outside the walls of Somersby. I have always kept abreast of world affairs although not with today’s sophisticated appliances. My small transistor radio is my best friend and the main link with the world outside. I am never without at least one set of spare batteries as it would be unthinkable to be trapped in this cell alone and cut off. I am unable to read anymore as I can’t hold a book and my worsening cataracts have rendered the television redundant.

It is nine fifteen on another Monday morning and I’m waiting for the assigned nurse to shower me. I dread the daily ritual of discovering just who my nurse will be for the day. Will it be an agency nurse or one of the new immigrant nurses? Neither will know anything about me and I will count myself lucky if she can even understand English. I’ll explain again how they have to lift me because my shoulders joints are worn out and painful, my right leg does not bend and at the same time I’ll pretend that I trust their expertise. I am unable to do much to help them and they all think I am an old fusspot because I am one of the herd who can still tell them what I want and need. They would prefer it if I had dementia because then I would just accept whatever care they were handing out that day. The demented residents never buzz because their pad is wet or the scrambled eggs are cold, again.

Hi Mrs Cross. I have come to shower you I did a swap with Dennis.

I relax because I have been granted a reprieve for today at least. Karen is my nurse and she has brought the padded toilet chair with her. There is only one of them on this floor and it regularly becomes a contentious issue when I refuse to sit on the cold steel type.

Thanks Karen, you are literally a life saver. Dennis may have been doing this for ten years but he still doesn’t seem to know how to wash someone, let alone talk to them

She checks my toilet bag. Today I will not be left half naked while the nurse races back to my room to fetch my shampoo or conditioner or even worse, will not even bother.

You know Karen your talents are wasted, have you ever considered doing nursing training?

Well I have made some enquiries but the uni fees are pretty steep and I still have to support two children. I wish I had the resolve I have now, when I was younger, but I have been a slow learner in that respect. Still if I ever win the lotto I would be at uni within the month. It is funny how you appreciate education more as you get older.

Her face was wistful as these thoughts were spoken. I see her push the moment away as she comes back to the present.

Okay I am just going to get another nurse to help lift you onto the chair.

Showering has become a bi-daily event and while I love the hot water pouring over me and being able to sit on the toilet it is always overshadowed by the fear of leaving the safe cocoon of my bed. Karen returns with Kylie and under her careful instruction I am hoisted onto the shower chair before being taken to the toilet down the corridor. It is always cool in the toilet but Karen remembers to wrap the crochet rug around me.

The morning shower frenzy resembles a production line as men and women are stripped naked and then for the sake of decency encased in a cotton cape before being wheeled down the narrow corridors to one of three bathrooms. It is rush hour every morning with the charge nurse guiding the drug trolley to every resident’s bedside, the kitchen hand dropping off breakfast trays or picking them up, the dressing sister doing her round and then of course the assistants in nursing wheeling all their residents to the toilet or the shower. If two parties meet in the corridor, one has to give way by backing up and moving into a doorway. The whole world knows that I am off to the toilet or the shower and for those of us whose brains are still capable of cognitive performance, we will dutifully attempt to train our bodily functions accordingly.

I will be in your room making the bed and tidying up so when you are ready just ring the bell.

I consider Karen is a good nurse because she concentrates on one patient at a time. I cannot tell you how often I have been forced to wait up to half an hour in the toilet on that damn uncomfortable toilet chair for my nurse to return and then shower me. I reckon the process of toileting and showering residents is treated as a speed event which nullifies any thought we might have of enjoying a lingering hot shower or the application of some moisturiser. Still I have to concede that the prospect of two nursing assistants showering or washing twelve worn-out people, with varying degrees of physical disability, before lunch is utterly absurd, yet that appears to be reality here. The indignity and powerlessness of my living is a constant reminder of how demeaning my life has become. I don’t want some useless gush of pity and I have no intention of becoming a victim.

An hour later I am back in my room all fresh and clean.

It looks like I have missed the tea lady again Karen, but that shower was worth it.

Don’t worry Pat my brief includes keeping you fed and hydrated, Karen laughs. I’ll be back in a jiffy.

I fantasise that if I was rich I would hire Karen every day to be my nurse. Unlike the breakfast cup of tea, the cup of tea Karen brings me is hot and my luck holds as there is also a soft piece of cake to go with it. Before rushing off to her next resident Karen ensures that my bedside table is properly positioned across my lap and she arranges the call bell, radio, tissues, glass of water and the jar of chocolate pieces so that they are all within my reach. It is her attention to the small details which I am sure makes any resident hope that Karen will be their nurse for the day.

I turn on the radio pleased that a talk show is on and savour my morning tea.

Chapter Two: Karen

"The most courageous act is still to think for yourself.

Aloud"

Coco Channel

Karen curses the Pacific Highway traffic as her car crawls toward Pearce Corner. It used to be that starting work at seven am meant that you missed the peak hour but in spite of new motorways and extra lanes Sydney roads are unable to keep pace with the increasing numbers of cars and peak hours have lengthened at both ends of the day. Who would believe that one idiot driver parked in a no-parking lane on the Pacific Highway could reek such havoc. She hates running late because the morning shift is always busy and she wants to shower at least two residents before breakfast.

