It was movie star Bette Davis who famously observed: “Old age ain’t no place for sissies”. But in the wake of a report published this week, her phrase has taken on an altogether darker resonance.
The Leonard Cheshire Foundation, a charity dedicated to promoting the concerns of the elderly and infirm in the UK, has been investigating the standard of care offered by the state to elderly people still managing in their own homes. And the findings make for grim reading.
Those who elect to stay put rather than move to a nursing home are supposed to be visited daily by an official care worker, whose brief is to check on the occupant’s welfare, ensure they’re fed and watered, and dispense any necessary medication. But the report throws a dismaying light on the reality of this option: for it turns out many such carers are being allocated only 15 minutes to attend each client before leaving for their next appointment.
Fifteen minutes is 900 seconds, hardly enough time to say hello and check that the client is still breathing. No surprise, then, that the dilemma of how best to use their time reads like a black farce.
One woman, 83 year-old Sally Lubanov, who is alone and housebound, and who relies on these so-called short call visits, gave a damning assessment when interviewed by the BBC in the wake of the report.
Even if the care worker arrives on time (so Miss Lubanov said), both carer and client are faced with ugly choices as to how use their precious slot. By the time the carer has let herself in, phoned the office to confirm her arrival, and put on an apron and rubber gloves to commence her duties, much of the allocation has already gone.
So how best to use the remaining time? Should the carer dispense vital drugs, help to bathe the occupant, or change her clothes? Preparing a freshly cooked meal is out of the question. “It would be wonderful to have my bed changed or my legs and feet done”, Miss Lubanov concluded wistfully. No chance of that with this schedule.
And lest we think it’s only the poor neglected resident who suffers, the beleaguered carers have also spoken of their own predicament, as they try to fulfil an impossible schedule. Little wonder that many in the industry suffer from stress, depression, and an overwhelming feeling of failure.
This regime of 15-minute slots was damningly summarised up by the Cheshire Foundation when it concluded that it often “forces disabled people to choose between whether to go thirsty or go to the toilet”. And with a constantly changing roster of staff, there’s no chance for companionship, comfort, or any break from the loneliness and isolation that is many people’s lot. Instead, the elderly have become units of production, to be serviced, made comfortable and ticked off in the folder.
It also illustrates the extent of social fragmentation in modern Britain. Where once families stayed emotionally and geographically close, nowadays the elderly too often find themselves marooned and alone, far from friends and relations, not knowing their neighbours, and unwilling (or unable) to brave the outside world.
And while it is admittedly a trend throughout much of the western world, in Britain this sense of dislocation seems particularly acute. “An epidemic of loneliness”, was how one commentator described it. Indeed, a friend of mine who grew up in Venezuela admitted to me recently that the attitude to the sick and elderly over here is culturally bewildering for him. “In my country”, he said, “we look after our parents at home in later life. That is what is expected”.
In fairness to the government, there may be a light on the horizon. Norman Lamb (minister of state for care and support), reacting to the report, described the current situation as “unacceptable and inappropriate”, and has indicated that an amendment to the current care bill will be introduced in Parliament that will require councils to focus on an individual’s well-being, rather than on the time it takes to provide it. But of course, this will mean hiring more staff, which in turn will cost money.
As for Miss Lubanov, she, at least, remains wonderfully defiant. “I will not let myself be brought down by my declining body”, was her war cry when asked how she coped with such meagre support. Her dignified attitude is likely to prove her greatest asset: for proper home-based nursing care, if it ever arrives on the statute books, is likely to take a great deal longer than 900 seconds.
Michael Simkins is an actor and writer based in London
On Twitter: @michael_simkins
