My grandmother died on Christmas Eve. I know that the death of a 90-year-old woman in her sleep is not a news story, however good and kind and loving she was -- but what happened to my grandmother in the 10 years leading up to her death should be a news story. It should be a national scandal. Except it is happening to hundreds of thousands of elderly people in Britain today, shunted into care homes that depress, drug and wither them. And as a direct result of David Cameron's policies, they are about to get even worse.
When she was 80, my grandmother was run over by a speeding drunk driver, and her life as a self-determining human being suddenly stopped. A woman who had always been frantic and frenetic -- raising three kids on her own in the Scottish tenements, working any job she could find -- had to stop and sit. It would have been hard for her, wherever she ended up, and however they treated her. She had been somebody who was always cleaning and clearing and running around, pausing only to watch Coronation Street and horrifically violent horror films. (Her favourites were Saw III and Sewage Baby.) But she ended up in a home that inflicted horrific physical pain on her -- and I had to move her through two other homes until I finally found one where I felt she was physically safe.
My grandmother did not believe in moaning about anything. So when I first visited her in that first home, and found her in a wheelchair staring into space, with a cold and foul pie in front of her, she said everything was fine. Although homes are supposed to lay on activities every day, I hardly ever saw any happening. There would be rows of people in metal chairs looking into the middle distance, and occasionally a surly member of staff would give them a balloon to pat to each other. Yet if you stopped and spoke to these people, they were lucid -- and agonisingly bored.
I knew something was badly wrong, but I was selfishly dashing around with my own worries -- until one day I visited my grandmother and she was refusing to get out of bed. She still had some mobility in her legs, so to make sure she didn't lose it, her medical notes said she should be made to walk to breakfast each day. She had been saying for months that it was far too painful, but the "carers" told her she wouldn't get any food if she didn't do it and it was "necessary". "I'm not walking," she said, crying. "It's agony." The staff were clucking and telling her she was "misbehaving", as if she was a toddler.
This was so out of character that I immediately knew something was wrong, and I insisted they call a doctor. They hummed and hahed and only agreed when I got angry. She was finally taken to hospital and X-rayed. The doctors found that her legs could no longer support her weight -- she was a big woman -- and had suffered severe stress fractures and breakages that must have been there for months. They had been forcing her to walk on broken legs.
I immediately assured her she would never have to go back there, and I have never seen anyone so relieved. So I found a home in London with good inspection reports. It was still bleak and boring, but there were activities in the day she really enjoyed. She was beginning to suffer from dementia -- occasionally, she would suddenly become paranoid for no reason, and think she was being secretly recorded or poisoned. The reaction of the staff startled me. Whenever she said this, they would burst out laughing, sometimes nervously, sometimes it seemed with genuine amusement. Sometimes they would rebuke her for being "stupid". Both reactions would, of course, antagonise my grandmother, only making her more paranoid. One day, in irritation, I asked one of the carers what training they were given in how to respond to dementia sufferers. "None," she said, bemused.
Then, one night, I went to visit my grandmother, and she was wheezing very heavily and having an asthma attack. A carer came in and thrust a glass of water into her hand. "They won't give me my inhaler," she said, panicking. "They just give me water." I asked the carer where the hell the inhalers were kept, and he looked at me blankly. I suddenly realized: he didn't speak enough English to know what an inhaler was. Like most of the staff, he had arrived in Britain only very recently. I didn't blame him -- he seemed incredibly concerned, and almost as panicked as my gran -- but the home managers who had put him in this position. I had to find the inhaler myself. What if I hadn't turned up?
It was only on the fourth home that I finally found somewhere decent. There were still lots of imperfections: there was nothing to do, and whenever any resident pushed the button to summon a staff member, a horrible high-pitched noise would echo through the whole home -- so about half the time my grandmother had to live with an awful piercing sound. But the staff were genuinely kind and talkative to her, and reacted to her increasing paranoia with reassurance.
This is not an unusual story. This is -- by and large -- how we are treating my grandparents' generation in their final days. At best, people in care homes are left in tedium, and at worst, they are placed in physical danger. Everybody in Britain knows who Baby P was, but who has heard of (say) Parkside House in Northampton, where five elderly people were found with great open wounds of rotting flesh because they hadn't been moved in weeks? They all died. Every month, a case like this is exposed, and passes silently in the night. Only last week, two care home workers from South Wales were convicted for tormenting dementia patients by flicking their ears until they were "red raw" and terrorizing them "for their own amusement". Yesterday they were given just a few hundred hours of community service.
It is about to get worse. The people who are supposed to inspect care homes -- the Care Quality Commission, or CQC -- are being massively cut back under David Cameron. Five years ago, there were 50,000 visits in a single year. This year, there will be a quarter of that. The Government is shifting to a model of "light touch regulation", where homes will largely assess themselves by filling in "paper reviews" -- essentially a series of forms.
