After reviewing my father’s case notes, the social worker suggested that I go and have a look at a few nursing homes funded by the state, where he would be entitled to admission if the National Health Service (NHS) decided to offer him what they called continuing care.
Continuing care is a British scheme that pays for the total funding of an individual’s needs in a nursing home. It is only available to a small percentage of the most extreme cases. As one nursing home administrator put it to me bluntly: ‘You have to be half-dead to be eligible.’ The alternative, if one does not fulfil the criteria, is self-funded care—which is very costly. The average private nursing home in the UK charges around one thousand pounds a week for its services at a basic level. It goes up substantially for residents who require more personalised attention.
Assessment for continuing care is determined by a panel of psychologists who rate key factors such as poor cognition, lack of ability to feed oneself and incontinence. In order to be entitled to the scheme, you have to score highly in at least two of these categories. Then there has to be room for you at the appropriate facility in your area—not based on where you live, necessarily, but the area under the jurisdiction of the hospital by which you have been referred. There is a complex network of health trusts to navigate as part of this process, and it is almost impossible to understand how it all works. Suffice to say that it is a procedure as frustrating and as byzantine as trying to get your child into the right school if they have special needs.
My father would be assessed in the coming few days, and in the meantime we could visit some of the available nursing homes. The social worker advised me that some places would automatically rule themselves out as they could not provide the level of security necessary to deal with a client who wandered and showed a tendency to attempt to abscond. I thought immediately of the distinction between maximum and low-security prisons.
We agreed right away that proximity to home was an important factor. The facility needed to be somewhere my mother could either drive to easily or get to by public transport with minimal fuss. We shortlisted three places and steeled ourselves to visit them. Phone calls determined that there was no availability at one of them, where the waiting list was already long. That left two. We decided to knock them off in one go to get it over with.
Both of the places we visited were staffed by women from the Philippines, often recruited together from villages so that, at least, when they come to an unfamiliar new country, they are with their friends. The nursing homes were almost identical. Contrary to what we expected, neither place smelled particularly bad—no lingering cooking smells or the choking vapours of disinfectant masking bodily functions. Dining rooms looked cheerful, staff smiled greetings at us in corridors, there were flowers, both fresh and artificial, on windowsills, pictures on walls. But the lounges were dismal.
This was where residents were parked while their rooms were cleaned, or waiting for family and friends to visit, abandoned to the mercies of daytime television. Most were asleep or semi-awake, dribbling, coughing or nodding off. ‘We call them the Os and Qs,’ said a friend who has long-term experience of visiting such places. ‘The Os have their mouths open, the Qs have their tongues hanging out.’
Hacking or rasping provided a constant background noise of throat-clearing punctuated by the occasional snore, grunt or moan.
So this, I thought, is Purgatory.
My mother and I scrutinised noticeboards to get an idea of the in-house activities organised to keep residents stimulated. In one, there was a pat-dog scheme, in which a trained, licensed dog comes in to be stroked on a weekly basis; in the other, cake decoration and flower arrangement were the only two programs. We could not see my father engaging in either.
On the way home, my mother tried to persuade herself, and me, that either of these places would be tolerable. I knew they were not and that my father would wither and die if he were left there. Defeated, we went to bed early.
Once it became clear that Papa would never be coming home, I had moved into his room, where the bed was more comfortable than the futon in the spare room. Now, as I lay on my side, listening through the thin walls to my mother tossing and turning, the mattress gave way with an audible sigh, almost toppling me off the edge. Could anything be more symbolic than its sagging springs collapsing?
It was as if the bed sensed that its rightful owner had been usurped and was rejecting me. Or maybe it was sympathetic and merely expressing the state I was close to. Rolling to the other side, which had not caved in, I listened to honking geese flying over the Thames, racking my brains as to how we could convince the authorities that there had to be a better alternative than the places we had seen.
In the morning, I remembered that Carolyn, a friend from my earliest schooldays had a grandmother in a nearby nursing home. Knowing that her family were successful Jewish businesspeople who enjoyed high standards, I could not imagine they had chosen anywhere that was less than five star. I gave her a call.
‘Look no further than Nightingale House,’ Carolyn said. Her certainty made me feel immediately reassured. She explained that her family had ‘researched exhaustively, believe me, and would have preferred somewhere near their home in St John’s Wood, but were prepared to schlep to Wandsworth on the other side of the city. Because it’s worth it.’
Wandsworth—right on my mother’s doorstep. It seemed too good to be true, but this was the kind of endorsement I could trust from a discerning source. Her father, Carolyn added, happened to be on the board of Nightingale House, and could fast-track us if there was any problem. Within minutes, she rang back to say the CEO was expecting my call and looking forward to welcoming me and my mother to inspect the premises.
We were there half an hour later, a bit surprised by the grandeur of the façade, which looked like that of a stately home. Nightingale House, a plaque by the entry told us, was formerly the home of a lord mayor of London until it was donated to a Jewish charity.