At twenty nine Karen knows her options are limited. She is a solo mum of two boys and somehow has ended up in a going-nowhere relationship with Matt, who struggles to maintain any type of reliable employment. This partnership is so different to her first marriage but she mustn’t let herself think about Jason because the pain of his death can still leave her breathless. She would be better off on her own but she still has not made the move. She may as well go it alone because in essence she is already doing that. She promises herself once again to get the control back in her life and start making plans which put Jack, Toby and herself in first place, not some insecure lazy man. Resolute once again Karen turns her attention to Somersby. By six thirty she is checking the workbook to see who her allocated residents will be.

Hell the last person I fancy seeing this morning is Mrs Cross,

Dennis grumbles. She will instructing me in every little thing and she will take ages.

You should try talking to your patients sometimes Dennis, you might find that they are real people who like to have a say in what is done to their body. Anyway I am happy to do a swap if you do Geoff instead.

She is pleased that she will be looking after Mrs Cross who has become increasingly frail in the last three months and while it is time-consuming caring for her unlike so many of her clients she is always responsive and interesting to chat with. She feels a sense of accomplishment when she manages to shower her and get her comfortable. After a brief handover report from the night staff Karen heads straight for Mrs Timm’s room.

Hi Edna, fancy an early shower today?

"You know I do, but you seem to be the only nurse here who notices?

Edna is lying amid a tumble of crumpled bedclothes doing her morning leg exercises. She is a tall lady, very slim and very proper. She hates being in a nursing home and blames her adopted daughter for putting her in Somersby. Until six months ago she was still living in her own large home in Turramurra but when her daughter, Alice, arrived from England following her last hospital admission, her independence became a contentious issue for a host of do-gooders. Of course this was all for her protection. Supposedly she should have been grateful that she had been given a single room with an ensuite bathroom, which in reality was a grossly exaggerated term. Her room could barely accommodate two chairs, her bed and a bedside cabinet. The bathroom comprised a toilet and shower with barely a metre in between them, hardly enough room for one person let alone if you needed some assistance.

Somersby House had been a small private hospital in the 1950’s which had been refurbished in the eighties to accommodate for the desperate lack of nursing home beds. There is a mismatch of dormitory style bedrooms, four single rooms with bathrooms haphazardly arranged in between and all connected by a long narrow hallway that winds around the three sides of a square. There is a large lounge/dining room situated at the end of the hallway that allows for communal meals, church services, entertainment, videos and another activities arranged by the diversional therapists.

I have no intention of being dumped in the dining room with all those senile people, Edna states as she sits up on the side of the bed.

Your choice, how about spending an hour in the sun for morning tea? I promise you, I will get you back to your room after an hour, Karen suggests. You might even want to stay out there for lunch if the new lady from room eighteen is out there. She is only forty-seven and is far from being senile.

Well we will see, only because I can trust you to come back when you say you will.

In spite of recent skin grafts to her lower legs due to chronic ulcers, Edna remains reasonably mobile however she is experiencing increasing episodes of forgetfulness and vagueness so supervision and assistance are required. As far as Karen is concerned Edna is one of the easier residents to look after. She sees it as her job to remember all the little things that individual residents like and dislike. Does it really matter that Edna wants to wash herself while she stands by waiting to help as Edna struggles to wash her hair. It is no big deal to guide Edna’s hand with the shower noozle so that all the shampoo is rinsed away or to jokingly suggest that she better not forget to clean her bottom all the while allowing Edna the dignity of her independence. It is plain to see and so what if it was a bit frustrating sometimes or took a bit longer. It was no different really to when her Jack was learning to ride his new bike with the training wheels, sometimes she just had to let go and let him do it on his own and be there only when he needed her. It was always tempting to do everything for him because she loved him, she was in a hurry or wanted to protect him, but in the end they were poor excuses and there should never be excuses when it comes down to helping someone to maintain their independence. Still it seems as though some staff here need to be taught that, or plainly do not care enough. There are no points for accounting for an individual resident’s needs or limitations and sometimes she is criticized for not working faster as if she is on a production line which takes note of how many bodies you wash and feed in a set time frame. Karen holds the mirror while Edna smears on some lipstick and on cue she hands Edna the Arpege perfume. The small bathroom shelf is crowded with only the best perfumes. Finally Edna insists on matching some beads with her outfit. With Edna there is no dragging out any handy garment from the wardrobe rather an outfit has to be co-coordinated. Karen has got into the habit of making it a game taking out navy trousers with a white shirt and navy cardigan for Edna’s approval casually mentioning that it is chilly this morning so a good day for pants. Naturally if Edna was going out for lunch with her nephew or a friend then it might be become a lengthier exercise but it was always a treat to glam her up for an outing.

Well this will do for a day stuck in here. Karen do you want a squirt of Arpege?

"Absolutely."

Edna sprays the perfume generously on Karen’s wrists and neck as she squats down beside her.

Okay Edna we’ll walk out to the patio. You concentrate on using the walking frame and I’ll bring the paper and your glasses. I’ll be back after eleven so that you can have lunch in your room.

Karen races back to Edna’s room, strips the bed, grabs the wet towels and throws them in the linen bag. The bed smells of stale urine and she sprays the deodorizer solution over the mattress and opens the window. She’ll come back later and put clean linen on the bed and tidy up. It is now ten fifteen and she has another three showers to do before lunch. God she hates this constant feeling of being rushed and she’s relieved that the next resident is more self-sufficient and all that is required is some organising and bed making. The trouble is that nursing homes do not want too many able-bodied residents as that considerably reduces the government funding. The