DEMENTIA CARE: THE WHEELCHAIR CLINIC.

Yes, it’s a clinic for sick wheelchairs. And the wheelchair is very ill. It has two trips left in it, I reckon. I delayed this blog post deep into the month so I could say a few words about our recent trip to the wheelchair clinic. Maybe more than a few words.
   The day started early for everyone concerned. To the credit of the morning care team, the day started at 8.30 instead of 9.00. I thought we’d get by with a 9.00 start leading to a 9.30 exit from the house with the wheelchair ready to roll. So I requested a start at 9.00.
   But we had extra time. Always have extra time. You will use it, without difficulty. My alarm clock was set to go off earlier anyway, and I was ready when the care team arrived.
   We changed a few details around. No TV on in the background. That’s just one more thing to switch off before you leave. No washing machine running in the kitchen. I’ll leave the fridge unattended and the heating on in winter, but washing machines and microwave ovens should be off if you are out and about.
   And no breakfast, in case of travel sickness. Or, rather, vomiting while in a wheelchair. I had a bag full of things in case of emergencies, but I prefer to reduce the risk of emergencies.
   Returning to the house would lead to TV, washing clothes, and food. All in a warm environment. The day looked like rain. Sudden heavy snow would have inconvenienced us. But heavy snow is a rarity.
   The day wasn’t icy. We’ll leave it at that.
   As usual, I’d already been to the venue to check it out. The internet was misleading. No big deal on the day. We just rolled down a few different corridors once we arrived at the wrong door.
   Getting there was a rainy experience. I described things as we rolled by them. Gave me something to say. Occasionally I stopped to adjust a wheelchair rain poncho gadget that was on its first outing. And it worked very well. Except, obviously, I’d forgotten to use the straps.
   The wind wouldn’t be that severe.
   Well, the wind picked up and the poncho flapped about on a pathway – always better than on a roadway. A quick adjustment, using the poppers on the straps, and away we went again. But the wind made its own adjustments to the flappy bit not strapped down.
   I narrate these excursions to let my passenger know that there’s a bump coming up. These warnings are handy.
   My earlier bout of reconnaissance told me not to take the shorter path on the left side of the hill. I switched to the longer path on the right side of the hill and…avoided the hill entirely. It’s a bumpy hill, as well as a hilly one. The hilliest hill we’d face. Not the north face of the Eiger. But any hill you can avoid…you should avoid. It’s a wheelchair thing.
   We were ready early. So we could take that longer safer path, and not worry too much about the delay in a-wandering. Would we be seen on time anyway? Not likely.
   The struggle with the wheelchair ramps was long behind me. It isn’t the business of getting out of the door that’s the bother. No. It’s the matter of returning to that door. One ramp overlaps the other, for a smooth transfer. The smooth transfer is theoretical.
   Half-hearted rain dribbled a little as I chatted. I spent the time pointing out features of the landscape, or the arrival of a tiny dog in its own tiny raincoat. There were a few doggy moments. If I announce a dog in advance of the event, the event is less eventful.
   One major road to cross. I’d navigated the land so as to minimise the number of main roads we had to cross. Parked vans distorted access to lowered sections of pavement. I checked both ways and both ways again. We had to go out onto the road, and along it for a short section, before reaching the lowered stretch of paving on the far side.
   Visibility was great. Cars went by. I attacked the problem with speed. This wasn’t a trolley dash along supermarket aisles to bag twenty jumbo packs of washing powder. Speed is never truly speedy, when pushing a wheelchair safely.
   Then we had a few encounters with dogs. All peaceful. Time to navigate the wilderness of hallways inside hospital buildings. And with the assistance of a nurse who materialised to guide us, we made good time.   
   The waiting game wasn’t long. There were random outbursts from someone with dementia, but not from the woman I’d wheeled along in the inadequate Basic Bitch wheelchair. This is always a feature of caring for someone with dementia…the bit about going to a clinic and not caring if dementia leads to outbursts.
   In the earlier phases, on a bus, on a train, in a taxi…life going on around us, well, that acted as a barrier against outbursts. Alone, in the house, random speech intruded. Occasionally, at the Memory Clinic, waiting, nothing to say, there’d be something said.
   Now, in the wheelchair place, there was tiredness after being wheeled through the rain. Someone else, waiting for a wheelchair consultation, was randomly sparking thoughts into speech. No big deal. Nothing you can do about it, except, perhaps, engage in conversation.
   But where I sat, I felt I didn’t have the option. I had to busy myself with observation. Pick up clues about the comings and goings. Lots of people moving around in that hallway. But no wheelchairs.
   A wheelchair emerges from this hall. Okay. It is more likely that a consultant will emerge from there. This proved correct. I’m listening for conversation aimed at the air in general. My mother’s name, being called.
   We were in one of those awkward crowds of people. A small crowd. Customers, punters, arrived after us. One couple, in before us, went off for a consultation. But then we were next, leaving other people behind. They’d arrived first. Were we queue-jumpers? Or had those others just arrived way too early?
