The Pharmacist -
: Part 1 – Chapter 13
‘Jack, how can I replace out if someone is dead or not?’ Sarah’s expression suggested she was serious, but Jack laughed at her question.
‘Take their pulse?’ he joked.
‘No, not like that. I mean in the past, if they died a few years ago.’
He straightened his face to take her seriously. ‘All deaths have to be registered, and I would think you could access that information online. You’ll be better at that than me; you know I’m a dinosaur with technology.’
‘But you must have to do these checks at work?’ she persisted.
‘Yes, but I delegate to someone who knows what they’re doing,’ Jack explained, then smiled at his wife.
‘I’ve already looked at a few websites, but I need the date of death, which I don’t know.’
‘What’s this all about?’ Jack put down his newspaper and looked at Sarah
‘You know Alice, the lady I was telling you about at The Elms? She’s convinced her husband’s not dead, but her daughter told us that he died nearly four years ago. His name’s Tom, so I’ve entered Thomas Roberts, Tom, and every other permutation I can think of, but there are dozens of them, and I don’t have a date of birth or death…’
‘Hang on here. If the daughter says he’s dead, why are you checking up on this? You’re on the dementia ward, aren’t you? Surely this resident only imagines her husband’s still alive?’
‘It’s not just that. Yes, Alice is convinced that he’s alive and there’s something about her daughter I don’t trust, so I’m inclined to believe Alice. And then yesterday, I heard Rachel telling her mother that it was Friday when it was Thursday. So I wondered if she was deliberately confusing Alice to keep her in the home.’
‘That’s quite a fanciful notion. Perhaps the daughter was simply mistaken about the day herself. I sometimes get confused about what day it is, particularly when I’m on a late shift. It’s hardly evidence of deliberate misdirection, is it?’
‘You and your evidence, Jack. Don’t you sometimes have those hunches for which detectives are famous? I just have this feeling that Alice isn’t as demented as we think she is and that her daughter has a hidden agenda.’
‘It can be a dangerous thing to meddle in another family’s affairs, you know. These patients of yours with dementia spin all sorts of yarns, don’t they? Surely the old girl’s just living in the past, or not wanting to face up to the fact that her husband is dead.’
‘I’ve considered that, but I can’t shake off the feeling that there’s nothing much wrong with Alice and her daughter’s deliberately confusing her. Sometimes the medication they’re prescribed can make them even more confused, so what if she is being held against her will? And she’s not an ‘old girl’, as you put it, she’s only fifty-five.’
‘It’s commendable of you to care so much, but I think it’s highly improbable that she’s in The Elms against her will, no matter how much you like this lady and want her to be well again. If you have genuine concerns, perhaps you should speak to your line manager and tell her all this, or does the woman have a social worker? If so, she would be the one to replace out more about the family circumstances. It’s not wise for you to go poking about trying to discover these things yourself. You’re only a volunteer there, so leave the diagnosis to the doctors. They know best, and I’m fairly sure they wouldn’t want a newcomer telling them they’ve got it wrong.’
Jack was right, Sarah knew it, but an uneasy feeling about the situation lingered in her mind. Perhaps she’d have a word with Lynne as he suggested. But Sarah couldn’t resist going back to her internet search of registered deaths, trying a combination of different years, months and even the specific area of Matlock where Alice had lived until recently. The search remained fruitless, dare she ask Alice for her husband’s date of birth, or would that disturb the poor woman even more?
* * *
When Monday morning arrived, Sarah was keen to get back to The Elms, her priority being to make an appointment with Lynne, the dementia ward sister, to discuss her concerns. They arranged to meet in the office at lunchtime when Sarah would be having her break and Lynne would have finished her shift.
‘So, what can I do for you?’ Lynne asked, her head tilted to one side and a smile on her lips. She was a great person to talk to, and Sarah would be happy to stay on her ward permanently.
‘It’s about Alice Roberts… I’ve got a few concerns about her.’
‘Ah, yes!’ Lynne gave Sarah a look which suggested that she felt Sarah was becoming too involved with this particular resident – she would get on well with Jack, Sarah thought. ‘No more trouble with her daughter, I hope?’
‘Well, no… except that I overheard her telling Alice it was Friday last week when it was Thursday. I know we all get mixed up with such things at times, but it seemed as if she was deliberately trying to confuse her mother.’
‘Is that all? Don’t you think you’re reading too much into it? Just because Rachel Roberts had a go at you doesn’t mean she’s the Wicked Witch of the West, you know. Relatives often take their frustrations out on the staff, particularly on the dementia ward, it’s a difficult time for them as well as their parent, but it’s all part of the job.’
‘Yes, I know all that, but most of the time, Alice appears to be quite lucid yet regresses after her daughter’s visits. Maybe she does have some memory problems but is she bad enough to be kept here?’
‘Wait a minute, let’s have another look at her notes.’ Lynne tapped on the computer keyboard and brought up Alice’s details.
‘It says here that Rachel is her only relative. Alice still has the DOL order in place, but she’s due for assessment by a Best Interest Assessor this week.’
‘What exactly will they do?’ Sarah asked.
‘They’ll chat with Alice and ask her a few questions and then make a decision about whether she has the mental capacity to make her own decisions. The assessor will then consult with the doctor, and if they feel Alice is capable of making her own choices, they’ll ask her what she wants to do.’
‘I’m certain the answer to that particular question will be that Alice wants to go home. Can her daughter reverse any decisions the doctor makes?’
‘If she has power of attorney, she’ll have some input into the decision, but there’s nothing on Alice’s notes to say her daughter has POA.’
‘What if Alice still maintains that her husband is alive, and now there’s this imaginary granddaughter too? Will that prevent her from going home?’ Sarah could see this as a possible stumbling block.
‘Not necessarily. We’ve had patients before who think that their partner’s still alive yet have been deemed safe to live alone. Very often, their delusions are a comfort to them. Being confused doesn’t automatically mean that someone has to go into care, and sadly the money aspect also comes into play. More and more people need places in care homes, and there just isn’t the money available to fund them, so, in reality, only the very worst cases will get a funded place. Perhaps Alice’s circumstances are such that she could fund a place privately, but from what we know, that’s certainly not what she wants.’ Lynne looked at the concerned expression on Sarah’s face.
‘Look, don’t get too involved in this, okay? Our residents are transient for one reason or another, and this is a tough ward to work on. You can’t afford to become emotionally involved with them all. You need to be a few degrees detached for your own sanity. Believe me, I know!’
‘You’re right. Thank you for explaining everything, Lynne. Can I tell Alice that this assessment is coming up?
‘Of course, it’s not a secret, and she has a right to be informed, but choose your moment carefully, won’t you?’
‘You mean when her daughter’s not with her?’ Sarah grinned. ‘Now, I’d better grab a sandwich before I get back to work. Enjoy your afternoon off.’ Sarah was heartened by what she’d learned. It appeared to be a possibility that Alice could go home after all. Sarah knew that this piece of news would cheer her up immensely.
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