Care of older people in comparison to other services:
My experience of care homes, and domiciliary services is probably very similar to many other people with elderly relatives. I’ve seen the best and the worst of care.
Experiencing the best is heartwarming and gives you faith in human nature, experiencing poor care makes me very sad, especially because I am convinced that the way we treat older people would never be tolerated if they were children or people who are dying with a terminal illness. It’s if it were happening in a different world.
I’m not trying to single out individuals here or even specific homes or organisations. We all need to consider how we value older people; why we have different standards for different illnesses and why we seem to consider care of the elderly as something which does not require much skill.
I work with many staff groups across many organisations and I take my hat off to to those who work in elderly care settings. They do a job I could not do day in and day out, often in difficult circumstances where organisations overlap in the care and treatment of individuals, and vital information frequently gets lost in the gaping cracks between services.
I don’t believe my Dad’s story is unusual:
My Dad (who lived in the Midlands) became increasingly confused and immobile in August 2011 and eventually was admitted to hospital. Following this, in the last 6 months of his life, he was in hospital twice and in three nursing homes, two of which were really poor and one of which was good. Fortunately, the home he died in was a kind and welcoming place. But I still feel guilty about the other two, and especially as I am a health care professional. Why I didn’t see they were not the right place for him from the outset?
And why did I find it so hard for my concerns to be listened to? (This will be the subject of a future blog).
In the first home he entered a whistleblower alerted the Care Quality Commission [CQC] to a shortage of night staff and resident’s bells not being answered. So Dad’s complaints that they ‘tortured’ him at night and never came to him, which led us to remove him, were for a good reason. The second nursing home looked tidy and clean. In reality it was a dismal institution which was run like a factory and, despite having some lovely staff, was generally unwelcoming. The third and final home looked a bit rough around the edges but was friendly, caring and welcoming.
Interestingly the two homes where he suffered were rated as good by the Care Quality Commission, the home he ended up in, which the family were very happy with, was rated as poor both before and after his stay.
So what can be done to end this suffering?
The first version of this blog contained a number of recommendations. On reflection I don’t believe that the current system (if you can call it a ‘system’) can be made better, we need to look at the situation in a completely new way.
Ways to make the transition include:
Stop measuring the providers input and measure the outcomes and quality of life for those cared for. Regulators currently look at ‘surrogate markers’ rather than asking those who receive the care, and their relatives / carers.
Involve patients and the public directly in inspecting services and care homes.
Make sure that we identify all existing good practice and take a strengths based approach to change.
Author: Steve Turner
Date: 26/2/15. Updated 1/6/2016