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EXPERIENCES IN MENTAL HEALTH CARING |
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KITH AND KIN (Sixties Press 2004) |
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CONTENTS |
CARRY ON CARING - A One Act Play Written by: Emily Machin and Lucy Machin |
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The entirety of this play is spoken by Jane. She is middle-aged and a single parent. On the stage are a side-table and an upright chair. On the table are a telephone, lamp, pen and paper and an opened letter. Projected on the wall at the back of the stage area is a colour image of Jane’s living room. It is late afternoon. Jane enters and switches on her desktop lamp. She picks up the phone and dials. (After a pause.).......Hello, it’s Jane Gibson here. May I speak to Mr. Wallace please? Thankyou. (Pause).......Yes, hello Michael, it’s Jane Gibson. I was just phoning to arrange a meeting about Paul.......Yes, he’s actually doing well at the moment, but there has been some problems at home that I think you should know about before his review......Yes.......that would be good. I can be there at 11am........Yes, thankyou. See you on Friday then. |
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After putting the receiver down and writing down the details, she acknowledges the audience. Well, I didn’t used to think that would ever be possible! But, you know what they say...? “Never say never” and all that. She picks a letter up from the desk and opens it. (Reading aloud).......Dear Mrs. Gibson (looks at audience then back to letter) I am writing to inform you that Paul has been invited for a review meeting with Dr. Collins and myself, on Monday 10th May. Paul continues to express his wish that you don’t attend the meeting. I would therefore like to suggest that, as before, I call in to see you before his review to discuss any relevant issues.............la di la di da..........As we discussed at our last meeting, we will let you know the outcome of Paul’s review as soon as possible afterwards, subject to any confidential points. Best regards, Michael Wallace, Care-Co-ordinator (Looking up) You see, my son, Paul has schizophrenia. Since leaving hospital he’s been living at home, but his condition couldn’t really be described as stable. He’s been prescribed medication, although we’ve not managed to get the combination right yet. Well, to be more accurate, I’m told his state of mind fluctuates because of the balance of drugs he’s taking, but also it’s because Paul only chooses to take the medication periodically.........I mean, I don’t know for definite, but from little things I’ve noticed, I suspect that he pretends to take them........ I can tell by the number of tablets left in the boxes and if they don’t match up to the number of days he’s meant to’ave taken them for. If they don’t, then he’s either hidden them or flushed them or thrown them away, thinking I wouldn’t notice....... I decided to do something about it, when I realised what he was up to, so I started getting the tablets out for him with a glass of water and I stayed with him until he took them. It seemed to be working for the first few weeks, but then I spotted him doing this sneaky thing - keeping his hand closed as he put them into his mouth, and his hand went straight to his pocket!.....(she mimes the action).....did you see that?...quite clever actually, but hardly a new trick! He’s funny like that, thinking I wouldn’t notice. I asked him about it, but then of course he got very angry and accused me of spying on him......... “Stop controlling me” he said. “You’re always working against me!” I was only trying to help, I said. “You’re working with them, aren’t you? Trying to poison me!” I’m his mother, I said, why would I want to poison my own son? But as usual, there was no reasoning with him. I was his enemy, he said, colluding with “them” – that invisible group he’s invented that he’s always so terrified of. He wasn’t stupid, he said – He knew what was going on....... A few days later he calmed down, but took to taking them in another room instead, so really I had no idea whether he was actually taking them or not. That was about a year ago now, and it’s been going on ever since. It was from then on that I became the “witch”, plotting against him....He’s called me much worse, but you just get used to it...........The thing is, I know that deep down somewhere inside him, the real Paul – my son Paul – knows that I’m not those things. I love him, he’s not well and I’m trying to help him better in the best way I know how.......... That’s how I know. If he really believed his fantasies then he would move out like he threatens to. I suppose he’s frightened of that too.......Of change, and of strangers. He feels more comfortable with his known enemy than with a host of unknown