When your patient needs care but wants company, it can be difficult to find the right balance, as community nurse Sue McCreadie found when she nursed Cherry.
Cherry* sat with a serene smile on her face wearing oven gloves and stroking a tiny hedgehog, fleas jumping off the bed around them.
“Look,” she said, shaking with excitement. “Look what we found in the garden”.
”Cherry you can’t have that in here there are fleas everywhere,” I said as I leaned over the sides of her bed and tried to take the creature from her, but the prickles from the hedgehog and my patient prevented it.
“I’m going to call him Harry,” she cried in triumph. “And he can live in a box at the bottom of my bed.”
Cherry was 43 but totally childlike, unschooled due to childhood rheumatic fever with a simplicity about her that some called slowness.
“From her gated cot sides she commanded all about her”
Reasoning with her about the folly of letting a flea-ridden hedgehog in her bed was futile. Her bed was her life and from her gated cot sides she commanded all about her.
She had taken to her room when heart disease and breathlessness made movement too stressful. She had confined herself to bed, scared of the epileptic fits that she had frequently and of the outside world that was alien to her.
She sat in colourful splendour, her cot sides festooned with ribbons, beads and bright wools. Her room was a haven for tat with dizzy sherbet colours the hue of highlighter pens clashing with the dusky pink rose pattern on the sticky carpet. She wore lime green and sherbet lemon ribbons in her hair and a red cardigan with matching red lipstick.
”She sat in colourful splendour, her cot sides festooned with ribbons, beads and bright wools”
Her home help had tried to make some inroads to the clutter but Cherry liked everything around her, the piles of cushions and throws, magazines, TV and radio, and chocolate - lots of chocolate - which her neighbours brought in when they delivered her shopping.
So much so that despite my efforts of controlling her diet she had grown steadily over the years that I nursed her, until her hips touched the edges of her multi-coloured cage causing sores that needed dressing daily.
The TV was on constantly, a background to the radio which simultaneously blared in discord. She listened to neither but was transfixed if her favourite star came on the TV. She spent her days drawing, copying animal pictures from children’s books with wax crayons which she gave with pride to her carers.
She loved singing and would render us with the latest song that was ‘top of the pops’. She giggled at the handsome film stars she watched day and night and had posters of her favourites around the room like a teenager with a crush. She dreamed of a knight who would somehow find her and sweep her off in his arms to a better life.
”She dreamed of a knight who would somehow find her and sweep her off in his arms to a better life”
And then there was Pablo! Pablo was a snappy chihuahua who was Cherry’s baby. He lived on her bed cuddled under her arm slowly getting as rotund as his mistress as she constantly fed him cake and chocolate.
Pablo snarled at everyone who entered Cherry’s boudoir except the home help and nurses. He reluctantly allowed me to lift him off the bed so that I could tend to her. Pablo wore a red ’kerchief around his neck that was never allowed to see the washing machine as Cherry claimed he would be cold if we removed it for a minute.
We had to share out our visits to Cherry and Pablo to protect our sanity. She was visited every day of the year and her care took over an hour, her demands and ways to delay us meant that we were there for sometimes two hours a day. Over the five years I looked after her we had the same conversation almost word for word every day:
“Morning Sue, where have you been today? Bet I am the worst one on your list.”
“Just the usual rounds, Cherry. Now shall we get started?”
“Well I must be the worst one on your list being disabled an’ all that?”
“Yes you are very special Cherry, now shall we get started?”
“I haven’t finished my breakfast yet.”
Cherry used every tactic to delay us and sometimes I had to sit in my car outside her house and take a deep breath to gear myself up for the morning. She would have had us stay all day if she could as she had no family. I understood her loneliness but couldn’t provide the full time company she needed. She had alienated several home helps with her demands and only one faithful carer remained.
”I understood her loneliness but couldn’t provide the full time company she needed”
Inventing ailments that needed “just to be checked out by the doc” were a regular occurrence and if we let slip that her favourite GP was on call we could guarantee that she would have a pain that only a doctor could sort out.
Cherry was the mistress of manipulation and she had tried over the years to get us to bend to her will by playing us off against each other.
We decided to split the week up between us so that we only had to run the Cherry gauntlet every other day and we had to make sure we knew the Cherryism of the day. The other district nurse would hear “Well Sue said I could” while I was met with “Well May said I could”.
This often ended in us carrying out some task that we thought had been ordered by the doctor only to find out it was just something she thought would be a good idea. We had to check everything out with each other daily just to be sure.
”We had to check everything out with each other daily just to be sure”
The home help was also a target for Cherry’s games. I arrived one morning to find that she had been told that Sue had said she needed to have her legs put over the edge of the bed every two hours to be massaged. I found a hostile carer creaming her legs and shooting me filthy looks until I asked her what was going on and we realised we had been ‘Cherryied’.
Cherry lived a small confined life, her only companion a small irritable dog, her only visitors carers and the odd hedgehog! But she was always smiling and contented unless anything threatened her routine such as a replacement carer or change of delivery times for her meals on wheels. Then she would become as hostile and childish as a grounded teenager.
“She was always smiling and contented unless anything threatened her routine”
As the years passed Cherry became frailer and quieter, her breathing laboured as her overloaded heart struggled to cope with her weight and immobility. Doctors had long despaired of getting her into a home where she would have company and care as she refused to leave her home.
Cherry was alone for long periods in the afternoons between home help visits and evening nurse visits to settle her for the night.
It was during one of these times that she passed away quietly a week after Pablo died of old age in her arms. Still in her gilded cage with her ribbons and bows.
Sue McCready is retired from the NHS and now works as a CQC inspector
*Please note: Names have been changed to protect confidentiality
- More from Sue: When providing care becomes a battle of wills