Locking Horns

Jan has suffered a stroke and thus her left side has very restricted movement. She can speak but it is sometimes confused and difficult to understand. However, as far I know she is compos mentis and can make herself understood. She is wheelchair-bound as you would expect and needs a lot of assistance. She is petite, slim and is still quite attractive; she has big blue eyes and high cheekbones. Her hair is grey but quite well cut. She dresses as nicely as her condition allows and often wears pretty black slips and underskirts.

However, despite all this, and the possibility of her mental health being compromised by her stroke, she is one of the most argumentative, difficult people I have EVER met. Take Tuesday evening for example; I was asked to get her ready for bed. The Nurse twinkled at me over her glasses and said in a slightly pointed way that she would just be next door getting Miss King ready for bed and changing her dressings should I need her.

I toileted her first and that went well as I had done it before and knew the way she liked things to be done. The trouble started when I began to get her undressed. She first kept saying ‘down, down DOWN!’ when she really meant for me to pull her knickers up until she had undressed and changed her top half. I appreciated this was obviously confusion as a result of her stroke and just smiled and apologised for misunderstanding. I then took her shoes and stockings off; as directed I put her shoes in the wardrobe at the back.

‘Back?’ Jan said, narrowing her eyes at me.

‘Yes, I put them at the back Jan.’

‘Hmph. Cloths.’ She said next, pointing at the two blue cloths on her wheelchair. She does not like wearing a pad and so the cloths are a precautionary measure. I picked them up and put them on the floor, thinking she would want them washed.

‘No!’ Jan snapped at me, hitting me on the arm with her good hand. I looked at her in surprise; I had not expected to be hit for something as small as that.

‘Jan, do not hit me, please. How would you like it if I turned around and hit you for no good reason?’ I said firmly as I picked up the blue cloths off the floor and held them out to her.

‘NO!’ She screeched at me hitting the cloths out of my hand and scratching me – I’m not sure if it was intentional or not.

‘Jan! You’re not helping matters by hitting, scratching and shouting at me. Please don’t do it again. We get on much better if you just point at what you want me to put away.’ I said quietly, trying to calm her down and temper my irritation.

‘Where is Hannah?! Where?!’ Jan glared at me with unveiled dislike as I picked up the blue cloths again and put them near the door. Hannah is another of the Carer’s who Jan has taken a liking to.

‘Hannah is on her break, Jan, so you’ve got me.’ I smiled encouragingly, trying to make her smile with me.

‘I want Hannah!’ Jan shouted at me, stamping her good foot and nearly sliding off the commode. I rushed forwards and caught her to make sure she didn’t fall.

‘HOLD ME!’ Shouted Jan down my ear, gripping the collar of my uniform and a good handful of my hair too. ‘HOLD ME UP!’

‘Jan, what do you think I’m doing?!’ I said through gritted teeth, my irritation getting the better of me. ‘Let go of my uniform and I’ll help you back onto the commode.’

She eventually did, with much grumbling and whinging, as if her falling off the commode was somehow all my doing. Once she was settled back on the commode and I had tied my hair up again, she stared at me again and said imperiously,

‘Armchair.’

I thought she meant that her nightclothes were on the armchair and so I went to look.

‘ARMCHAIR!’ She screeched, pointing at it, as if I would understand what she meant by her force of effort.

‘What about the armchair, Jan?’ I said as evenly as I could whilst biting the inside of my cheek. Her lack of basic manners such as saying please and thank you is something which rankles with the entire staff.

‘ARRRRMCHAAAAIR!!!’ Jan shrieked, stabbing her finger towards the armchair again, glaring at me with intense dislike. ‘I WANT HANNAAAAAH!’

‘Look, we’re not getting anywhere here. Do NOT shriek at me like that, you wouldn’t like it if I did it to you.’ I said curtly, my patience wearing thin.

‘ARMCHAIR!’ She shrieked again, completely disregarding everything I said. At this point I had just about had enough of her shrieks, anger and rude orders so I announced to her utter astonishment,

‘I’m going to go away for ten minutes and when I come back I hope we can start again without you shouting at me. You certainly would not like it if I did it to you, so I don’t see why I have to put up with you doing it to me.’

