by Cathy Glass
Once Melody and Amanda had made a bracelet each, Melody was eager to go to her mother’s room. I thanked the occupational therapist and, with Amanda and Melody wearing the bracelets they’d made, we left the lounge. As before, Amanda took us straight to her room without any hesitation, which again struck me as odd given how much she forgot.
Her room was as we’d left it the week before, with the plant on the table, the card Melody had made on the bedside cabinet, the ornaments and photos on her shelves and Melody’s drawings on the pinboard. Melody added another drawing to the pinboard first, and then as Amanda watched she set a new ornament on her shelf. She then took out the box of cakes, but this time stayed in charge of it. She gave her mother one, had one for herself and put the box in the bedside cabinet for her mother for later. I retrieved the old stay-fresh box from the cabinet. The photograph album was in there too and Melody now took it out. Encouraging her mother to sit beside her on the bed, she began going through the photographs as she had the week before, telling her mother a bit about each picture. Every so often I saw a flash of recognition cross Amanda’s eyes, as if she might remember seeing the photograph before. Had she remembered it from last week or had she been looking at them since? I didn’t know. Then, as if to prove she remembered, she suddenly said, ‘Melody looking very smart in her school uniform,’ before Melody had said it.
‘Yes, well done,’ I said.
Melody was ecstatic. ‘You remembered!’ she exclaimed, kissing her cheek. ‘You remembered what I told you.’ Then to me, ‘Mummy’s getting better!’
My heart sank. ‘It’s good she could remember the photograph,’ I said carefully. I’d have to explain again later that people didn’t recover from dementia. It was very difficult. I knew from what I’d read that dementia didn’t always progress evenly but in fits and starts, which allowed snatches of memory and lucidity from time to time until the final stage when it all disappeared for good.
We spent the rest of the afternoon in Amanda’s room and then, when it was time to go, she came with us to the main door. There was no sign of Mr and Mrs Bennett, but as soon as I rang the bell for a care assistant to let us out they appeared from just around the corner. I looked round the corner and saw an open door leading to another, much smaller sitting room. So that was where they waited for the bell to ring. While it seemed a bit depressing that their lives centred on the doorbell ringing, they weren’t distressed and appeared reasonably content. So I told myself it was just part of their ritualistic behaviour, similar to Mr Andrews visiting the ladies’ lounge and Mr Wilson calling out he had a plane to catch. The alternative – that they were really desperate to get out – was too painful to contemplate.
The care assistant arrived and Melody kissed her mother goodbye. Mrs Bennett then offered her cheek for kissing, which moved me. ‘She has a granddaughter about your age,’ the care assistant said to Melody. ‘She always kisses her goodbye.’ I was so pleased to hear they had family who visited them, and Melody was happy to kiss her cheek. The care assistant then moved them aside to let us out. As we went down the path we turned to wave goodbye. Amanda was standing between Mr and Mrs Bennett and the three of them waved back.
‘I don’t mind Mummy being friends with them now,’ Melody said. ‘I think they’re nice.’ Now she’d got to know them their behaviour was no longer intimidating and frightening, as it had been on our first visit.
From then on we visited Amanda either Friday after school or Saturday afternoon, depending on what I’d planned for the weekend. We always baked cakes on Thursday evening and also took in the ornaments Melody had bought with her pocket money, fruit, a packet of biscuits and any other food Melody thought her mother might like. I’m sure Amanda was very well fed at the care home, and I’d reassured Melody this was so, but like many children who come from homes where food has been scarce, she was still anxious about it. It can take months, sometimes years, before they stop worrying about where their next meal will come from. At each visit we spent some time in Amanda’s room and Melody took pride in making it look nice, tidying it, rearranging the shelves, adding to and adjusting the pictures on the pinboard and so on. The room looked far more homely now and while it pleased Melody and me, I doubted Amanda knew or cared, or perhaps she did. With so little language she rarely expressed her thoughts and feelings.