We were greeted at the door by the director, who took us into the sunny café and asked about our situation. He nodded sympathetically, putting our minds at ease straightaway that there were places available immediately for either short- or long-term respite care or permanent residence, and that individuals could come to Nightingale either on a private self-funding basis or under the auspices of the NHS. There was a special unit for high-risk dementia patients, and he suggested we take a walk around it. My mother, visibly tense, relaxed a little when it emerged that the director had a French wife and sent his children to my school. Tribalism and its little details can be very reassuring at such times.
We noticed that rooms were slightly smaller than in the other two facilities we had inspected, and were told that this was because residents were encouraged to spend as little time as possible in them, with a range of activities that were meant to keep them interested and active. These included a music appreciation and film society, French conversation classes and a reading group run by former Tory MP Edwina Currie, whose membership included several vigorous centenarians. We were shown an art studio where residents learned pottery and ceramics; a fully equipped physio and fitness centre; a theatre with a raised stage and cinema projection; extensive gardens with benches, gazebos and fountains; small lounges for private family gatherings; and larger rooms for watching television. The place felt busy and dynamic, as if everyone was occupied rather than in God’s waiting room. Every resident’s door featured a photograph of them, and the date was clearly displayed on each floor. The staircases between levels were secured with gates, and there was a security man at the front door to make sure that no one could wander off and get lost. The menu for the week was posted on every floor and varied weekly. It was, of course, strictly kosher. We declined a visit to the synagogue.
‘Actually, our religious counsellor is away with some of our residents this week,’ the director mentioned. We nodded polite interest. ‘He’s taken a group of them to Paris for a few days.’ We struggled to imagine t
he logistical challenges of such an outing, but were too shy to ask. ‘They went on Eurostar,’ he added, registering our curiosity. Suddenly, old age and infirmity were not looking quite so bad.
The very existence of Nightingale House lifted our spirits. It became the benchmark against which we measured the other options and we realised there was no choice. But would they accept him as an NHS patient and would he pass the relevant assessment? My mother was adamant that she could not afford the fees. As far as I was concerned, nothing less would do. I could not have my father’s well-being on my conscience. But would the NHS pay for what was clearly a much more costly facility than the ones it had suggested to us? Nightingale was the Ritz by comparison with the cheap motels they had nominated.
The burden of the responsibility for doing the right thing was so oppressive that it made it impossible to think of anything else. I felt more alone than at any other point in my adult life. As in childhood moments of desperation, I reverted to my childhood habit of asking myself what my favourite fictional heroines would do: except now, instead of Scarlett O’Hara or Jo March, I turned to the always level-headed and crisis-cool C.J. Cregg in The West Wing. I watched a couple of episodes to try to boost my morale, but this was no political scandal or policy conflict.
That’s when I realised: the thing no one tells you about being an only child is that it really hits home when you are an adult. None of the attention lavished on a singleton can help or prepare you for the level of responsibility when your parents need you. Suddenly I understood, in the starkest possible terms, that there was no one to share that burden and sense of duty with. My husband was far away and unfamiliar with the care landscape I was trying to navigate. Apart from Carolyn, friends were at a loss: none of them had yet faced a similar situation.
I wanted to do the right thing by my father. One of his favourite mottos was ‘Nothing but the best’. He had always tried to give me that and now it was my turn to do the same for him. But it seemed perverse to hope that when it came to the assessment, my father would behave as badly as possible and be seen as an extreme and therefore deserving case.
At about 3 a.m., the classic hour of despair, it came to me, lying on the uneven lumpy mattress, almost in a blinding flash, except that I was too weary and strung-out for anything so energising. I began to sweat. Of course. How could I have been so stupid? I had forgotten to tell the social worker the one crucial piece of information that could determine where my father was cared for. It had determined his fate once before. Now, it just might again.
I could not wait for it to become light, for me to be able to get on the phone, to start preparing my case. I knew what I had to do. I lay in bed, plotting and strategising. Then I went to the computer and wrote a three-page report about my father’s childhood.
As soon as I could, I rang the social worker.
‘I need to come and talk to you,’ I said.
He agreed to meet me at the hospital in half an hour.
When we found each other in the coffee shop, he was with a slight young woman in faded denim jeans. He introduced her as the colleague to whom my father’s case had been assigned. It was her job to find the suitable placement for him, and she would be making a recommendation to the panel after seeing my father, talking to me, and hearing what the specialist psychiatrists had to say. I realised that this young woman, who looked barely out of her teens, wielded tremendous power over our case. I knew that my appeal to her had to strike an emotional chord. I needed to make her care. Perhaps those hours watching C.J. were not wasted after all. What I needed was to channel her skills and lobby eloquently and persuasively for my father.
Almost immediately, the ice was broken when she revealed that she had studied in Melbourne. The fact that she had been to Australia created a bond of kinship as we joked about how obsessed Australians are with good coffee, and how dreadful the coffee in England is. She turned out to be Swedish and I stored that fact away, knowing I could use it when my time came.