I then gave her the bell and left the room to find the Nurse outside looking at me over her glasses with a small smile. ‘I see you and Jan have locked horns. What was the problem?’

‘She kept shouting 'armchair' – I thought she meant her nightdress was on the chair and when I couldn’t work out what she wanted she began to shriek at me... Hannah told me to leave her for ten minutes when she gets like that as it only goes from bad to worse, and she said we don’t have to put up with it as she is pretty compos mentis and knows what she is doing...’

Despite this, I still felt guilty for losing my temper and walking out. I wondered if that was akin to abuse as I had pretty much abandoned her, albeit with her bell and an assurance that I would come back.

‘Don’t look so anxious; all of the new Carers end up getting into a mess with Jan. Even her own daughter loses her temper with her almost every time she visits. You’re not alone. Hannah is pretty much the only one who can get on with her and that’s because she takes absolutely no nonsense from her.’ The Nurse twinkled at me kindly over her spectacles again. ‘When she says ‘Armchair’ she wants you to hang all her clothes over the back of it. You need two new blue cloths for her wheelchair and to take the old ones to the laundry, same with her knickers. When you go back in go and put the light on immediately and close the curtains. Close the bathroom door... oh, and get the cream out of her bedside drawer for her joints. Make sure she can see you put it back in precisely the same place you got it from. Let her choose her own nightie...’ The Nurse looked thoughtful for a moment. ‘No I think that’s it. Not much to remember. Oh and if she demands that you close the door of the gentleman opposite, tell her that if she doesn’t want to see into his room, she can shut her own door.’

At that moment Jan’s bell went off. Both the Nurse and I looked at it for a moment and then the Nurse said with an encouraging smile,

‘Call if you need me, I’m right next door.’

So I trudged off with a sinking feeling in my stomach as despite what the Nurse had said, I still felt as if my telling her off could be construed in some way as abuse. I felt very exposed and inexperienced; last summer I had had a complaint filed against another Carer (who has since left) and myself and certainly did not what that to happen again. I felt utterly awful when I was told off by the Nurse in Charge as I did not really know what I had done wrong. When I went to apologise to the lady in question, she said I had not done anything wrong, it was the other girl who was very rough and rude but because we were putting her into bed together, the complaint had to be filed against both of us. The fear of reprimand still makes me anxious even today.

Jan eyed me warily as I entered and switched off her bell.

‘Shall we try again Jan?’ I said quietly as I set about closing the curtains and turning on the lamp.

Stony silence.

I placed her clothes on the bed so I didn’t have to keep bending down to retrieve them.
‘Armchair!’ Jan snapped, but with less force than previously. I think I had surprised her somewhat when I felt her to argue with herself.

‘I know Jan. I’m just folding them.’ I said a little tiredly.

The rest of the night time routine passed off without event, apart from when I couldn’t find her cream and she began to lose her temper; disaster was averted when I found it under her handkerchiefs. The kindly Nurse came in to dress the blood blisters on Jan’s legs and we tucked her into bed.

‘Thank you.’ Jan said, looking at me. I could not help my eyebrow flicking up in surprise but she seemed to mean it.

‘That’s ok Jan. Night.’

The Nurse and I left, switching off the light and leaving the door open as she likes it. Five minutes later, her bell went. The Nurse went to see what she wanted as I tidied the sluice and piled the bedpans and commode pots. I kept one ear open in case I could hear what Jan wanted.
‘DOOR!’ I heard the faint screech echoing down the corridor.

‘Jan, if you don’t want to see into his room, ask us to shut your door. If he wants his door open, he can have it open!’ I heard the Nurse’s voice grow a little louder as she left Jan’s room.

‘DOOOOOOOOOOOOOOOOOOR! DOOR!’

‘I said NO. I am NOT asking him to shut his door as he has the freedom to have his door open if he wants to. I will, however, shut yours if you want me to.’

Stony Silence.

‘What’s it to be Jan?’

Something mumbled which I could not understand.

‘Goodnight then.’

I stuck my head out of the door as the Nurse passed to go to the Nurses Station. ‘She wanted his door closing then?’

‘Yeah.’ She twinkled at me over her glasses again and winked. ‘Just got to give her as good as you get.’