I work as a care assistant in people’s houses, a job which earns me a lot of insight into various ailments that folk acquire in their latter years. The more frequent of these ailments, being dementia. No two clients display the same patterns of memory loss, but each client who experiences dementia does so in their own particular consistent way. If you’ve ever experienced caring for someone who has dementia, you’ll know all about the ‘back stage’ work that needs to be done… preparing memory aids, constant repetition, tidying away of triggering things, and endless patience.

I have one client in particular who is tough going. She has an extremely transient memory of about ten to fifteen seconds, so her mind constantly resets. She also has ‘anosognosia’ which means that she has no awareness of, and vehemently denies the existence of her own dementia. She ironically uses the phrase ‘completely compos mentis!’ roughly 40 times during my daily two hour visit. My work is to cook lunch for her, provide company and conversation, and complete some light housework that she’d find challenging.

It’s worth noting that all but three carers are completely refusing to do this house-call due to its intensity from a mental health point of view. This lady doesn’t believe that she needs carers, therefore assumes that we must be cleaners. She’s in her ninety-fourth year in age and is entirely nimble, so loves to follow us around ordering us to scrub on our hands and knees while she micro-manages our cleaning abilities and tells us how many spots we’ve missed.

I wonder if it wouldn’t be cathartic for me to understand her world by working through it from her point of view.

***

What time is it?

12.45pm. It’s lunchtime. I don’t feel hungry. I’d better go and see if staff are around.

There’s a woman in a uniform. And an empty bowl on a tray. I recognise her, she tells me I’ve just eaten and that I have fruit salad on the way. Jolly good.

The garden is looking well, I must go out and prune the roses. Am I hungry? I must see if anyone is here.

A full lap of the house, nobody is here! Was there someone here? There must have been, the kitchen is tidy. My diary has writing on it that isn’t mine. It says “Lunch @ 12.20pm: Soup and bread roll, fruit salad and yoghurt, green tea and ginger biscuit”. I don’t remember eating that. I’ll look in the fridge to see if I left anything there.

What time is it?

12.30pm

This floor needs to be swept. Where are my staff? It’s lunchtime and I’m hungry. What am I paying these people for?

There’s a woman in a uniform, she’s familiar but I’ve no idea what her name is. She’s drying dishes. Or is she just pretending to? I inform her that the table needs to be cleaned, she smiles and reminds me that there’s food on my table. It’s half-eaten. It must be mine, how embarrassing! Why am I in this room instead of that one? Why did I get up? I’m so hungry, where is that girl and why is she idle? I find her in my bedroom changing my sheets. I inform her that I require my lunch and she tells me that it’s already on the table, my ice-cream is melting. How rude of her! I already knew this, I think! What a very condescending tone she uses. She pleads with me not to use the oven hob in my own kitchen! How else am I going to heat up my soup?

The washing machine is running, and I didn’t put it on. I must stop it before any more electricity is wasted. I do wish people would consult me before running machinery. What time is it?

12.50pm

She’s out in the garden now, that woman with the uniform. I must go out and inform her that I require my lunch. She’s emptying the bin, at least she’s doing something useful. I fear she’s idle here with nothing to do, I’ve done all of the housework already myself. She walks indoors with me and shows me what she’s written down, food that I’ve eaten already for lunch. I see no evidence, I fear she’s lying, taking advantage of me. She’s boiling the kettle now. I inform her that I require lunch.

What time is it?

11.15am

Am I alone in the house? I find a woman in the living room, she’s using the vacuum cleaner on a floor that’s already clean. What a pointless waste of electricity! I inform her that the floor doesn’t require cleaning, that she should move the furniture back to their original positions and switch it off. I must find some work for her to do, she’s clearly wasting time looking busy. There’s a cup of tea in my hand, it must be mine but it’s cold! Why am I drinking cold tea? The woman in the uniform is carrying the vacuum cleaner away, I must tell her to do this room before she finishes. She tells me she will, once the washing machine is loaded and put on. She seems to be working hard today, that’s something.

What time is it?

12.35pm

The woman in the uniform is missing again. Idle, presumably. I find her by the washing machine, watching it empty. She says she’s waiting for it to reset, staff these days have a poor idea of how kitchen equipment works. She hasn’t made my lunch yet and I inform her of this. She tells me I’ve already eaten! How strange, I don’t remember. But true enough, I don’t feel hungry. I must have made lunch myself. I go to the fridge and find a carton of soup, I must go and put the hob on to heat it up.

What time is it?

1.35pm

I’m alone. Someone was here, what does my diary say? I’ve had lunch it seems, jolly good. Washing is drying on my line, I must have done that earlier after I made lunch. Do I have tea? Tea would be lovely, I must boil the kettle. The garden looks well, I’ll go and prune the roses in a moment. There are two cups of tea on the table, both hot! Is there someone else here? I must enlist the help of some staff to help me to keep track of this house. There are notes everywhere, none of them pertinent. Reading them might be helpful I suppose, but there should be staff here to do that. Have I eaten?

***

Maybe not so cathartic after all. I still don’t understand her world from her point of view, but I have a greater appreciation of my own mind. Except that I wonder sometimes, how would I know if I had dementia? People would tell me but then I’d forget, so I wouldn’t know. Is my world as I know it imagined, is it a memory that I’m just assuming is the present? Time appears to be linear for me, but then again it would if I had a short term memory.

Have I had lunch, even?