In the Midst of Life

and circulatory failure, before you have to die of cancer? In the end, we are all in the hands of God, and nothing we do will alter our fate.
    I had gained a good impression of the nursing home. The matron was the only trained nurse on the staff, but she set a good example and the assistants and carers whom I met
all
seemed pleasant men and women, who looked after the residents with cheerful goodwill. I saw a lot of smiling faces the day I was there. Leah’s room was spacious and airy, with two windows facing south and west, both overlooking the gardens, and she had a large bathroom leading off the main room. I felt she would be comfortable and happy there in the last weeks and months of her life.
    However, an incident occurred that shattered the calm. Leah was barely digesting food, felt nauseous much of the time, andsometimes she was sick. Both constipation and diarrhoea plagued her. Most of these nasty emissions she could control, but not always. One night, shortly after I had seen her, she tried to get to the bathroom, but what with the struggle to get out of bed and manoeuvre her Zimmer frame, she could not quite make it, and vomited all over the bathroom floor.
    Leah called for a member of the night staff, to whom she explained what had happened, apologised, and asked if the woman would clear it up. The woman looked at the mess, looked at Leah, said, ‘Clear it up yourself,’ and walked out.
    Leah told me that she had struggled into the bathroom again, and managed, though she was fearful of falling, to detach the showerhead and spray water all over the vomit. Then she got hold of towels and spread them over the watery mess to soak it up. Finally, she returned to bed and got some sleep.
    But that did it for Leah. In the morning she demanded to see the matron, told her what had happened, and said she was leaving that day. Poor matron was profuse in her apologies. She said that the woman came from an agency and would never be employed there again. But nothing would change Leah’s mind. ‘Because of that woman I am leaving this morning,’ she said. A taxi came, and by ten o’clock she had left the nursing home, although she was in no way fit to do so.
    Matron was deeply ashamed and embarrassed. None of her staff were trained nurses, and ninety per cent of them came from agencies. Only ten per cent were employed full or part time because of the impossibility of getting rid of anyone who was unsatisfactory. If an agency care assistant did not work properly, the matron could say that she would not have the person back. The care assistants were always being shifted around, and some were trained, some not; some experienced, others not; some were very good, others poor or bad. It was always a lottery who was sent by the agency, and night duty was the hardest to cover satisfactorily.
    Poor Leah arrived home, and no one was expecting her. She was seriously ill, and had to climb the front steps to the house, openthe front door, which is heavy, cross the hallway, and open the door to her flat, which had been double-locked and is even heavier due to fire regulations. She was cold, and the heating had been switched off. She had to go to the cupboard and pull down the main switch, which is stiff. I just cannot imagine how she managed to do all this in her condition, but she did. Later that day a driver brought a case with her things in it, and left it in the hallway. That was the first clue that anyone in the house had of her return.
    Steve went round to her flat and found her in a state of utter exhaustion, collapsed in her armchair. He telephoned the family in Israel to inform them. The doctor and community nurses had been informed by the matron, but visits could not be started straight away and Leah had to wait several days for a district nurse, carer, or home help. Sandy cooked meals for her, but she could not eat.
    Once again, though, Leah perked up. Perhaps being at home, which is where she had always wanted to be, stimulated her. Added to this was the knowledge that she
had
to cope, because she adamantly refused to return to the nursing home, and there was no alternative. So each morning she got up, bathed, dressed, and received her friends, with whom she talked intelligently and with humour. She played with Steve and Sandy’s baby, did her crossword puzzles and word games, and generally spread around her a love of life that was infectious.
    Yet all the time she was growing weaker and losing weight. The weight