Reflections on Dementia Care

I now have a Level 2 Certificate in Dementia Care to add to my collection of qualifications. Achievement Unlocked.

Since August last year I have worked as a carer for the elderly in the countryside town of Easingwold. This job seemed to follow naturally on from my full-time volunteering in York and my childcare volunteering in Cambodia, forming a 'Care Trilogy' of life experiences.

Some reflections from the last eight months:

Carers are not paid enough for what the job entails. We are paid for every 15 minutes work, and if we break down the hourly rate to each call time, it starts to seem a bit silly, as though our employer is saying: "I'll give you £1.90 if you go to Mrs Alpha and make sure she takes the right tablets; then go to Mr Beta to help him shower, shave, dress, get his breakfast ready and give him his tablets, and I'll give you £3.78; then go to Mrs Gamma with Colleague A, and together hoist her onto the toilet, then help her shower and dress, etc, and I'll give you another fiver." Etc. I expect the issue of low-pay-considering-what-is-involved extends throughout the healthcare sector.

I am young. I now know many people who have been retired for longer than I have been alive. I look back at the time I have been alive: 24 years in total, only 6 years of being an adult. I look ahead at an estimated natural lifespan, and realize that I have at least twice my total lifetime to date still to live. I have 8 times my time as an adult still to go. I am young.

Many of our clients suffer from extreme boredom and loneliness. They struggle to find things to do; their friends and family have moved away or died; they're frail or disabled. Watching TV is often the default activity. One client sits in their flat all day, TV off, radio off, just sitting there, occasionally sipping their drink or napping, waiting for the next carer to visit. It is a shame that they are not open to technology; I expect that when we are older we will have ample apps, games and internet things to keep us more occupied and entertained during our senescence. I have lent my Kindle to one client who - their right arm is their only functioning limb - had been unable to read paper books. I've been trying to convince them to buy their own, but that is proving quite a challenge: they are extremely fiscally austere.

I don't know whether it's a generational thing or a countryside thing, or a bit of both, but most of our clients have had very few jobs in their lives. I haven't had many jobs, but I've already had more than a lot of our clients, who got a job straight after school and stayed in it until retirement. This doesn't seem either possible or desirable nowadays.

I have become increasingly sympathetic towards euthanasia over the past 8 months, encountering people who say they want to die but cannot.

Living in the countryside has shown me that I am very much not a countryside person. After the initial novelty wore off, it became very apparent that living in the countryside is extremely dull. An island in a sea of farms, Easingwold is a countryside town with a population of about 5000 people, most of whom are either retired or have lived here all their lives. Your personal universe shrinks in the countryside: everything beyond the farmy horizon may as well not exist, so little it seems to matter to your life. I am reminded of Terry Pratchett's Bromeliad trilogy, which gets its name from a species of plant in the Amazon, inside which small frogs can live out their entire lives. This is used as a metaphor throughout the books. It is easy to imagine Easingwold as a bromeliad, whose inhabitants - in the absence of modern communication technology - would spend their entire lives here, barely cognizant of the rest of the world, or the rest of the UK, or the rest of England.

The sheer dullness of the place seems to be accepted as a fact of life by those who have lived their entire lives here. (Thoreau's line, 'The mass of men lead lives of quiet desperation', rings in my ears.) In Dante's Inferno, the first circle of Hell, Limbo, contains the souls of righteous non-Christians who are unable to go to Heaven because they happened to live too early in human history: they lived in the centuries before Jesus sacrificed himself to wash away humanity's innate sinfulness, so were unable to accept him as their saviour. The souls of Limbo are not actively punished or rewarded, they wait around, bored, with no connection to God: it is a Godforsaken place. Distancing myself slightly from religious language, I would say that Easingwold is:

(a) fun-forsaken, in that there is fuck all to do. Easingwold has a disproportionate number of alcoholics and drug-addicts, because there's fuck all to do. The smell of weed in the air seems out of place, almost anachronistic, in a quaint countryside setting, but it frequently forms around the loitering youth, because there's fuck all to do.

(b) spirit-forsaken, in that it is hard here to cultivate a sense of the numinous, the transcendent, etc. It is hard to get a feeling of the interconnectedness of all things when you feel like your personal universe is being forcibly shrunk by the Island in the Sea of Farms. (The pelagic metaphor is enhanced by the bus journey from Easingwold to York: a ricketty old bus on bumpy country roads feels like an, admittedly short in nautical terms, oceanic voyage.) The sky does not feel like a window looking on to an incomprehensibly vast and complicated cosmos; it feels like a dome trapping you in, the sky-firmament of ancient cosmologies.

(I am perhaps being a tad harsh: there are benefits to rural isolation. The myriad political, economic and humanitarian crises and atrocities around the globe might as well be on another planet, so far away they feel. I suppose this might contribute to why the fear of immigrants is rather strong in rural areas: aliens coming over here, interrupting our isolation, making us realize that the Earth has more in it than we thought.)

I do not like this isolation. I am a city person. I intend to move to a city by the end of the year. I also feel like I am done with care work now, and so intend to go into something completely different next, whatever that may be.