Geraldine

We gather in the Doctor's office for the CPA meeting. The doctor is graced with the presence of me, the Mental Health Support Worker, the Occupational Therapist, the shiny new Community Psychiatric Nurse and Geraldine, the reason for our meeting.
Geraldine is delighted to be there. Her little round face is split with a beaming smile, the lips constantly moving over her dry teeth because the Anti Psychotic medication makes her mouth dry. We go to Geraldine each morning with additional calls to accompany her to the shops and to help with cleaning.It was hard to get her to accept it but now she loves our visits, adoring "the girls" and looking forward to their outings because she says they are trained to look after her and keep her safe. She is a complex mass of anxieties, everything is terrifying. She dwells on the sadnesses her life has brought, the death of her precious Mother, a heart operation her brother had some ten years ago. Her broad face is as expressive as a child's toy and her moods swing like a weather vane, going from laughter to tears to panic to despair and back to smiles in a matter of moments.
She has two touchstones in life - her love for her brother and her love for her home. And, although she cannot deal with the smallest decision or disruption to her routine, she has a character in there that is pure steel.
The CPN is newly minted, fresh on the job and bustling with enthusiasm, she just knows she can make Geraldine's life better. She is reckoning without Geraldine. Geraldine is only sixty six but every time it is suggested that she may need help she insists that it is only to be expected that she struggles because she is an old lady. The CPN is quite rightly worried that Geraldine is terrified of the stairs. She comes down in the morning on her bottom and returns at night one stair at a time, it can take her twenty minutes to get up to the top. The CPN tried to institute an evening call to help her to bed. We go at six - Geraldine takes to going to bed at half past five. The OT suggests a stair lift - Geraldine says she cannot possibly learn to use such a complicated contraption at her great age and she would be far more likely to fall with it than without it. The idea of a bath seat is rejected out of hand because it would spoil the bathroom her brother had put in for her. Any further discussion on these subjects is cut short by Geraldine launching into one of her diatribes about how she loves her brother (huge smile and hands clasped in ecstacy) or how she cared for her Mother and how much suffering she went through before she was "cruelly taken" at the unfairly early age of ninety one (trembling lips, face a mask of misery). She successfully redirects all attention to her story and the subject has to be dragged back to the matter in hand. The doctor is concerned about her Pancreatitis which has resulted in a recent hospital admission. He suggests that Geraldine needs a low fat diet. Geraldine says that she is a Vegetarian, she doesn't like fish and she has never eaten vegetables. The startled doctor asks gently what she does like. She likes jam sandwiches and chips. In large quantities. She is very old and it's all she can manage to make. More home care is suggested, Geraldine pulls her trump card. She screws up her eyes, her face a mask of misery, and with her hands over her ears wails "Stop nagging me, Please, please, can't I go home yet?" You would think she was manipulating and in a way she is but any exasperation disappears when she tells us that she wakes in the night and wonders if someone will break in and murder her because "she has never been popular" or when she says matter of factly that when she got home from hospital she cut off her hair with the kitchen scissors. The World is not safe and Geraldine needs to keep it exactly the same, even if that means that the life she has is needlessly difficult.
The professionals accept defeat and the meeting is brought to an end with no changes made. As I stand to leave I touch Geraldine's arm and tell her how nice it is to see her out of hospital and looking so well. She looks up at me with fat tears beginning to trickle down her cheeks "I haven't been rude have I?" she asks. I tell her for the umpteenth time in our association that she has never been rude, that she is a pleasure to visit and that we are only there to try to make her life easier. I have lost her though, her expression has returned to a distant smile as she clasps her hands together and looks beyond me "Oh I DO love my brother" she says.