Tales of love and loss from the end of days

More than 160,000 Australians now live in permanent residential aged-care. Ninety of them call St George's, in Altona Meadows, home.

More than 160,000 Australians now live in permanent residential aged-care. Ninety of them call St George's, in Altona Meadows, home.

EVERY time she says hello it hurts a little. The word arrives like a question, but she fills it with much more: surprise, pleasure in the meeting, and genuine, courteous interest - as if she'd really like to know all about you and your story. But then she asks, ''Who are you?''

And after 54 years of marriage that's a question you never want to hear from the woman you love.

Lately she's begun denying you. Telling you, no, you're not her husband. Sometimes even asking other men if they are. ''That hurts. It bloody hurts like hell,'' whispers Jack Hallowell, 80, holding his wife Eveline's hand as they sit on the edge of her single bed. ''I wouldn't wish this on any bastard, I tell you. It's bloody cruel.''

Then he kisses her, gets up and goes home alone again.

Funny thing is, if she tries hard she can remember the night they met. The Orama Ballroom in Hopkins Street, Footscray. She'd gone with a girlfriend, but this strapping, dark-haired young man picked her out and asked for a dance. And then another.

''I don't know how the girlfriend got home that night,'' says Jack. He took Eveline back to Seaholme, where she lived with her parents. She was making him a cuppa when they heard a train whistle and then her mother's bird-like voice: ''Eveline? Eveline? The last train's gone.''

''I was stuck. Her old man had to get out of bed and run me home to Sunshine,'' says Jack. ''I thought, 'This is a good start, this is'. But it worked out beaut.''

He was a refinery worker and she was a dressmaker at Georges in Collins Street. They married and had three daughters and barely spent a day apart over the next five decades. As a couple, says their eldest, Leanne, they were an entity, ''a oneness''.

Until September 1, 2009, when he moved her in here, St George's residential aged care facility in Altona Meadows. ''I just couldn't handle her at home any more,'' he says. She'd been slipping for five or six years. Always a fastidious dresser, she was taking less care, wearing odd socks. She began forgetting things, repeating conversations, asking where the toilet was. Sometimes, making coffee, she'd pour the hot water into the jar, not the cup. She started leaving the gas on.

Eveline, now 74, was diagnosed with short-term memory loss and confusion, or in that uglier word, dementia. Jack knew the signs. Eveline's parents had both suffered it and spent their last foggy days together in St George's. After they died, Eveline and Jack stayed on as volunteers, so they knew the quality of the place. But it didn't make it any easier when the crunch came.

''It was heartbreaking,'' he says. ''I was depressed, but I'm feeling worse now than I was then, because I don't know what I'm walking into each day.''

Jack lives alone now, in their home four blocks away. ''You're sitting down watching TV and something will come on and you'll turn around to say something to Eveline and she's not there. Or roll over in the bed and she's not there. It's damned hard, bloody hard.''

His own health suffered. Temporal arteritis, inflammation of the blood vessels in his forehead, nearly blinded him, and he needed a hip replacement. But he still visits four or five days a week, watching her decline into deeper confusion. When he's not there, she wanders the corridors of the nursing home, walking into other people's rooms, wondering where she is and why. Over the past five or six months, she has begun forgetting Jack and her girls.

On a Saturday morning Leanne brings fruit loaf and photos on her iPad. Her mother gives her one of those hellos: ''I knew someone called Leanne once,'' she says.

''Yes, that was probably me.''

Eveline introduces her to Jack: ''This is my daughter Leanne. Do you know her?'' Jack nods and stares out the window for a very long time.

''I'll have a cry when I go home,'' says Leanne afterwards. She nods towards her father: ''He hasn't got the woman he married. That woman over there is not the one he married at all. He's got the body but he hasn't got her heart any more, he hasn't got that close physical connection and he hasn't got that mental connection. And it breaks our hearts.''

ST GEORGE'S is a low-slung, modern building on half a block of quiet Howard Street in Altona Meadows, the working-class pocket of brick veneers between Laverton and the bay. A 2008 expansion of a nursing home first opened in 1994, it is one of 11 aged-care facilities run by the not-for-profit Benetas. It is home to 90 residents, a third of them in the low-care hostel, and the rest in the high-care nursing home.

Their ages range from the late 60s to 100 and they hail from 17 birthplaces, mainly Australia, England and Italy, but also Malta, Russia, Croatia, Serbia, New Zealand, Scotland, Poland, Greece, South Africa, India, Germany, Macedonia, Ukraine and the Philippines. They came to the home for a variety of reasons - though rarely by choice - ranging from the general debilitation of age to falls and Alzheimer's disease.

