DEMENTIA CARE: GOLD DUST.

This problem doesn’t occur to me until it becomes an issue. That, itself, is an issue. I am meant to think ahead, anticipate everything, and be ready for anything. Dementia is there, year in, year out, and I think nothing of this one problem. It isn’t a problem. An obvious thing isn’t obvious. I don’t notice.
   Socks? Lined up and waiting in ranks. All the clothes are present and as correct as they are going to be. So many clothes. The right ones. No tight ones. Loose ones. Garments for every season. Drinks? Bottles, standing in formation, on parade, are ready for action. These things all get added. But I think nothing of taking something away.
   Taking stuff away is a problem in the care of those with dementia. I knew at the start that I had to step in – step lightly. If you take everything away, instantly, there’s nothing left. So, gradually, the difficult things faded away as they became difficult. By lowly degree rather than by lofty decree.
   I removed and I relocated and I replaced…fixed, switched, altered, rarely faltered, and I did it all by degrees. At the start, there was something to deal with. I didn’t deal with it, though. Don’t take everything away at once, remember. You really need that floor beneath you. This one thing, however, slipped through the cracks. The one thing.
   It should have slipped off and away at some point, but no. I believed, wrongly, when the daily carers came along, that they would do something about something I wasn’t doing anything about. But they didn’t. And I failed to notice. Where was the problem? No problem.
   If no problem is spotted, does the problem still exist? If it still exists, does the problem ever arise? And if it arises, are you instantly fucked?
   Recently, the problem finally arose. Almost. But almost was enough. The cared-for returned to an old habit: waving hands around without checking how close to the wall those hands were. Not a huge difficulty. There were a few non-collisions.
   But that was that. Just the hint of a crash. Enough for me to spring into action to save the cared-for any additional grief. I hadn’t removed her rings when dementia surfaced.
   A carer complimented her on her rings. And that was within earshot. I am not there for the bathing scene. My mistake was to think that the daily carers removed the rings during bathing. I heard the comment and thought nothing of it. She had nice rings.
   Time for a disaster in the making. Another journey through the house. Wall, close by. A wave of the hand.
   It all comes crashing in on me when it comes crashing in on me. If those rings are on tight and there’s sudden swelling from a collision with a wall, then there’ll be awkwardness. What if I can’t get the rings off and the restriction turns a finger blue? Ambulance job.
   Hassle. Ambulance jobs are fine. They are finer if you can avoid them utterly.
   We are vaccinated. Fully. Still, every contact with a crew that goes in for daily contact, hell, that’s to be avoided. Booted, suited, masked, gloved, or no, it’s better to stay better by not catching an illness.
   Easy fix. I remove the rings. There are three. The one nearest the knuckle does not fit over the knuckle. Ring two looks a tight fight as well. I guess that the third ring would slide off, but for the other two rings in the way.
   This is no good. Arthritis is the shameless culprit. There’s minor distortion in the shape of both hands. Irrelevant. Mainly, for the purposes of this problem, I am staring at one swollen knuckle. Now this is a problem. A problem that hasn’t turned nasty.
   When did it happen? Does it matter? At what point was the first ring trapped? Within the last half-decade, after dementia started. That’s as good a guess as I can manage. It’ll do. Okay. Problem finally identified. Solution? Lubricate the area with solution.
   I start and end with soapy water. Hell, if that doesn’t do the job, what will? Raise the afflicted area to reduce swelling. Dementia poses a difficult there, but the more awkward obstacle is the knuckle itself. Even if I packed it with ice now, and that’s a task more slippery than is the application of soap and water, the knuckle had already reached the point at which little could be done.
   It is just possible to slip a tool in there, to have a go at cutting the ring off. I order one online. It’s a shiny circular blade, toothed, and you clamp it in place. The lower jaw fits under the ring and protects the finger.
   With great difficulty and ingenuity, you might be able to use this on yourself. Just about. But why would you? When it arrives in the post, it seems sturdy enough. But is it going to do the job asked of it? I ask. Asking isn’t enough.
   I set to work. Dementia has done its number on the old concentration. There is no objection to the application of the device. I explain that this is for her safety. And I start to work, turning the thumbscrew.
   It never occurred to me that gold dust would go everywhere. Her fingers are spangled with golden motes. It’s a strange poetic moment. I don’t saw off a finger. There’s a snip as the last particles of gold are mined. No blood and no screaming.
   Then I face the awkwardness of removing the first ring without causing the tiniest injury. I fetch thin pliers. And I mostly use my fingers. I’m not there to slash myself or crush a bone. Luckily, I can always go in again and prise away very slowly. I’m not on a timer.
   There’s no medical emergency. No great rush. The first ring is the hardest to deal with, as it is of solid construction the whole way around. Doesn’t matter where I start on the task, the width of metal is the same. Eventually, and I mean after two minutes or so, the first ring is gone. Tricky. Swift. Without pain. Problem-free finger maintenance.
   I must go through the basic motions anyway. Even if I think the second ring won’t come off at all, I have to test it. Arthritis is still present. So you can guess the outcome of that test. The second ring won’t come off.
   We knew that. With the second ring, though, the width of the design varies around the band. I choose my battlefield and make the cut in the best place possible. Create as great and good a lever as you can, out of the position chosen for the cut, to make the final removal simple after the miniature rotary saw stops turning.
   The third ring slides off all by its lonesome. No need for a cut. I see where decades of wear thinned the finger. Some of that compression fades as the hours pass. I have a few wipes on standby, and clear the golden particles away.
   This elimination of glimmer is something I take seriously. I don’t want gold dust flitting into food. Also, for the record, I took all the cutting seriously. None of this was frivolous, though the appearance of golden fragments was whimsical.
   That was all for her safety. I told her so before I began the indelicate operation. And I kept explaining that to her as I worked through the operation. Safety. She was lying back in bed, first thing in the morning, before routine started. Luckily, the parcel flopped through the letterbox early enough for that.
   Obviously, I ended with the explanation all over again. This was still done for her safety. Warped rings, once precious, were cut free. Had her rings been trapped by arthritis with no dementia present, she’d have been screaming about not cutting her rings off.
   A week later, she had mildly bruised knuckles from some unknown misadventure or moment I missed. And I had that reassurance. No restrictive metal, no swollen digits, and all was well.
   Except for the two mutilated rings. Better than one mutilated finger. Bands of gold, set free. They were cut from the moorings and twisted open. It’s the fingers you are out to save. Sensitive skin.
   Will I ever need this handy tool of destruction again? The complex technical answer is…nah. Still…
   The ring cutter makes a rather fine addition to a portable kit for first aid. If someone’s hand is mangled by rings, you can get in there and reduce circulation problems within minutes.
   You may have to knock the potential patient out, first. Nothing to do with the relief of pain. Remember the golden tale, if you ever face this problem. It is a golden tale of a mighty question. Do you want to keep the finger intact, or the ring? Which of those is most precious to you?
   If you really want to keep the ring and not the finger, that ring had better be ONE RING TO RULE THEM ALL.