ones. This is his home and the place where he feels he belongs. And I wouldn’t have it any other way. It just becomes very difficult when he is so torn – being both terrified of staying and of leaving........so scared......... He was 19 when it all started......3 years ago now. Odd to think it’s been that long.......seems like yesterday. It was very gradual....it’s only now, thinking back that I remember the little things that he did that were not quite right. He began ignoring us – I thought nothing of it at first – he wouldn’t be the first teenager to do it! But then it was almost as if we weren’t there, and he started hiding in his room, locking his door, refusing to answer. Then one morning I was passing his door and heard him muttering, but it wasn’t like he was on the phone, it was to himself – swearing, crying - and he became more and more paranoid. He started shouting out his window down the street to no one, as far as I could see........It was after that that he disappeared. I was petrified – worried sick. I didn’t have a clue what was happening to my little boy. I tried the police, but they couldn’t help me – “All we can do for the moment, madam, is keep an eye out for him” they said. Well, thanks a lot..... It was 4 agonizing days later that I was sat in the kitchen on the phone to my friend Pippa, and he just strolled in through the back door, passed me, and up to his room......I didn’t know how to react. I mean, I was so relieved, and angry, and shocked all at once - I hadn’t recognised him at first - he looked dreadful - God knows where he’d been sleeping – and he obviously hadn’t been eating............ the next day I was able to persuade him to go with me to see our GP. The doctor advised that he go into hospital for a short time, and Paul was sectioned. He left hospital about 5 months later and as I say, he’s been living at home ever since. Anyway, it’s been a difficult time for the family, like anyone in our position I suppose. Paul’s dad left us 5 years ago now, and although he has kept in touch with the girls, he doesn’t want to have anything to do with Paul and his illness. He just doesn’t understand what has happened to his son – nor does he want to - I think it frightens him. So, it’s just me....and the girls’. Laura’s a big help, though she’s only 12, bless her. When Paul’s really bad, it’s Laura who he seems to respond to the best. Sarah’s 15, and doing what 15 year olds do - staying out late, completely ignoring any rules I lay down – I don’t know, the cheek of her, sometime! Just the other day she came swanning in for dinner, ate it and left! Not even a “Hi” “Bye” or “Thankyou mum”!!.......But I know she’s ok because she’s inseparable from Tracy, Pippa’s daughter........I do try to keep them away from Paul’s troubles as much as possible though. It’s just if I can’t get home from work on time in the evenings that it gets difficult. I’m a cashier at the local bank. My manager has been as good as could be expected in the circumstances. He doesn’t understand my situation fully, of course – no one would unless they’ve been through it themselves, but he understands well enough to let me have the odd day off when things are getting difficult at home. But that’s the thing, you see, it’s a full time job looking after Paul, let alone everything else I have to think about to get by. And the doctors and care workers never seemed to see me as his carer. His own mother, and they used to ignore me!....well, that’s what it felt like, anyway. Thinking back, it wasn’t so bad when he was first in hospital. The nurses did at least try to explain to me what was going on......it’s not an easy thing to understand at first.......suddenly my world had been stood on it’s head....I was living a nightmare - my son wasn’t acting like my son any more – how can you just accept that? Well, you can’t...........I couldn’t. Anyway, as I was saying, I felt isolated. I remember I used to get so angry because no one seemed to be listening to me or telling me anything about my son. It was around about the time when Paul started being frightened of me and I knew that he wasn’t taking his medication properly, if at all. He hadn’t spoken to me for at least 2 weeks and he had hardly been out of his room, just occasionally storming out and returning after a few hours. I had no idea where he’d been or what he’d been up to. He would then go straight back to his room and just sit up there listening to what he calls music.....What he sees in that Marilyne Manson, I don’t know – all that black lipstick, and those freaky eyes.........the “goth look”........ they think they’re expressing their individuality, but every goth looks the same to me!!.........Worryingly, Laura seems to have taken to the music as well, which I’ve had to accept is a good thing – it’s a point of communication for them........... So when he was in that state, she would take him his dinner. She was the only one who could get him to open his door......she just seems to have a way of talking to him and get him to respond normally......for a few moments at least! So, anyway, one morning he’d left the house early, so I had time to go into his room to have a clean up before I went to work. As I was collecting all the dirty plates, and washing, I noticed the charred remains of something in the bin – he’s lucky that bin is metal!..... I picked it out carefully and realised that it was his benefit book. For some reason I couldn’t fathom, he’d decided to set fire to it........it was at that very moment, of course that he came back.........There was me, stood in his room searching through his bin.......it couldn’t have looked worse!!.....especially in his state of mind!.....I don’t know what I was thinking – I hadn’t even considered that he might come back......... I can laugh at it now, but at the time my heart was in my mouth. I knew that he’d probably blow up at me because he saw me as a spy in the first place. I felt so guilty, and frightened........ Then I thought, No, this isn’t fair! Why should I feel like this in my own house?!.....Because I worked night and day to keep our family together and was just about able to make ends meet, and here was my son standing in front of me, and I was feeling guilty for finding the benefit book that he’d burned! It felt like abuse – a slap in the face...... and I couldn’t get the thought out of my head that he was doing this to spite me..........I snapped.......I couldn’t help it, I’d had enough. I shouted “What the bleedin’ hell do you think you’re doing? Do you have any idea what it takes for me to run this house? .....Paul!....We needed this money!........” And he didn’t say a word........not a sound. He just looked at me. But cold, like I was this evil person..........I’d betrayed him......God, that was horrible........He pushed me back onto his bed, grabbed the book and left............. He came back that afternoon while I was at work and things carried on as if nothing had happened. That’s the thing – I can never predict what’s going on in his head. There was me, sick to the stomach with worry and anger and frustration and.....he acts as if it never happened......sometimes I question my own sanity! It was a week or so later that I found a letter for him from the hospital. It was around about the right time for his review, so I guessed what it was. I posted it under his door and waited. But he never told me about it.......... I had another chance to clean his room after a couple of days – I was more careful this time! - so I checked the date of the review then. I was becoming more and more concerned that he wasn’t going to take me with him.........Fine, you say, he’s the patient after all, but after going to every single review with him in the past, I was upset that I hadn’t been told. Of course, all the other times Paul had told me himself, and had, when he was thinking straight, asked me to go with him. This time he hadn’t told me and I didn’t believe for one minute that he meant to, because he hadn’t said a word to me since the benefit book........ Which was exactly why I had to be there. If Paul actually turned up to the meeting there was no way in the world he was going to tell them he wasn’t taking his medication, or that he’d been sitting in his room for 2 weeks non stop, or that he would only communicate with his little sister, or that he was refusing to accept the benefits he was entitled to, had burnt his benefit book............They would have no idea what the situation was........I was desperate by now - I needed help - I couldn’t cope anymore..........So I phoned his consultant. The slide changes to a black and white image of living room. She picks up the phone and dials.
(After a pause)........Hello. May I speak to Dr. Collins please?........Oh, well could you tell me when I can contact him please?..............He’s on holiday.......Back on Monday.......Right, well, it’s very important that I speak to him before next Wednesday. You see, it’s my so........Yes, my name’s Jane Gibson.......yes....that’s right.....Dr. Collins is my sons consultant and..........oh....thankyou. (The person on the other end has hung up. She takes a second to realise and then puts the phone down herself.)
Slide change back to colour.
(Looking at audience) Well that went well!!
As I said, I felt desperate and I couldn’t wait till Monday to see if I could get help or not. So I tried Paul’s care-coordinator, Michael. I’d met him a couple of times when he came to visit Paul and he seemed nice enough, but he never had time to speak to me. I didn’t mind. I was just relieved that Paul had found someone in the services he felt he trusted.
The slide changes to a black and white image of living room. She picks up the phone and dials.