Forty-nine per cent have been diagnosed with dementia and, perhaps more disturbingly, 36 per cent with depression. They are among the more than 160,000 Australians who live in permanent residential aged care like this, most receiving high-level care. Through these doors is the reality and the future of ageing Australia. But punch in the code and step through the security airlock and you meet 90 men and women who are not statistics or exemplars of a social dilemma. As manager Chris Smith points out, they didn't leave their lives at the door.

And there are love stories at the end of days. Many have lasted lifetimes. Some, like that of Jack and Eveline, in one sad sense, are coming to an end. Others have just begun.

WEDNESDAY, 11am. Morning Melodies at Kooringal Golf Club, 20 tables of happy older folk enjoying the stylings of multi-instrumentalist Marceau Camille. A mini-busload from St George's has a spot by the stage, clapping and tapping in time. John Corcoran has driven here with Prue Wickens in his little green Kia. He was a member here and played the course for years. Now someone's urging him to get up and dance. ''I used to be a very good ballroom dancer when I was young,'' he tells the table. ''Now I'd fall arse over head.''

But he succumbs, and he and Prue get up to a fiddle-driven version of Jambalaya. He leans in and gently kisses her on the lips.

''We've become special friends,'' Prue says later. ''I love him and he knows it. If I hadn't John, I'd be going to bed thinking, 'I hope I don't wake up'.''

A former wharfie, John, 89, came to St George's in August 2009. His third wife, Nancy, had moved in in late 2008 after she began losing the use of her legs.

''Eventually we got her in here,'' he says. ''I used to come around every morning and spend all day. I'd have dinner with her then go home. I said, this is foolish ? and within a short space of time I'd moved in too.''

Nancy died on Christmas Eve 2009 but John stayed, moving into her room.

Prue, 82, arrived in February 2010. She'd been married twice, once back home in Durham, England, and the second time less than a month after she migrated to Australia with her three children. Evan Wickens was the penfriend of one of her girlfriends. ''He was here to meet me when I arrived and I'd been out here three weeks when we got married,'' she remembers. ''I loved him to death.''

After he died, she lived in Altona near her eldest son, Paul Lishman, but began losing short-term memory and neglecting herself, missing meals and losing weight. After a number of falls, she was assessed as needing 24-hour care. At first she hated it.

Like most relatives, Paul, too, was suffering. His brother and sister live in Europe and the decision - and blame - fell on him. He speaks of anxiety, doubt, apprehension, hope that it would turn out right, but particularly guilt.

''Mum was a young widow, bringing up three kids and I know what she gave up for us,'' he says, choking up. ''That's why it's hard putting her in a home.'' Prue spent the first few months in her room. ''But he got me out,'' she says pointing at John, a gregarious, no-nonsense type who made it his mission to pull her out of her loneliness. Since then they've formed what he calls ''a nice friendship''. They share a table, he takes her to Morning Melodies and on Sundays for a drive around the beach and to the golf club: ''She's had a bit of a rough go and we can have long talks about our lives and troubles and woes. She's lovely company.''

And more than that. Staff have learnt to knock loudly on their doors, then wait. ''We've got our privacy,'' says John. ''I've got signs that I can throw on my door. I've said to them I'll be in Prue's room or she'll be in mine and their attitude is it's your home, you do what you want in there.''

When the friendship became romance, and particularly when John started taking Prue out in his car, management notified their children. Paul still finds that pretty funny. ''I don't have a problem at all. I think she's old enough to know what she's doing, so good luck to them both,'' he says, noting that she has started to ''come alive again''.

And that's vital, insists John. ''If you haven't got a friend in here, mate, you'll quickly finish up down the other end,'' he says, nodding towards high-care. ''I'd go out of me mind.''

BOB Slater is lost. The 85-year-old arrived yesterday afternoon and this morning walks slow, unhappy laps of the nursing home, waiting for his wife, Joan, to come to take him home. ''I asked them to call her,'' he says. ''Offered a couple of dollars for the phone, but they refused.

''This retirement, it's not all it's cracked up to be.''

The high-care section of St George's is in two wings, each three sides of a square around a central, diamond-shaped dining and day room, bathed in natural light from ceiling-high windows. Most of the residents have been assessed as needing full-time personal care. These are the people at what manager Chris Smith calls ''the really pointy end of their care continuum''. A range of community packages, from Meals on Wheels to Extended Aged Care and dementia-specific offerings, keep people at home longer, she says. ''[So] we get people coming in a lot later and a lot sicker now. Maybe 10 years ago people were in facilities for 10 years, now it's something like 10 months.''

