“I know you like doing that sort of thing”, my crewmate said, “but I can do it this time seeing as you are getting old and fat”.

—–

It was 3am in the morning (as it always seems to be) and we were being sent out of our area, although quite close to where I live, to go and see an elderly woman who had called for an ambulance and seemed a bit confused.

Knocking on the front door I could see a hunched shape moving around in the hallway. It came to the door, fiddled around a bit and then wandered away.

It's more normal that when people call for an ambulance they open the front door for us.*

I tried knocking again – this time the living room window opened and I was suddenly face to face with a little old lady.

“I can't let you in, the door is locked and I can't find a key”, she waved her arm at me – even in the dark I could see that it looked like she was sporting a broken wrist. “I know what”, she said, “I'll try the back door”.

My crewmate and I walked around to the back door where the same event played out. This time she opened the kitchen window.

“Oh dear, this one is locked as well”, she said, “Maybe the front door is unlocked”.

I explained that she had already tried the front door.

I eyed the kitchen window. It opened pretty wide, I was certain I could climb through it.

“Can you climb in through the window?”, asked our patient. Behind me I could hear my crewmate groan. She knows I love climbing over, through and into things.

“I know you like doing that sort of thing”, my crewmate said, “but I can do it this time seeing as you are getting old and fat”.

Well, that was a red flag to a bull. I had to climb through the window now.

My plan was simple – the patient was obviously mildly confused, I'd nip through the window, find the keys and open the front door to let my crewmate in.

Climbing through the window was fairly easy, and if my crewmate leaves a comment saying that I barely squeezed through and was panting and red faced by the end of it then I would trust you all to ignore her.

Once I was in the kitchen I could give our patient a look over – my suspicions were right in that it looked like she had broken her wrist while climbing out of bed, although my patient couldn't remember falling, her obvious dementia meant that she couldn't remember much.

But she was a nice old stick and we had a nice chat while I searched the house for the front door keys.

I looked everywhere, from where you would expect to find keys to the more inventive places that someone with dementia can hide something (ovens, fridges, teapots) – but no keys were found.

My crewmate had gone to sit in the cab, there was nothing she could do standing around in the cold.

I'd noticed, because I'm funny like that, that there was a 'keysafe' on the outside of the house – this is a little combination lock box that holds a spare set of keys, it's normally used when a person has carers but isn't always able to open the door for them.

“Do you know the code to the keysafe”, I asked hopefully, “the little box outside that holds the keys for your carers?”

“I have a keysafe?”, she answered, “Sorry love, I've no idea”.

I looked in the care notes for an out of hours phone number – surely they would know.

But, of course, the sun had gone down and the 'out of hours' phone number just went through to the normal office phone.

“Our hours are between nine am and five pm…. please leave a message”. Considering my shift ended at 7am I didn't fancy waiting that long to get an answer.

So I called up Control on my radio and asked them to try and get in contact with the care suppliers – maybe they could find a different number and ask what the code to the keysafe was.

—–

A little while later Control got back to me – the care provider didn't have the slightest clue about the lady.

So I set about a bit of detective work and found the phone number for our patient's daughter. I didn't really want to ring them (it was about 3:45 by now), but she was my last hope if I didn't want to be stuck in the house all night. While the company was lovely, her wrist really needed looking at by a doctor.

The first ring went to an answerphone, but I know how difficult it is to find your phone when you've been woken from your sleep, so I hung up and dialled again.

This time success!

—–

Now, one thing I learnt when I was a nurse and was ringing relatives all the time, is that you need to keep them calm and relaxed, otherwise they can think the worst.

“Hello there, this is the London Ambulance Service, I'm with your mother and she's absolutely fine, just a bit of a fall….”

All absolutely true – and it's best to get the 'absolutely fine' bit out of the way before their imagination jumps in with “…and she's dead as a dodo”.

I apologised for ringing at that time of the morning and I told her my situation. I was very thankful that she didn't laugh down the phone at me.

Happily the daughter knew the combination to the keysafe, and wasn't bothered by me waking her up at the crack of sparrowfart.

So my crewmate was able to open the box, retrieve the key and then fail horribly at trying to open the front door.

One of the keys fit, but it just didn't turn in the lock…

Thankfully one of the keys fit the back door and we could soon get our patient off to hospital where she was well looked after.

—–

I'm glad that we managed to get the door open, because otherwise it would have needed the police to arrive and rescue me by kicking down the door. Something I could do without…

Sadly, although not unusually, I was let down by the lack of coordination and information from the care team. It really does seem that once the sun goes down and the firefighters all go to bed** it really is just us and the police out there to keep people safe.

But of course, all that will soon change – what with Labour's plans. Why, I fully expect every carer to be bright, determined and committed. Not underpaid, undereducated and uncaring – that would never happen, and certainly never be the norm. I'll tell you what Gordon, Andy, and whoever the Conservatives will have as health secretary – let me come and explain why ambulances count as social care, it was something that your predecessor was surprised to hear from me.

Never mind, I'm sure that the numbers will show that there is more social care – but I bet they won't show the increased ambulance usage because the social care is so slipshod.

What is really sad is that I sometimes see superb social and residential care – it's just that it is increasingly rare.

—–

*However, I could not count the number of times someone has called for an ambulance, we've turned up four minutes later and on knocking at the door the occupants have asked who it is…

**I do of course jest – they don't go to sleep. They watch porn instead***.

***I love 'em really – mostly because a lot of them look like they box for a hobby and could take me in a fair fight.****

****Especially the women.