Eleanor was a tall, sturdy-boned but sparely-covered lady, with dark-grey bobbed hair, who had lived in the residential hostel for a number of years. She was a gentle, easy-going, happy personality, and although she had a tendency to anxiety around the unfamiliar, was always game to try new things. When I found a sewing-machine at the back of a cupboard, Eleanor had been one of the first to sign up to do a little basic dressmaking, in spite of the mild cerebral palsy that affected her hands and speech. She learned to pin, cut and tack the patterns, and even, after repeated coaching and much reassurance, got enough confidence to attempt some straight seams under supervision, very slowly and cautiously. However, it took a very long time for new things to ‘stick’ with Eleanor. To help her move items from her short-term into her long-term memory so that she could do them unprompted was a near-Sisyphean task. Indeed, even once a task seemed mastered, she could lose her ability to perform it if she did not keep practising, so endless, patient repetition was the order of the day.
Eleanor regularly spent weekends visiting or entertaining the families of her brothers and sister and liked to bake on Friday mornings (often her favourite sponge sandwich cake with raspberry jam) as her contribution to these occasions. The sponge sandwich was one recipe that she could do start to finish unaided; on other popular items she needed support – for example with reminders of the movements needed for ‘rubbing-in’ of fat to flour, when making scones. Friday afternoons were for having her hair washed and set in preparation for these family gatherings. On Monday, she would tell us all about who had visited, or where she had gone, and took great pride in there never being a crumb left over from her baking.
With a firm base of routines, Eleanor led a full and happy life. I expect it was her apparent flexibility and competence that made her a candidate for being moved to more independent living, as the third person in June and Agnes’ flat. I won’t pretend that the staff at the Centre thought this would be a good thing for Eleanor – or for June and Agnes, come to that. We knew how much Eleanor relied on a scaffolding built from absolutely reliable routines and gentle, repeated prompting with non-routine things. We didn’t think it was fair to ask June and Agnes to supply this scaffolding for Eleanor, and we didn’t think it was fair to expect Eleanor to do well without it. So when we heard that an independent assessor would be coming to test Eleanor’s ability to look after herself, and to check that she had enough everyday knowledge to manage daily living, we were privately relieved. It seemed to us that anybody who asked even simple, relevant questions – How much money do you expect to put aside each week for food shopping? For gas and electric? What other things will you need to budget for? If something costs two pounds and you hand over a five pound note, how much change would you expect to get? How long do potatoes take to cook? What number would you telephone if someone in the flat were ill? Tell me about your medicines and how you know whether you’ve taken them properly? – would soon realise that Eleanor would need more support than she would get in the flat.
The assessor was coming to see Eleanor in the evening, at the hostel. The following day, Eleanor was very excited. She had been given the go-ahead to move. There was a moment of stunned silence. Then:
“Tell us about what happened?” said the manageress, breathlessly.
Eleanor said that the assessor had met her in the common-room of the hostel. He had asked her a number of questions about current affairs – what year it was, and who was the Prime Minister. He had talked to some of the hostel staff. And he had asked her to make a cup of instant coffee and some cheese-on-toast. She had succeeded, and that meant she was capable of living independently and managing all her affairs for herself.