Towards the end of March, Neave and Jill visited us for their statutory visits. We discussed Melody’s progress and Jill checked and signed off my log notes. Neave also spent a short time alone with Melody and checked her bedroom before she left. Neave hadn’t seen Amanda since she’d been admitted to Oak Lane House, as once Amanda had been diagnosed and assessed a social worker from a different team was responsible for her. From what Neave said she wasn’t in regular contact with Amanda’s new social worker, so it was left to me (and Melody) to tell Neave how Amanda was. Melody’s version was slightly different to mine. She told Neave about the cakes, the ornaments, the drawings she’d done for her mother, and of course Mr Boo-Boo, Mr Aeroplane Man, and Mr and Mrs Bennett ‘trying to escape’ as she put it, while I told Neave (out of earshot of Melody) that Amanda’s dementia seemed to be advancing very quickly.
‘Does she still recognize Melody?’ Neave asked.
‘Sometimes. But those times are getting fewer.’ She made a note.
Melody also told Miss May about her visits to her mother, so that when I collected her from school on Monday Miss May always had something positive to say about the visit; for example, ‘Melody tells me she and her mother made some lovely bracelets.’ Or, ‘I hear Amanda’s room is looking pretty.’ Although Miss May would know the grim reality from watching her father’s decline.
At the start of April the schools broke up for the two-week Easter holiday. Adrian planned to spend most of it studying, as his exams began in May, so I took the girls on plenty of daytrips, which allowed some quiet in the house. Melody and I also visited Amanda on both Friday afternoons, while Lucy and Paula stayed at home ‘chilling’. I suppose they could have come with us, but neither of them nor Melody had suggested it, and I knew they would find the experience very upsetting. And part of me felt this was Melody’s special one-to-one with her mother and that she needed to make the most of whatever time there was left.
I received a letter in the post from CAMHS (Child and Adolescent Mental Health Service) with details of Melody’s long-awaited appointment to see a therapist. It was in ten days’ time. While there didn’t seem such a pressing need now for Melody to have therapy, as she was doing so well, she must still have many dark thoughts and unresolved issues that she needed to talk about, and a trained therapist would help her. I noted the appointment in my diary and let Neave know the next time we spoke.
Fostering is often marked with flurries of activity when the phone seems to be constantly ringing and there is a steady procession of professionals coming into the house, then it eases off, and you all fall into a routine and the household runs relatively smoothly. It’s always very hectic when a child first arrives and then it tends to settle down (unless anything untoward happens) until the final court hearing approaches, when there is renewed activity. The final court hearing wasn’t until November and at present everything seemed to be ticking along. School returned for the summer term and the air was warmer and the sun shone (well, sometimes – it was the UK, after all!). The days were longer now and I was driving back from Oak Lane House in daylight.
I took Melody for her CAMHS appointment. The unit was sited in a separate wing at our local hospital and I knew its location from having taken other children I’d fostered there. I gave our names to the receptionist and then we sat in the waiting room. It was very child-friendly, with bright collages of birds, butterflies and animals on the walls and plenty of toys and books for all ages of children. We were the only ones there and Melody didn’t want to play with anything, so I read to her from one of the books. After about five minutes a woman came in and introduced herself as Dr Marina Short, ‘But call me M
arina,’ she said pleasantly. She was indeed short and I hoped Melody didn’t comment. I guessed Marina to be in her mid-fifties; she had grey hair knotted tightly in a tall bun on top of her head, which I thought perhaps was intended to give her some height. She told Melody it was very nice to meet her and then showed us into a consulting room. I remembered being in it before with another child but not with this therapist. It was carpeted and contained a desk, filing cabinets, shelves of books, toy boxes and a circle of chairs around a low coffee table in the centre, on which was a box of tissues.
Melody and I sat down as Marina collected a notepad and pen from her desk and then joined us, facing Melody and me. I knew from experience that the first appointment is largely an assessment. Marina would have received the background information from Neave, and this session was to find out how Melody was and what CAMHS could do to help her. Marina began by asking Melody how she felt she’d settled in with me.