While we made small talk, I was preparing a performance. I keyed myself up for what I knew were the most decisive and crucial minutes of my life. Every bit of skill I have in communicating, in creating a quick and warm rapport, in reading body language from years of interviewing people, came into play. I tried to access the adrenalin that always energises me at live events, when it seems to sharpen my brain and make my responses smarter.
I am not an actor. Despite years of work as a television presenter, I’m self-conscious. I cannot improvise or speak off the cuff, and get paralysed by nerves before any public event. I have never understood how some actors can cry on demand. But I knew I would have to cry now; in the heightened state I was in, sleep-deprived, psyched up, frayed with emotion and anxiety, it was not that hard.
‘I need to tell you something important about my father,’ I said, and almost immediately the tears started to fall. ‘I have written it down for you in more detail but the simple main point is that he had his identity stolen from him once and I am not prepared to let that happen to him again.’
It was easy to cry now, choked by the significance of the moment. Though I was in a public place I did not care who saw or heard me, or how I looked, or that my voice quavered and wobbled and suddenly shot up an octave like a pubescent boy whose vocal chords are still working out which register to speak in. I knew I had their attention. I did not want to overwhelm them with too much information, and knew I had to keep it short, to maximise the impact of my story.
‘My father is Jewish,’ I said. ‘He was taken from his parents in Vienna when he was ten as part of a refugee rescue operation for children in Europe in 1938. He lost his father in the Holocaust and was adopted into a family here in England after several traumatic episodes. He made a life here but never really recovered. He needs to be looked after somewhere he can hear Jewish words and prayers and eat Jewish food.’
The two social workers hardly nodded, and said nothing, but I knew there had been a subtle shift, like a mild change in the weather. The moment was intense, the silence pregnant. I looked straight into their eyes, trying not to blink from the constant wash of tears.
I wasn’t lying, exactly. But I was, as my father would have said, being economical with the truth. He had never gone to a synagogue, never chosen to belong to a Jewish community or eaten kosher food, although he had a fondness for traditional Yiddish dishes such as potato latkes and herrings in dill sauce. Once, when we visited Jerusalem, we had a chance to take part in the traditional Friday-night seder (sabbath) dinner at the King David Hotel, but my father opted for the coffee shop instead. I think he did not want to be embarrassed at not knowing the ritual or the prayers that would be said. But the fact of the matter is that he was born into the Jewish faith. Now was not the time to argue over the semantics of Semitism. Now was a time to convince these two people, and any others I needed to persuade, that this was the single most important fact about my father’s sense of self.
I turned to the young Swedish woman.
‘After the war, my father worked to set up the travel arm of the National Union of Students, and at that time he became friends with your countryman Olof Palme,’ I said, knowing this would impress her. Palme had gone on to become the distinguished and much-loved socialist prime minister of his country, until he was murdered by an assassin’s bullet. My father mourned him as one of his fallen heroes. C.J. would have approved of my calculated comment.
The case manager nodded almost imperceptibly. I handed her a copy of my three-page report on my father. She immediately started to read, her colleague craning to do so too. I let the stillness of the moment resonate, as if we were not in a busy place with strangers milling all around us. We had created an oasis, just the three of us, and I did not want to hurry and break the spell. I knew the longer they spent with me now in this state, the more invested they would be in representing my father’s interests.
The young woman looked up. Perhaps there were tears in her eyes, I couldn’t be sure, because the
y were already such limpid pools.
‘I promise you that I will be the best advocate for your father. I will make sure we get him the care he deserves,’ she said. Her colleague smiled encouragingly. I felt a surge of relief in my body, like warmth flooding my veins. Human connection is so mysterious. When it is genuine and sincere, you just know. I felt sure I could trust them.
‘Thank you, thank you,’ I said, the tears flowing hot and free as we stood and shook hands. ‘I am counting on you. I have to go home to Australia in a few days. I cannot leave my mother to cope … breakdown … no other family …’ I said, my sentences getting more incoherent and shorter as my distress increased. ‘I’m an only child,’ I finished, worn out.
‘We will do our best to see if we can speed things up because of the circumstances,’ said the young woman. ‘We’ll be in touch. Try not to worry. You’ve done the very best you can in helping your father. Now I’ll go upstairs and meet him.’
I prayed that he would be on his worst behaviour and then felt like a traitor for the thought.
‘Tell him you’re Swedish,’ I urged. ‘He’ll like that. If only this country were as compassionate as yours in the way it looks after the elderly,’ I said, shaking my head. ‘You should be very proud of your country.’
‘Thank you,’ replied the young woman, with a big open smile. ‘I am.’
I cried all the way home, when it no longer mattered, staring out of the window of the bus. I cried with gratitude at finding people who seemed to care, who radiated integrity and kindness. I cried because C.J. had come to my rescue. And because my father would never know what I had done.
CHAPTER 23
Scammers
When my father was a boy and fear was spreading through Vienna’s Jewish community, con artists preyed on families, promising schemes to secure their most precious possessions. One claimed to have arranged a special shipment of bicycles to Australia, filling their inner tubes with small valuables and jewellery. My father’s trusting family handed over whatever modest treasures they possessed.
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