Last week, I went to see an elderly man who has dementia. I’ve known him for a couple of years and have seen the progression of this dementia. Sometimes the progression happens at different rates. We’ve had a lot of time to chat, over the past couple of years though.
I visited him in the residential home in which he is now placed, where he said he never wanted to end up a couple of years ago.
Circumstances change though. No, it doesn’t feel good, it doesn’t feel comfortable but it is right for him now. He needs 24 hour care.
When I met him, it was to be our final meeting. The six-week placement review meeting. He occasionally remembers me as I’ve visited him more recently but this time the deterioration in his mental state was palpable and it cut like a knife.
As it was obvious my rudimentary questions were going over his head, the standard ‘Do you know what city this is?’.
His eyes flashed with grief and he drew a quiet ‘You know, I can’t quite remember’ From a proud and native Londoner, that dampened my heart.
I switched the conversation back to something I was sure he would want to talk about. He had proudly served in the Royal Navy during the war and the immediate years afterwards.
‘So tell me, was it the Merchant Navy or the Royal Navy you were serving in?’, I said ‘I can’t quite remember’.
His eyes lit up. ‘The ROYAL Navy’, he gruffly confirmed.
‘Tell me about your time in the Navy’, I prompted him with my memories of some of the stories he had told me.
‘Ah yes,’ he said, and proceeded to the very familiar stories that he had always enjoyed telling. About the war, about being one of the few to survive a number of sea assaults. About the people on his ship who had been killed. About his friends who returned and his friends who didn’t. About how he had pretended he was older than he was because he wanted to enlist at the start of the Second World War back in 1939.
But even these stories, which I had heard hundreds of times, were vaguer in the details. Sometimes I found myself prompting him and filling them in.
The conversation made him happy but it made me resolutely aware of the nature of memories and how they form who we are.
As I looked around his room in the residential care home which is filled with photographs of family, favourite paintings from home, I pondered at the brief echo of his life and sense of being that remains.
I picked up a photograph of him with his wife who died a couple of years ago. They had been married for over 40 years.
‘Who’s this?’ I said, first pointing at him.
‘That’s me’, he said, and he looked at me as if I had completely lost it. I smiled and nodded ‘of course it is’.
‘And who’s this woman?’ I said, pointing at his wife.
‘That’s Mary,’ he said, his voice softening. ‘She’s a fine woman. The best. I would have married her’. He stopped for a moment and it was as if his thoughts had caught up with him. He looked at me with stronger resolution and said quietly ‘I think I did’.
I looked at the fading picture of the couple who had raised a family together.
This spark of life and increasingly vague recollection that continues to hold on in the face of the loss of everything that might be related to the sense of self we have is what always grips me. He had, over the years, shared his memories of battles and wars long gone – of times that would never return and of a world that is slowly but surely slipping away. I don’t have any remaining parents or grandparents. When I heard their stories of the war I was young enough to think little of it and not realise, perhaps, the enormity of the changes that had happened in the world since they were young .
I feel honoured to be able to share and hold some of the recollections of those people with whom I work and it has enabled me to build up a strong picture of a London and Londoners both native and from all corners of world and the people that have inhabited this city and this country over the decades.
When the memories fly away, it is the family, friends and yes, even the grumpy social workers who will keep a hold of those memories and draw on them.
He thanked me as a I left and I thanked him.
‘Thank you’, I said and I meant it with all my heart. Knowing him and working with and alongside him has made me a richer person and has granted me the gift of deeper understanding of who he is but also who we are as people.
This is why I love my job and that’s why I despair at some of the changes in social work that push contact time to the minimum. This job is best and most effective when the relationships can build and grew and can be built over time.
So when I go to review someone in a residential home, I know who they are and who they were. I know the individual from more than a piece of paper. Sometimes it is not possible of course, fast work needs to be done and the pressures of the job increase to the extent that these conversations about the past, the so-called idle chats about memories, might be lost in favour of task-based visits. Visit to assess. Visit to review. Rarely does ‘visit to build and develop a relationship and sense of identity of this person from their own mouth over a longer term period’ count on statistics.
It’s easy to see where the better service would lie but this is the price to be paid by the cuts in staffing.