dementia | Pills & Pillow-Talk

She is asleep with her mouth open, so Geoff sits down quietly and watches for a bit. At 92 she still has some of her own teeth but the interior of her mouth has that glazed look that comes with age, and with candida.

Geoff is a GP from the pages of One Night at the Jacaranda. He can’t help making these observations.

Grandma stirs, and soon she’s sitting up yelling for the nurse. “I’m in agony” she’s saying as she jabs the bell repeatedly. “I’m in agony” she repeats to the rest of the ward. The three other old ladies appear to have heard this before.

Today Geoff had to put on a mask and gown before entering the ward. Some nasty germs have been isolated on the unit, but high bed occupancy means it can’t be emptied and deep cleaned. He’d asked a nurse which germs, and got a shrug by way of reply.

The lunch tray arrives. It looks vile, all that sloppy food designed to slip down elderly gullets. “Feed me” demands Granny.

She watches Geoff with beady eyes as he spoons some of the beige slurry into her mouth. That’s probably where the germs are, he thinks. After a couple of mouthfuls Granny has had enough. She’s staring at his head now. “I like your hair” she says and reaches out to touch it.

She reminds him of Davey. She might like to see her great-grandson again, but hospitals aren’t good places for 5-year olds, unless maybe they’ve got Henoch-Schonlein purpura.

There’s a miniature Christmas tree on the bedside locker. “It’s nearly February” Geoff points out. “And you’re Jewish.”

“I’m 95 now” Granny replies with impeccable logic.

A nurse comes in, switches off the call button and offers Granny tablets for pain. Which Granny refuses, saying she’s fine.

The nurse then rearranges things at one of the beds. Geoff notices that she hasn’t bothered with a mask, gown or gloves. She senses his stare and says “I’m not touching the patients.” The nurse probably wouldn’t believe it if Geoff told her that viruses and bacteria can live on call buttons, beds and bedding.

“The priest came to see me” Granny tells Geoff.

“Why, Grandma?”

“Because I’m getting married, of course. To Marvin.”

This is news to Geoff. “Do I know Marvin?”

Granny swats at him with a bony hand. “Of course you know him. He sits next to me in class.”

She’s gone downhill faster than he thought. Only last week Geoff was thinking of testing her with the SAGE questionnaire for cognitive problems. He hasn’t used it on patients yet but it looks a useful test, with low false positives, and no copyright issues, unlike the MMSE. But not much point trying it on Granny any more. Although her mental state fluctuates from day to day, she seems proper demented now. An MRI of her brain would probably look like cheese.

Now she says “Make me comfortable.”

The nurse has gone, so Geoff tries adjusting the hospital bed. It has lots of buttons. Granny develops a liking for the buttons that controls the foot end.

No harm in that, thinks Geoff. After she raises and lowers the foot of the bed about a dozen times, he remarks that it’s just like a see-saw.

She gives him one of her stares. “You’re really very stupid.”

Before Geoff leaves, he asks if Marvin’s going to visit.

“Who’s Marvin?” replies Granny.

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No matter how good a doctor you are, if you don’t look after your own, you’re right at the bottom of the class. That’s the opinion of Geoff, a 30-something general practitioner from the pages of my novel One Night at the Jacaranda.

Granny shuffles to the door in furry Elmo slippers. ‘I haven’t been for three days,’ she says, adding, ‘I’m 92 you know.’ Geoff is pretty sure she’s only 90 but Granny often adds a year or more for effect.

She doesn’t see her friends anymore. Yet today she insists she sees them daily and plays bridge. ‘Elsie even brought me chocolates this morning.’ When Geoff looks at the box, he sees the sell-by date is 2011.

Apart from her bowels, Granny’s life now revolves around food and meal times, but she only picks. Geoff checks her fridge and throws out rotten pears and expired cheese.

Today she demands a haircut. ‘You were going to be surgeon,’ she reminds him. He’s not sure he was training to cut the three strands of white hair left on the old girl’s head, but he gives it a go. She stands in the bathroom, clutching the sink and bending down so he can reach even though he’s no longer the small boy she read stories to. He’s 5’11” and she’s shrunk to about 4’10”, so he practically has to kneel.

Although it’s August, there are Christmas decorations all over the bathroom, or rather the bits she can reach. Granny has never before celebrated Christmas. Now she reaches out with a sinewy hand to adjust the tinsel on the towel rail then looks at him proudly. ‘I’m 93, you know.’

Today is a good day because it’s only her shoulder and her constipation. Last week it was her knee and a rash. The week before, it was her ankle, which she sprained on VE Day 1945. He said it was just wear and tear, so she poked him with her walking stick and called him stupid. Geoff can’t understand why her mental state fluctuates so much. Obviously dementia has a vascular component, but how can it possibly change to that degree?

‘I’m going to do Big Poo,’ she announces. This reminds Geoff of his son. The difference is that five-year old Davey’s brain is still making new connections between cells. In Granny’s case, the opposite is happening. He imagines her brain full of holes, like Emmental cheese. He’s glad his mother died before she got like this, even though it meant Granny lost a daughter.

She installs herself in the toilet, legs not touching the ground. Geoff knows this because she won’t let him shut the door.

So he waits in the darkened living room, where there’s a pile of plastic bags, all neatly folded on the sideboard, a stack of old envelopes which could be useful for making lists, and electricity receipts going back to 1988.

Alte kakers. Only Granny makes Geoff want to break into Yiddish. She makes him want to break into the Bristol Cream sherry too. There must be an unopened bottle in the sideboard.

Geoff remembers that alte kaker means ‘old shitter’. As he waits for Granny, he thinks of the words patients use. Faeces. Number Two. Dump. Crap. Ploppies.

He’s sure an hour has passed, but when he checks Granny is still on the throne, with her legs sticking straight out.

‘You know I love you, Bubala,‘ she calls out from the toilet, voice still strong.

‘I love you too, Granny.’