   There’s no queue to jump, when you roll in.
   Anyway, there’s no resentment of who is ahead of you and who is behind. You don’t have time for that, when the consultant is steering you through a mini-maze of halls to a place where…I sit down.
   Then we go through a strange conversation. Strange in the sense that it is normal for me. Not so for the consultant. I’m there to find out what the hell they’ll give us. A wheelchair, I am guessing. Going out on a shaky branch there, I’ll admit.
   All I know is, the daycare centre people have health and safety and insurance regulations. She started daycare again and slumped in her chair. No good. She needed a five-point harness, which sounded as though she’d be kitted out with something jet fighter pilots use on particularly tricky sorties.
   That’s all I know. This five-point harness.
   It’s a four-point harness, I’m told. Attaches to the wheelchair at four points. Some people call the seatbelt connector, the clicky bit, the fifth point. Well, that’s all I know. I explain that daycare was out until we find a solution to slumping, and a harness was all they mentioned.
   We go through the equipment at home. The new reclining chair, the old hospital bed, the temporary hoist and sling to assist with transfer from bed to chair. All the equipment is in place, yes, and I spent week after week moving furniture around to accommodate the changes. A lot of thinking, moving, and more thinking and moving.
   The consultant thinks this is fantastic. He’s had it up to here with people walking in and telling him his job. Instead, I walked in and told him my job. That’s what he wanted to hear. You explain the circumstances at home, and he proposes a solution.
   Apparently, customers, punters, clients…carers…had been coming in and giving the serial number of the exact specialised wheelchair they needed. They turn up with a Basic Bitch wheelchair and ask for the Dustbuster 3000 Mark 2.1, with added menthol, and expect to be given that precise model.
   For technical reasons, I didn’t have a fucking clue about what was on offer. I thought I’d let the guy explain that to me. It seemed reasonable. I was told about a five-point harness, and thought I’d be handed a rig to attach to the wheelchair…or there’d be another wheelchair passed into our hands.
   Here’s the situation.
   It sounds so simple. But there are people out in the rain who don’t see things that way. And so, I had an ordinary conversation with the consultant that he found refreshing for a change. That is what struck me most about our trip to the clinic.
   His solution was to give us the Dustbuster 3000 Mark 2.1, with added menthol. There might be one in stores right now. We can go back for a fitting, once he’s wheeled it out of storage.
   The thing is…to me, a wheelchair is a wheeled chair. I used it to take her to the Memory Clinic for convenience. She could walk, then, but not fast and not too far. So a trip in the wheelchair was a cosy affair. Now, it is essential for clinic visits or daycare.
   That chair comes out of a cupboard and is used and goes back in the cupboard. This is where the consultant’s problem lies. Family members think the Dustbuster 3000 Mark 2.1, with added menthol, is a seating solution and not a transport solution.
   It is a reclining wheelchair. Once you are in position, you can sit it back like a recliner. This would be ideal for a short stint in daycare, if she falls asleep in the afternoon portion of the visit after having a meal. But that is TEMPORARY.
   Question. What does she sit in, during the day? Lie down in a bed? Fair enough. Sit in a chair, whether recliner or not? Also, fair enough. But people are requesting a recliner wheelchair to sit in for the whole day.
   No. It’s not for that. Our Basic Bitch wheelchair, with its very basic seatbelt, lasted two trips to daycare when the service started up again. And it took the second trip to realise there was a posture problem. And that was that until we could have all sorts of equipment put in at home…
   A specialised recliner to replace the recliner that was there. The hoist. Loads of old pieces of equipment had to go. I moved furniture around and gave furniture away to make SPACE. And SPACE is important for new bits of equipment.
   The consultant and I both agreed on a piece of common ground. It’s all about width of space between pieces of furniture, and all about turning-circles, too. You need proper bits of specialised furniture to sit in. Not a wheelchair for the duration.
   And this is the difficulty. Family members are parking the cared-for in wheelchairs during the day and demanding better wheelchairs to sit in. No. First have decent furniture to sit in. Yes, a wheelchair is a chair. But the main function is that it’s a chair that takes you somewhere.
   Even with the Basic Bitch wheelchair tricked out with all the gadgets and comforts, it is still just a thing to get from here to there and back again. If her posture were better, she’d be okay in a chair at daycare for a few hours. And then back to a comfortable chair or to bed.
   Her deteriorating mobility changed the entire building. Sometimes, on a weekly basis. What’s the result of our visit to the clinic? Oh, I’ll move more furniture. Let me see. We’ll have a new wheelchair that is a recliner, but it isn’t for sitting in all day. This is no substitute for a comfortable chair. It is a means of transportation. Luxury transportation, I’ll grant you. It will make a few hours at daycare much safer. Making daycare possible in the first place. Explain your situation to the consultant, and the consultant will offer solutions.
   What to look forward to? The hoist is being replaced by a ceiling hoist, so there’ll be more floorspace for the Dustbuster 3000 Mark 2.1, with added menthol. Believe me, it’s the added menthol that takes up the most room.