She was quite confused by the time I got back.  I sat at the table, filling out the form for claiming attendance allowance.  She sat with me, occasionally leaning forward to rest her head on the rim of her walking frame and uttering low moans.


‘What’s the matter, mum?’  I asked, as gently as I could, trying to disguise the tone of my irritation.


She raised her head.  Her gaze was heavy, vacant. 


‘I don’t know.  What am I meant to be doing?’


‘Nothing,’  I answered, ‘You can do what you like.’


Of course that was the wrong answer.  I knew it as soon as I said it – no – before I said it.  It was an answer born of all the unhelpfulness of reason, born out of irritation.  Mum just doesn’t know what she wants to do any more.   She really wanted to be organised.  She didn’t want to watch television because she couldn’t hear it.  She couldn’t listen to the radio because the music was flat.  She couldn’t read a book.  She could do her puzzles, but that didn’t satisfy her very much any more.  She just wanted to be entertained.  She wanted the attention of one person beamed on her the whole time, preferably me, because I was hers. I belonged.    


There isn’t any point of wanting to do anything.  Any desire she might have had has gone. There is just the obligation.  If others need her, even in a minor way, then her life has some use.  My ‘oh so reasonable’ answer removed any remnant of hope at a stroke.  It exposed the dreadful absence of meaning in her life.  It was cruel! 


I could have asked her to make me a cup of tea.  We could have played scrabble. OK, she would have struggled to know how many letters to pick up, she would not have completely grasped the idea of taking it in turns, the scores would have completely foxed her.  But finding words is a lacuna of functioning that makes her feel useful.  We could have even filled out the form together. 


So, why didn’t I?  Did her disabilities cause me to deny the painful reality of my impending incapacity?  Or did they impose a burden of obligation that was both overwhelming and unending?  So I responded with a gesture that was unhelpful,  meaningless, but defensible.  I went to see her, filled in her forms, made the tea, cleared up and did the business.  It satisfied my own guilt, but it didn’t give her what she really wanted. 


But why guilt?  Was it that, despite an all too painful an awareness of her plight, I showed a singular lack of understanding.  Or was it worse.  Was I getting at her with malicious helpfulness?


We can all too readily blame our parents for the disappointments in our lives.  They fuck you up, your mum and dad!, wrote Philip Larkin.  So was I fucked by her affair, the divorce, the need for my support and the subsequent abandonment?   ‘You’re old enough and ugly enough to look after yourself’, was her reaction to my teenage depression, ‘I’m not going to let you spoil my one chance of happiness.’  Now, at the end of her life, she needs me more than ever.  She has always demanded my attention, my achievement – ‘I’m so proud of you’ – I always had to be there to provide a sense of importance, but since her adoring husband died, I have had to provide the input to make life meaningful.  So do I now, fifty years later, mitigate responsibility for my own life by persecuting my poor, frail 92 year old mum with meaningless assistance.  


But if I am guilty of the meaningless care, the same burden of guilt must fall on the whole care system.  Let’s face it, the state is hopeless at caring for the sick and elderly. 


Before mum returned home, she had 4 weeks in residential care.  The home she went to had the reputation of being the best in Sheffield.  I was impressed when I visited.  It was light and efficient, the staff smiled a lot.  But the residents sat around the room in their tall chairs like monks in a chapter house, just staring or sleeping, not communicating with each other.  The home had five stars.  It ticked all the boxes; regular nutritious meals, trips out, entertainment, bright tidy rooms, excellent bathing and toilet facilities, but the staff rarely engaged with the inmates and they did little to encourage them to engage with each other.  With a resident/carer ratio of 6 to 1, there was little opportunity for one to one engagement.  Mum was desperately lonely and when the doctor came to visit another patient, she made the great escape.  She slumped and complained of chest pain and was admitted to hospital. 


Of course that was worse.  The assessment ward was just too busy, but the beds were blocked and she spent several days there before going to the assessment for the elderly.  But many of the patients had strokes, some were noisy and some were quite severely demented.  The nurses seemed more concerned with their reports and meetings than patient care and although mum was in direct vision from the nursing station, it didn’t prevent Bill, one of the male patients trying to climb into bed with her.  This was a very frightening experience.  


Mum is now back in her flat with a more intensive private care package. Ruth, her carer, smells of nicotine and has hair the same colour, but she is kind and understanding and prepared to give mum the special attention she so desperately craves.  I visit most days and now devoid of the responsibility for more practical care, can devote more time to establishing some focussed communication.


Is mum happy?  No, of course not.  Serious old age is rarely happy.  She seems animated and interested as long as she is holding court and listened to, but her memory is now short term, that she has forgotten the engagement within five minutes and with heavy sincerity, fixes me with baleful gaze and announces with heavy sincerity, ‘I feel so desperately lonely’.  But this does not mean she is solitary.  She has company for most of the hours she is awake, but she can‘t derive any meaning out of it.  Loneliness is a lack of meaning.  


But perhaps her life is stable.  Gabriel Garcia Marquez has written how in relationships, stability is more important than happiness.  Mum’s existence is predictable again.  She is back in what has been her home for the last 17 years, surrounded by her things, with the same carer coming in at the same times every day, me visiting her in the afternoons, the neighbours coming in regularly, trips to the Friday Club where she plays solo whist.  There is a predictability, a focus of grievance that domesticates an existential disappointment.  ‘Oh she’s a cheats!  She’s always trying to see my cards.’   


In the ancient hill villages in central Italy,  the elderly sit outside their houses and are greeted by everyone who passes.  They have their place in the community, their memories, a continuity through children and grandchildren.  Their body is supported, their mind reminded, their soul nurtured.  They belong so they exist!     


Unfortunately, even there, life is changing.  Many of the children have left.  People travel along the road enclosed in their cars.  Many of the cues that might have supported an identity are being eroded.  Without a sense of belonging, the soul perishes and the body must inevitably follow, no matter how well fed and cleaned it is.  We could say that our care system needs to wake up to this basic fact.  But how do you restore a family, community.  Memories need constant replenishment and reinforcement.   And if memories go, identity goes.