(After a pause)........Hello Michael, it’s Jane, Paul Gibson’s mum....... just about. I was just calling because I’ve discovered that Paul has a review next Wednesday and he’s not told me about it.........Well, he’s always told me before...........I know he needs his independence, but.......it’s just that I’m having a bit of trouble with him at home, and I he obviously doesn’t want me to come with him.....You see I need to let you know the situation before you see Paul because I don’t think he’s going to tell you everything.......................Well, I was wondering if we could arrange a meeting before his review so that I can let you know what the situa...........Oh.......Is that what he said? Well, like I said, he’s not in his right mind at the moment.........Look, I won’t “interfere” as he puts it, directly, but there are some things that you really need to kno..............(becoming more and more angry).......well, what do you expect me to do?....... But surely, I’m caring full time for him, I must have some say in this!..............Oh....... Fine! (Slams the phone down.)
Slide change back to colour.
As I said, no one seemed to be listening.........Michael told me that he couldn’t discuss Paul with me because any information regarding Paul was confidential, and had to be kept that way in order to keep the trust in their relationship. He suggested I try phoning Dr. Collins. I did feel rather helpless, I have to say!.......Talk about a rock and a hard place!...... Anyway, it was Thursday, so we managed through the weekend – me, Laura and Mr Manson blaring away.............. On Monday, I tried Dr. Collins again.
The slide changes to a black and white image of living room. She picks up the phone and dials.
(After a pause).......Hello, may I speak to Dr. Collins please......It’s Jane Gibson..........Hello, Dr. Collins, I don’t know whether you got the message, but I tried phoning last week to speak to you about my son Paul.......Oh, well you see we’re having some problems at home and I know he’s got a review on Wednesday........... I know he doesn’t want me to be there, but there are some things that you need to know...........I know he’s over 21, but he’s still living at home and I am supporting him.........I wouldn’t have it any other way, but he refuses to speak to me at the moment and he’s burnt his benefi.............but how do you expect to help him if you don’t know the whole story?......Please, I am his carer, and I need to know what is happening with my son!...............I see.......(She put the phone down.)
The slide changes back to the original image of the living room.
Confidential?! How is my son confidential to me? I see him every day! Dr. Collins sees him once every 3 months, if that! I just couldn’t understand why they couldn’t talk to me about Paul, and why they weren’t interested in how his illness was affecting me and the girls..............I agree with Dr. Collins. Paul has rights and he needs to feel as independent as possible. But this word! It was like hitting a brick wall every time I tried to talk to anyone about Paul. I knew that if they would just listen to me, they would be able to help Paul in the best way that they could, and it would happen sooner. I wondered if they knew what it’s like to live and care for someone with a mental illness. It’s all well and good knowing what all the different drugs do and being able to give them out, but what about the effect it has on families?....................I knew I couldn’t do it on my own, but that’s how I felt.......alone........ I wonder if that’s what they meant when they said “care in the community”? Do it yourself.............go it alone...........make it up as you go along!............I came into this blind, and was still blind two and a half years’ on......... I still had no idea what direction to go in.
I had to do something........ If you are standing still you might as well be going backwards – that’s what my dad used to say. I knew that I needed a meeting with both Dr. Collins and Michael – even if we didn’t discuss Paul’s issues, I needed to talk to them about my needs. If they wanted him to be out in the community, and I certainly did – I hated seeing him in that hospital - then they were going to have to help me cope with the situation.
So I wrote a letter............ I sent copies to Dr. Collins, Michael, and – my master stroke - our GP, who had been very supportive over the years – I knew if I could get him on my side from the start there would be a chance that this would work. In the letter, very simply, I asked for help. I explained my situation, and Paul’s behavior and that I understood that his case was confidential, but as his carer I needed an input into his care plan, as they had themselves. I was as important to his well being as they were, and they couldn’t deny that. I didn’t hear anything for a while, it was a couple of weeks at least, and then one evening the doorbell rang, and it was Michael Wallace. I thought at first that he’d come to see Paul, but he asked if I’d got a few minutes to spare. When we’d sat down, he explained that there had been a meeting with himself, Dr. Collins and our GP to discuss Paul’s case. He said that they had come up with a few ideas that would help to improve our situation. He explained exactly what they were aiming for with Paul: his medication and their efforts to stabilise the illness, which in turn they were hoping would give him more independence. They would then be thinking along the lines of getting him involved with voluntary schemes, or something that would interest him during the day. This would help build up his confidence and give him a sense of self-worth, and may well lead on to very positive opportunities. Then he asked me if there was anything else I wanted to know, or if there was anything that he could help me with. It took me a moment to realise what he was saying! I just sat there, stunned. I didn’t know whether to laugh or cry. Finally they were asking me for my opinion, and trusting me with information about my own son. I would have a degree of control over our lives again!