Today, four residents soak up morning sun by the windows and are patiently spoon-fed their pureed lunches by a PCW or personal care worker. Each has about six residents to look after per shift, getting them up, showering, toileting, dressing and, in cases like these, feeding them.

Across the room, Josefina Petkovic, 87, sits with her daughter, enjoying her weekly treat: chicken nuggets, chips and a single stubby of VB. ''Is good for you,'' insists Josefina later. But she's cut down her smoking to seven a day.

Dot Farrar, 79, has been here ''three years too long'' after a series of mini-strokes and finally fracturing a vertebra in a fall. For the past four months she has been cocooned in a tub chair and hates the thing. Her son David visits almost daily: ''I like to think I'm helping keep her sane.''

''But sometimes you wonder, don't you?'' says Dot.

David smiles, but he's another wrestling with guilt: ''The reality with society, and it's not a very nice thing, is that if you're an old person you're seen as a bit disposable, past your use-by date.''

A smiling little white dog called Nicky trots by, dragging Bob Slater's wife, Joan, 80, looking exhausted. As Bob's dementia worsened, he'd been getting up three or four times a night wanting to take Nicky for a walk. Then a month ago he had a stroke and ended here. ''When I see him here I think, how cruel,'' Joan says in tears. ''He's so unhappy. He can't understand why I can't take him home. I say, 'I can't because you're sick. He doesn't know yet that it's permanent, because I think, myself, it's not going to be - when I think, 'What have I done?'''

In his room, the day after his 90th birthday, Fred Saffery confesses to being a ''miserable old B''. He lost the use of his lower body through a spinal disorder and is tethered to an oxygen tube. His wife, Eileen, 91, drives to visit nearly every early morning before the traffic gets too bad - ''she's a remarkable woman,'' says Fred - but he rarely leaves his room.

''They don't know what day it is, most of them,'' he says, cocking his head towards the day room. ''I hope I don't catch it, so I don't go out there.''

The door bangs open. ''Gidday. I just thought I'd stick my head in,'' says 25-year-old enrolled nurse Eleanor Morris. ''I just came to tell you that I love you and give you a hug, that's all.'' When she first came here Fred reminded her of her grandfather. ''And we took a shine to each other.''

''Yeah,'' says Fred. ''She's been a great mate.''

THURSDAY, November 10, Queen of Peace Roman Catholic Church. More than 400 people have come to a Requiem Mass for Clara Camilleri, 89, who passed away, surrounded by family, at St George's the previous Friday. Granddaughter Simone Sultana bravely delivers the eulogy, but needs to get outside when it finishes. Rosanna Slavik goes to her, folds her into her arms and they stand together, softly weeping.

Rosanna came to St George's 17 years ago. She applied for a job when the building was still going up and started as a cleaner but two weeks later was given a trial run as a carer. After 12 months' work, lectures and after-hours study, she had her personal care assistant certificate.

''But it's not something you can be taught,'' she says. ''Most of all you've got to have a passion, empathy and respect for elderly people. I know this is pretty much their last stop and they deserve the respect. They have so much knowledge.

''I had an opportunity to get to know Clara on a very personal, emotional level - spiritual also, because she was a wonderful Christian woman. She asked me to pray with her sometimes and when I was on night shift I spent a lot of time just sitting by her bed and listening to her life's journey. That was my privilege.''

It takes 133 people, working across three shifts, to care for the 90 men and women here. There are 17 registered nurses, 22 enrolled nurses and 74 PCWs. Another 13 tend the kitchen, there are two in the laundry, four in the office and a clinical service manager. A third are casuals. They come from 30 nations and speak a babel of languages, from French, Spanish and Ethiopian to Tanzanian and Filipino dialects such as Tagalog and Cebuan.

Personal care workers are among this country's most lowly paid - on about $17 or $18 an hour - and there is a long-standing disparity between the wages of nurses in aged-care and those in the public health system. The work is dirty, relentless, emotionally confronting and, too often, disparaged and thankless. Yet for many here, incredibly fulfilling.

When Bosnian Ed Vladic arrived in Australia in 1995, he didn't have a word of English and his first job at St George's was kitchen hand. He moved into personal care, then nursing school and is now nursing team leader. ''If you're here because of the money, you're in the wrong profession,'' he says. ''You have to have a heart to be here.''

Seraphine Bakirame, 41, came to Australia from Tanzania 11 years ago with a degree in banking and finance and a master's in business administration. While completing a master's in computer science, he worked as a personal carer and decided to do a bachelor of nursing.

''It's the people,'' he explains. ''You're looking after the elderly and you - how do I say it? - come to almost feel their pain, come to know their life's journey, and you know you're doing something to change their lives. You learn their life stories and it really touches you. You go home and you're satisfied that you've made somebody's day.''

