The view from inside

An article in one of our local newspapers refers to ‘vulnerable oldies’. That’s us. The article in question was built around the views of my wife’s geriatrician, and they are exactly what the official advice is: keep isolated, wash our hands, stay out of trouble. Of course, we need some food (I make a lot of my breakfasts) and either I go out to a supermarket or my daughter does, or (as at the moment I’m using an online supermarket). There are about a hundred of us in this aged-care facility, and like Macbeth some of us are showing some of the signs of being  ‘cabined, cribbed, confined’. It’s now impossible for visitors to come, and there’s tons of parking. A son and another daughter came to visit me the other day, and we sat outside at the regulation distance away from each other. It was not the most satisfactory encounter we have ever had, but at least my rellies came. That was then. Now we are in total lockdown.

It was not the rellies’ fault. The facility made it hard. You had to go through tests (not the Covid-19 test) and have your temperature taken, and you had to be a close family member. It was not the facility’s fault. It was only doing what it was told to do. The ACT Minister had issued new restrictions. That was just a day or so ago. Covid-19 is a fast-moving event.

“Visitors will be restricted to care and support visits that are limited to one visit per day of no longer than two hours made to the resident by one person, or two persons together,” she said.

People under the age of 16 will not be able to visit, according to Minister Stephen-Smith, who said they can only visit for compassionate reasons for the purposes of anyone who is at end of life.

The traffic past our place has shrunk a great deal, and it is a major road. I can feel the growing isolation. Indeed, I can see it: no one comes at mealtimes, though they used to. My wife and I have each other, and that is a huge plus for us. Two other married couples in the place have the same benefit. The rest are singles, mostly widows, and all of them, all of us, carry some life-threatening disease that requires high care. Otherwise we couldn’t be here.

And we’re just at the beginning of what the Prime Minister says could be a six-month endurance test. Why mightn’t we succeed? I’ve thought a bit about this, because for a variety of reasons I do rather more for the facility than most other residents can (I’m mobile and sentient, and used to doing things that need doing), and I’m a tad worried. To start with, some of the residents, lacking visits and interaction, will retreat into themselves, and thereby reduce their quality of life. The facility is doing its best, by keeping activity going. But my guess is that it is the intimate contacts that will become increasingly important as the six months roll on. Somehow we have to be able provide them. Mind you, there are people here who have no friends or family in Australia, let alone in Canberra, so none of this is new to them.

The second worry is interaction between residents. Not everyone is universally popular! From time to time there are spats, and the common politeness we acquire quickly once we’re here (if we didn’t have it before) can become quickly abraded. Aged-care facilities are highly democratic places: it doesn’t matter who you were or what you’ve done. Once you’re here, you’re like everyone else. Dementia is common, and presents in all sorts of ways. What was once funny can become irritating, and lead to words, and even to physicality. I think I can see signs of that already.

A third worry, and it follows naturally from the second, is harmful interaction between the residents and the carers. Our place is divided into four ‘communities’, and each of them has about 24 residents and a set of carers and a registered nurse. I cannot speak highly enough of the devotion and assistance given by the carers and the nurses. But as nerves become ragged, I can see carers being assaulted by residents. What are they to do? An angry resident, especially one without much control anyway, can assault a carer, scratch and punch. I’ve seen it happen, and I worry that the incidence will increase. You hear about carers assaulting residents. I’ve seen the other side. Usually the carers are quick to avoid contact, but it doesn’t always work. In any case, that is not what they are there for.

Three worries are enough. I’ll say it again. This facility I live in is a great place, and senior management and everyone connected with ageing sick residents are doing their best. Yet I worry about six months of this endurance test. What will it be like elsewhere? I had wanted to say that if you know someone who is in such a facility, see if you can pay them a visit, or ring them up. But now we are in total lockdown. For the foreseeable future it will increasingly be like prison, and from time to time I already feel a bit stir-crazy. I want to go out and lead a normal life, at least for half an hour. But unless I’m shopping my drive, though important to me, would be regarded as non-essential unless I’ve got that wrong. My wife needs a drive every other day so she can see the world. It is good for her dementia. We used to do a lot of that kind of driving. It’s going to be a tough half-year.

I jump to another thought about ‘culture’. Many years ago I welcomed our first Bangladeshi students. They were all dressed to the nines, the girls especially so. I shook hands with the young men, and began to do so to the girls, who retreated. The diplomat attending them said to me, ‘They do not shake hands with men. It is not part of their culture.’ Of course, I felt like a complete ning-nong, but afterwards I thought again. They’re coming in to our culture, and in our culture we shake hands. It is a sign of agreement, of welcome, of equality in some respect. Why should they bring their culture and expect us to honour it? Of course, I’ve had to wrestle with that one for the last twenty-five or so years.

The other day one of our carers did something for me, something important she did well. I was unable to do it. When it was done, and I saw the result I was pleased indeed, and as she came toward me I gave her a kiss on the cheek. ‘Wonderful! Thank you,’ I said. One of the other carers said to me, observing my lapse, ‘You do not kiss in her culture!’ It was a gentle reproof, not a severe one.

   ‘Ah,’ I said, the Bangladeshi incident still in my head, ‘aren’t you lucky you’re in Australia, where we do kiss!’

   ‘Yes,’ she said, grinning.