So I told him why I had written the letter, that I was upset about being kept in the dark, and that I needed help. We talked for a good hour about my difficulties with caring for Paul and the girls and working on top of that, and he suggested that I have a carers assessment. We then talked about the fact that Paul didn’t want me involved, and Michael agreed that given the circumstances I needed to be involved to some extent, and said he’d have a work with Paul about it to see if he could persuade him to talk to me. He also told me I could contact him at any time if I needed to, and gave me a leaflet of a local carers group who might be of some support. It was such a relief to be taken seriously at last.
I did have a carers assessment, and it led to my getting a couple of hours respite a week – there’s another carer comes round on Wednesdays so that’s now my night out with Pippa – we go to the cinema or the pub.......it’s my little oasis.
It took several months to work out properly, but eventually when they had found a better balance for Paul’s medication, things became a bit easier. Dr. Collins advised him that he would be speaking to me about his condition, but if there were anything Paul didn’t want me to know, he would keep it confidential. I’m sure there are some things I don’t know, but they don’t matter, because now I know what I need to in order to do my job as the carer..... I get a separate letter of each review he is asked to attend and invited to a meeting beforehand to discuss his needs. Paul never asks me to go now – I think it makes him feel more independent, but at least I get my say........He started helping on a special work scheme about a month ago – interior decorating, two days a week. He gets a bit of money for that and it’s certainly cheered him up....... He’s got a new benefit book and collects it when he remembers to! And I discovered I’m eligible for a carers benefit, which is a godsend!
The best thing about it all though is that Paul has started to speak to me again. And that’s how all this came about. Communication...........So talking is the key.............And if you talk, eventually someone has to listen......(She gets up and picks up her mug.)....Well, anyway,..... I need to get tea ready before the kids get home from school,..........maybe Paul will eat with us today......(She switches the lamp off.)
The projector fades to black and music swells.
The End
Things to think about: - Giving Jane more character/character traits, etc. - Humour – there needs to be some in there somewhere!.......Possibly use projections for this as well as the dialogue. - Re-structuring? Tell me what you think. - Look at accuracy of scenario. - Look at whether the play as a whole gives across the correct/entire message we want it to effectively! Do we need to simplify, or explain things in more depth? (REMEMBER: the simpler the better!!!!......in most cases.....) I’m sounding cynical now, I know, but it’s not to say that there aren’t a good many people who work in what I’ve come to know as “the services”, who do care very much for their jobs, and consequently, the people who they have to care for. No one wants to treat anyone badly, but sometimes that’s just how it comes across.
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One Carer’s Story - Barry Tebb Schizophrenia - A Carer’s Journal - Mike Schizophrenia – A Mother’s Story – Georgina Wakefield My Journey Of Sadness – Stan Hagon The Voice Of Carers – Amanda Cummin Yemeni Carers’ Stories – Debjani Chaterjee Beyond Our Reach, But Not Our Love – Brian D’arcy Carry On Caring – Emily Machin & Lucy Machin Enigma And Other Poems - Georgina Wakefield Killingbeck Drive – Brenda Williams Searching The Beyond And Other Poems – Daisy Abey Sharp Edge – Daisy Abey The Long Good Bye – Barry Tebb Looking Back – Barry Tebb Nameless In Camden – Brenda Williams Autobiography – Simon Jenner The Sick Image Of My Father Fades – John Horder Are You A Carer? Caring About Carers
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