When my mum was in hospital, my visit to one particular ward stayed with me. It wasn’t anything to do with how she was – which was not well – but the whole experience of the ward.

It was a short-stay ward filled solely with older people. It smelt in there, it smelt of urine and faeces from the old people using the commode by their bed, or in nappies – or in a mess. It also smelt of futility and of lost hope. Drugs kept some people asleep, while others simply stared, others still called out in distress or sang strange songs. The television blared out but no-one watched. You got the impression that the noise was there as a mask rather than an entertainment.

I was sad that my mum had to be in there. She wasn’t well physically but was fine mentally. She was a fairly private person who wouldn’t have enjoyed being on a ward anyway and certainly wouldn’t have wanted to endure those environs while in such a physically debilitated state herself. She’d have understood that these other people couldn’t help any of this of course – she was kind, thoughtful, a mother, grandmother and former nurse – but this wouldn’t have made her time there any more comfortable.

The nurse was efficient and not unkind. He still spoke to the patients with respect but not with engagement. There was, though, little engagement available to him. This must be one of the least rewarding areas of nursing. No feedback, little thanks, not much hope.

During visiting hours one day, the woman in the next bed was talking to her son. She seemed to be just chatting away normally but I began to notice that she occasionally disappeared down verbal rabbit holes and uttered things that had me wondering if I’d heard right. Clearly she was slowly losing her mind – or losing the mind that she once had, the mind that had defined her for so many years – but the strange thing was the way she veered seamlessly from normal chat to bizarre ramblings and back again, occasionally punctuating a flight of fancy with a withering insight. ‘If you had your chance again, would you do anything different?’ she asked her son out of the blue.

She asked for a hair brush and followed it up with, ‘The rats and mice are in my hair. The dog’s going to lick my hair dry.’ Then she followed this up with some nursery rhymes, one of which ended in a non-traditional fashion and used the word ‘bum’ quite a lot. If you were looking for a definition of tragi-comic, here it was in all its glory.

Rhyming was something she did a lot of, some real words, some nonsense ones. It was as if rhyming were some sort of primal linguistic retreat. Is this because it’s a natural sound we like to hear or one that speaks unconsciously of the reassuring comfort and certainty of childhood – or indeed of parenthood? The verbal dexterity behind the nonsense she spoke was remarkable. We’d be praising it in a child, I thought. I wonder if we could bring ourselves simply to enjoy it from an old person, if we were to ditch our expectations and just delight in the moment?

‘Where’s my cup of tea?’ punctuated the whole conversation this lady had with her son, along with cross complaints of ‘no-one’s listening to me’ to her son, who was calm, said he was listening. But you could see, he was tired. Tired of it all. He went early, telling her that visiting time was over despite everyone else still being there. ‘I’ll see you tomorrow Mam,’, ‘Will you?’, ‘Of course I will.’, ‘Are you going to give me a kissy-wissy?’, ‘Of course I am Mam, I’m not going without a kiss.’, ‘Oh, you’re a good boy. He doesn’t hit his wife you know.’, ‘See you tomorrow Mam.’, ‘Do you have to go?’,  ‘Yes.’,  ‘See you tomorrow son.’

She returned to her songs and calls for tea.

Scenes like this, I imagine, are enacted all the time all over the country, all over the world. Children sit with their parents, who still look like their parents but don’t act like it so much anymore. They behave in ways that would have been excruciating to them just a few years before. The child becomes the parent and vice versa.

A bit later, the lady tried to address me. I didn’t know what to do. I’d have been happy to exchange a few words with her, whether those words made any sense to either of us or not. But I knew that if I turned round once then I wouldn’t be left alone. And I’d come to see my Mum after all and she needed me with her. So I ignored this old lady who simply wanted the comfort of the company of another human being. It’s not much to ask. I hoped the nurses would come. One came, fleetingly, asked if she was ok, ignored the faecal stench coming from her, said she’d help her to sit up and then went away again. She hadn’t come back half an hour later, the stench remained, the lady had not sat up.

But what do we do with people like this? Old people with many medical problems and varying stages of dementia on top. They’re still human beings and deserve to be treated as such. But they are shadows of their former selves and all the rules of social engagement have changed. How do we honour their life but treat their current selves? What is the treatment hoping to achieve? Do the rules change if the person doesn’t even understand the rules anymore? Is this simply a test of our humanity and if it is, do we pass?

As I left, the old lady near the door looked at me and called the name of, presumably, her son or husband, called it plaintively then ‘please, please, please’ as I walked past and out of the door.

What could I do? What could we do?