MILLIE Andrew giggles. It's Chat Group and Millie, 92, is telling Lee Arnold, the only other of ''the girls'' here today, about the time decades ago that she found a dead man in pyjamas under her bed at a B&B in Ireland: '' 'What are you worried about?' the landlady told me. 'He can't hurt you.' ''

Her lodgings here are much more amenable. Most agree that Millie has the prettiest room at St George's. It is colour-themed in purples and mauves, much like the unit in Altona she reluctantly left 2? years ago, with a floral bedspread, paintings and a cabinet of figurines and plates all in similar tones. It even somehow smells pleasantly purple, like snapdragons and lavender.

Millie arrived after a number of falls - ''no damage done, but it was on the cards''. Initially she was depressed at leaving so many of her lovely things, particularly from her garden.

Management sent her in the facility's bus to collect as many pots and plants as she wanted and she started digging, building a new garden in the courtyard across from her room. When they heard her talking about her garden gnomes, they sent the bus back a second time and now a dozen of the bright, quirky statues share the garden with Clara Camilleri's Madonna.

''It just makes my life,'' says Millie. ''I spend half my time out there, and I've got a nice room I can sit in for the rest. I'm very happy.''

Lee, 94, is much less so. She arrived in June, also after a bad fall and seven weeks in hospital. ''I don't think anybody would want to be in a place like this,'' she says later. ''They're kind, the staff here, you couldn't fault them ? But I don't like that we're locked in. I know the doors have to be locked because of the dementia patients, but I feel it's a jail and this is my cell.

''I might have been sitting reading my paper at home, but I didn't sit around all day. People would pop in and I'd go out. Here, I have breakfast, come back and sit here. I have lunch, come back and sit here, fall asleep reading something. I don't think I'm living. I think what years I've got left, I feel my time's been wasted. I've been given this time and I'm wasting it.

''As far as society is concerned it is God's waiting room and I don't like that.''

Millie understands but feels Lee will be happier when she gets to better know the place. Accentuate the positive, she advises. With Lorna Dorrington, 81, and Billie Anderson, 94, she is part of a tight, chatty trio who sit together for meals. Unlike most residents, the other two ''checked in'' here themselves.

There's nothing like home, concedes Millie, but she has stopped looking back. ''It's no good regretting what you've done. Once you've done it, well, you've done it. And I can honestly say I've done the right thing.''

THREE pages ripped from a small spiral notepad, 242 often misspelt words in scratchy, wobbling capital letters to tell a lifetime's story of love and loss.

At their usual table for two in high-care, Hugh Wilson, 68, helps his wife, Nancy, 83, with her lunch. This has been his routine, lunch and dinner every single day since she came to St George's at the end of 2009, supplementing her meals with fruit and soup he prepares and brings from home.

Today it is strawberries cut into small pieces and a bit of jam doughnut. Tonight he'll vitamise one of those canned Chunky soups and bring it in a small silver Thermos with some tinned pears for dessert.

He says he'd do breakfast, too, except the hormone injections for his prostate keep him awake nights with hot flushes and he's ''knackered'' in the mornings.

He was a crane driver with Mobil just down the road. She was from Port Melbourne but came across the bay to an RSL dance in Altona with his sister. She had a few years on him, but they were both Scots and, besides, she was beautiful.

''Ah, she was a good looker,'' he says in his still-thick burr. ''Good singer too. Very smart, lot smarter than me.''

They married, had a son and daughter, worked hard, moved up to Brisbane for a while, then back home again after the kids married. ''We looked like having a life,'' he says.

But at the turn of the century Nancy started changing, misremembering things, bumping off the walls at night, neglecting to drink during the day. She was diagnosed with Alzheimer's and when it worsened around 2002, Hugh took a job shutting down a refinery, 12 hours a day, seven days a week, until he could pay off their home, then retired to look after her.

But after six years her personality had altered, too. She was nagging him, accusing him of the strangest things and it was killing him - ''I was going a bit loopy ? I didn't notice I'd started to shout at people and at her'' - and he brought her, and in a sense himself, here.

''I didn't want to, but I had to,'' he says, beginning to weep. ''You wouldn't believe it, I thought I was a strong person.''

When it is suggested that theirs is a deep, enduring love story, he breaks down. But he goes home that night and block letters his thoughts onto those three pieces of notepaper, ending with the words ''I love my wife and I will never give up on her''.

He never does. Ten days later, Nancy suddenly falls ill with renal failure. She gently passes away early the next morning, Sunday, November 27.

Her darling Hughie gets the phone call at 3am, gets out of his lonely bed and makes one last visit to kiss her goodbye.

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