‘OK,’ Melody said with a nervous shrug. I threw her a reassuring smile.
‘How do you think Melody has settled in?’ Marina asked me. ‘I believe you have older children in the family?’
‘Yes, two daughters and a son. Melody has settled in very well.’ I outlined the progress she’d made at home and school as Marina made some notes.
‘Excellent,’ she said, smiling at Melody. Then she asked her what she liked about school.
‘Miss May,’ Melody said. ‘She’s nice and helps me with my work.’ Marina asked her about friends and Melody said, ‘Lizzie is my best friend,’ and told her about going to each other’s houses for tea.
‘Do you have any problems making friends?’ Marina asked.
‘No,’ Melody said. ‘Sometimes.’
Marina looked at me. ‘Because Melody hadn’t been in school mixing with her peer group, she struggled a little to make friends to begin with,’ I said. ‘Her TA, Miss May, and her teacher tell me she is doing well now.’
‘Good. That is progress,’ Marina said and made another note.
‘What about your family?’ she asked Melody. ‘You’re seeing your mother three times a week at contact. How is that going?’
Melody looked confused, as well she might.
‘Amanda is in a care home,’ I said. ‘Didn’t you know?’
‘No. The referral was made in January from her social worker. It says Melody has supervised contact at the Family Centre on Monday, Wednesday and Friday. I assume I haven’t been updated.’
‘Apparently not.’ I then went over as concisely as I could what had happened in the interim, including Amanda being sectioned, her stay in hospital, diagnosis, move to Oak Lane House and the present contact arrangements. It was a pity Melody had to hear all this, but there was no alternative.
‘I see,’ Marina said as I finished, frowning as she wrote. ‘Things have changed.’ I thought she really should have known all this, although whose responsibility it was to update her I didn’t know – Neave’s? Or perhaps it was up to Marina to check she had the latest information.
‘So you see your mother once a week at the care home?’ she now said to Melody. Melody nodded. ‘How is that going?’
‘OK,’ Melody said. Marina waited for more to follow and I wondered if Melody would start talking about Mr Boo-Boo and so on, but she didn’t.
‘How do you feel when you see your mother?’ Marina now asked.
‘I want to see Mummy,’ Melody said a little defensively, as though she thought Marina might stop her.
‘Good, and after you’ve seen her at the care home do you think about her a lot?’
Melody shrugged. ‘Sometimes.’
‘We always have a talk about our visit in the car on the way home,’ I said. ‘And if Melody has any questions or if there is anything worrying her, I hope she feels she can tell me.’
Marina nodded as she wrote, then, glancing up at me, she said, ‘I’m sure Melody must have many emotions, some of them conflicting.’
‘I’m sure she does, and I try to help her deal with them as best I can.’
‘When you see your mother, do you feel sad?’ she asked Melody.
‘Sometimes, but I know the care assistants look after Mummy. She has a nice room and it’s warm, and there’s plenty of food. On Thursday we bake cakes for her, and Cathy always takes in fruit.’
‘Good. What was life like with your mother before you came into care? Can you remember?’
‘Some of it,’ Melody said guardedly.
‘Would you like to tell me about it?’
Melody thought for a moment and then shook her head.
‘OK, maybe another time. What do you like about living at Cathy’s?’
Melody looked embarrassed and self-conscious. ‘Lots of things.’
‘What do you like doing?’ Marina asked, rephrasing.
‘Baking cakes and playing with Lucy and Paula. I like Adrian too, but he’s always in his room, studying.’
I smiled. ‘He has exams starting next week.’
‘Do you go to any clubs or activities?’ she asked.
Melody shook her head. I thought that before long the poor child would sign up to an activity just to keep the professionals in her life happy.
‘We go swimming most weekends,’ I said. ‘Melody knows if she wants to join an after-school activity then she only has to say, but at present she prefers to come home and relax.’
