The report published today by the Equality and Human Rights Commission, which has found that at least a quarter of a million elderly people receive poor or very poor standards of care within their own home, is distressing to read.
In my surgery I occasionally hear stories of neglect brought to me by relatives or a neighbour often, sadly, after a person has died. The last case involved an elderly lady who refused to move from the house in which she had lived for sixty years to be nearer to her daughter and family and chose to receive home care visits twice a day.
Her daughter noticed after each visit that slowly things went missing. Her mother’s money appeared to be being spent faster than usual. Items of food left in the cupboard quickly went and suspicion was finally raised when a tin of biscuits had completely disappeared. It was the disappearance of the tin which clinched it.
If only theft were the sum total of the problem, however, the situation is far more serious.
Whenever a report is produced looking into the standards of health and social care delivered to people within their own homes the inevitable conclusion is always that there is a gap between demand and resources available. Local Authorities never seem to be able to procure the correct level of service provision to meet the needs of the elderly within their own community. Local Authorities will complain that they are never provided with enough money by government in order to meet local demand. It’s always the same old chestnut, always the same tired excuses. The political colour of the local authority or government of the day matters not, it’s always the same.
As the chart above demonstrates, those people making the excuses may well be on the receiving end of the care which they themselves are procuring today as we are all going to live a lot longer. They have a vested interest in cracking this cycle of neglect and getting care delivery to the elderly right.
You could be forgiven for thinking that helping someone to get out of bed, preparing a meal, bathing and toileting was brain surgery, it isn’t, it involves three vital components: time, compassion and training.
A Local Authority has a responsibility to ensure that it procures enough time in terms of hours from the service deliverer which in turn has a responsibility to ensure that they employ people with the right level of skills and training to deliver the care required.
Today’s report from Baroness Greengross highlights how some people feel abused and neglected. How some are left in tears and left feeling like they want to die.
The problem isn’t just about carers not having the time to deliver the care needed, it is also as much about the attitude of carers towards the patient when delivering care.
Training is vital and should involve helping carers to understand the importance of dignity and respect. After all, many of the elderly being cared for today have played their part in shaping the society we live in. They may have fought in a war, given their life to a service or a profession. They may have been dedicated teachers, nurses, fire-fighters, police officers or have simply worked hard and at one time been wonderful parents or carers themselves. If two carers enter a home, social conversation between the two should be an absolute taboo, as should the use of mobile phones. All thought, time and conversation should be focused on the elderly patient. Kind words and compassion should be standard. The only other human being many of the elderly will see all day will be their carer. It is the only conversation they will have and the only opportunity available to speak to another human being.
Whilst carers are bathing or dressing a patient, the only person they should be talking to is the patient. Feeling ‘cared for’ would go a long way towards helping those in need of care feel valued and appreciated.
To those in Government and local Authorities who speak the mantra of patient choice and control and believe that delivering platitude sound bites in a similar vein will end the problem, it won’t.
The problem is not difficult to resolve. Local Authorities need to procure the correct amount of time to meet demand. Care providers need to employ people with a disposition towards care and compassion and who are prepared to learn and develop caring skills. Appropriate standards of behaviour whilst caring need to be developed and enforced and we need a strong and robust method of inspection with the ability to fine authorities who fall short in standards of delivery. Governments need to pay up and accept that as a society we have a responsibility towards our elderly which should be a priority. And finally, patients should have choice and control over who enters their homes, if they are strong and able enough to do so. A patient with dementia has very little control over anything as the illness progresses.
Maybe if governments and local authorities accept this responsibility, the attitude within society towards the elderly may one day begin to change as a result.