‘Sounds good to me,’ Marina said with a smile. Then to Melody, ‘Is there anything you would like to tell me? Our hour is nearly up.’
Melody shook her head.
‘All right,’ she said, addressing us both. ‘I think that’s enough for now. Here at CAMHS we offer a number of different therapies, and for a child of Melody’s age play therapy is usually considered more appropriate than a talking therapy. We have two therapy rooms here that are equipped with a variety of toys and art materials. The children usually come for an hour a week and work in small groups, but at their own pace. It allows them the space and time to explore issues that are affecting them, past and present.’ Then, looking at Melody, she asked, ‘Would you like to come here once a week and do some painting and play with other children? I can arrange it for after school so you don’t miss any more school.’
‘OK, but not Thursday,’ Melody said. ‘I bake cakes for Mummy on Thursday.’
‘I’ll make sure it’s not Thursday then,’ Marina said.
‘Thank you,’ I said.
‘You’re welcome. I’ll have the appointment letter sent to you with a copy to her social worker. You shouldn’t have to wait too long.’
I thanked her again and, saying goodbye, we left. Once outside I told Melody she had done well.
‘It was boring,’ she said. ‘Why did she ask me all those questions?’
‘Marina was trying to find out more about you and if there was anything worrying you, so she can help.’
‘I’m not going if she keeps asking me questions. That’s what the social workers did before they took me away.’ So I wondered if some of Melody’s reluctance to talk to Marina had been due to that.
‘Next time will be different. You’ll be playing and doing art work with the other children.’
She didn’t look convinced.
‘We’ll see how it goes,’ I said, and left it at that.
Therapy doesn’t suit everyone and I’d fostered children before who had stopped going. Therapy has to come at the right time in a child or young person’s life and they have to be able to relate to the therapist just as an adult in therapy does. We all have different coping mechanisms and some find therapy helpful, others not so much. But at least Melody was being given the chance, and CAMHS has helped thousands of children and young people. It is available to them whether they are in foster care or living with their family and is funded by our National Health Service, so is free for the user.
Chapter Eighteen
Developments
Melody’s second LAC review was approaching and we received the review forms in the pos
t for us to complete. My form had changed a little since the first review and now included a section entitled ‘Staying Safe’, with details of any accidents or notifiable incidents. I wrote ‘None’. Melody’s form was unchanged and I sat with her after dinner one evening to help her complete it. She could write well enough now to form her own letters and some words but still needed help with spelling and reading the questions. When we got to the question, What has gone well for you since your last review? she said without hesitation, ‘Seeing Mummy.’ I was relieved. What has gone badly since your last review? I helped her read.
‘Having to keep answering questions!’ she said vehemently.
I laughed out loud. ‘Very good.’
‘Can I put that then?’
‘Yes, if you want to, it’s your review form.’ Why shouldn’t she put that if it was what she felt? Her social worker always asked her questions, so too did Jill when she saw her, the Guardian ad Litem, Marina and now another review form. Compared with the average child living with their family, Melody must have felt that her life was full of questions, although of course they were all being asked in her best interests.
In response to the question, If you have any problems, who do you talk to? Melody said, ‘You, Lucy, Paula and Lizzie. I used to talk to Mummy, but she doesn’t understand any more.’
‘But it’s still important we talk to her,’ I said. ‘I know she doesn’t say much, but we don’t know what she understands.’
‘What’s the next question?’ Melody asked, not wanting to dwell on this, and she moved on.
The following week, as I set off for the review, I wasn’t expecting any big surprises, which was naïve. Fostering should have taught me never to become complacent. As far as I knew this second review was routine – to make sure everything was being done to help Melody and that the care plan was up to date. Again it was being held at Melody’s school and she would come in towards the end. I dressed smartly and arrived in plenty of time, signed in, and then one of the school secretaries took me to the Head’s room for the meeting. The IRO and Miss May were already there and we said hello.