We saw in the banking sector that people behave much worse when they know nobody is checking on them. In 2009, a heroic nurse called Phil Brown exposed that the home he was working in was neglecting and abusing its residents. He told the BBC's File on Four that the new inspections are "absolutely shameful, because it reduces the inspectorate to a toothless paper tiger, where nobody is physically going in". My grandmother's case shows that we need to increase inspections massively. Instead, they are being slashed. There will be many more Parkside Houses now.
As I was clearing through my grandmother's few possessions, I heard Bob Diamond, the head of Barclays, on the radio, bragging about how bankers should be "rewarded". The money for multimillion-pound bonuses at the state-owned Royal Bank of Scotland, and the bank bailouts more broadly, will come from cutting many services. These include the inspectors who check old people aren't being abused. So in 2011, to reward the people who crashed the world economy, we are punishing the people who saved the world from the Nazis. Didn't my grandmother -- and yours -- deserve a better ending to her story than this?
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I don't know how any of this can change, but if all of the baby boomers actually saw where we could be headed and we would make some king of change. Seniors deserve so much more.
Mr. Hari's article is a wake-up call which should be published everywhere because we baby boomers are heading toward a deeply horrible future. The conditions in the nursing home or retirement homes he describes are about to get worse for several reasons: we are entering our old age in unprecedented numbers, continued poor diet and lack of exercise is creating a sicker society, medical journals are predicting a huge shortage of qualified medical practitioners in the near future, there has been a growing isolation between family members in our society and, as the article clearly explains, government oversight costs money and is being eliminated thus creating a vacuum in which rampant abuse and crimes to our elderly can occur.
If you are over 50, here's your motivation to start eating more fruits and veggies and begin walking every day!
It wasn't luxury, but she had a lovely room with a view of the park that reminded me of my university dorm room--only more spacious, with maids and a private bath. There were caring people all around, social activities and diversions galore, outdoors and in town. Importantly, it was completely affordable. In the German system, you don't spend your children's inheritance in the last years of your life--the assumption is that you've supported the system long enough and now the system supports you. My grandmother-in-law stayed there until she died, in good hands.
My own grandmother lived in a similar home in Florida at four times the cost--until she couldn't afford it any more. We moved her to successively less opulent places, until she ended up in a multi-bed Medicare home. By then it didn't matter--she wasn't really that cognizant--but it was an interesting study in the different ways we treat our elders.
Re the "personal responsibility" meme, below, used to justify abandoning families in need, who often aren't able to adequately care for their elders for a myriad of reasons--just more of the conservative "Am I my brother's keeper?" callousness, "it's your problem" disguised, waved off, as "accountability."
They are designed to suck every last penny of your savings away, and little more.
It's unfortunate that the state has so much trouble going the extra mile for marginalized groups like the elderly. Frankly, I think they have to be embarrassed into doing the right thing, if possible. They're powerful, yes, but so are social commentators like yourself. Even if the money continues to flow somehow, I think it's also important for everyone to see that we develop a mindset that prioritizes our social contract with others. We can't always leave it to the government -- or to families, for that matter -- to assure the welfare of the elderly, the single moms, or schoolkids in legal trouble. True, you don't owe them anything, except for the fact that we're all connected in ways that aren't always obvious.
The shifting sands of economic, political and demographic realities will create the social pressures and the Camerons of the world, and sometimes to a more stark degree than we see now, if that's imaginable. We can afford to do better with our tax revenues, and with the hundreds of opportunities for community service. But we won't do it with the profit motive as a centerpiece. The needs of the disadvantaged aren't commodities.
I have seen and met some of the most dedicated and compassionate people doing one of the toughest jobs in the world. I realize there are horror stories out there and I'm sorry but that just hasn't been my experience. My mother had caretakers that told her they loved her and kissed her goodnight. My aunt was not as receptive to that kind of affection so it may be that you get what you give. They are both gone. I will also say that they were self pays, but they were roommates with Medicaid patients that weren't treated differently. My brother is in a nursing home now and has had issues with bed sores but I don't blame them - it's something they work on constantly. He loves his staff. He has a terrible situation but they make it as good as it could be. I hope we aren't the only family that has been blessed.
Nobody wants to be there but in my experience if you look around there are good places for your moved ones. Also, visit a lot and don't let them know when you're coming. Be part of their family and they will think of your loved one as part of theirs.
How can you be so judgmental of others while admitting that you could not do it yourself? Caring for an elder in one's own home is an incredibly demanding and stressful situation. If you have not been there and done that, you have no business making self-righteous pronouncements about what people should do to care for their elders.
My intention was to show that people expect nurses to take care of their loved one because they are not willing or able to do so, but then they want to point the finger at the caregivers when they aren't "good enough". It's easy to say people aren't doing a good job, but for you it was an IMPOSSIBLE job. This is not to say that people shouldn't try to find the absolute best place to put their loved one, but as the nursing shortage grows and healthcare is cut more and more, you will hear more and more horror stories.
My mother suffered incredibly under the nursing home she was in. Lemonade mix instead of milk or real juices. Food poisoning. No assistance in getting a support for her legs in her wheelchair. Employees asking for donations to feed the wild cats from her. Their was no fund for them. Nurses aides pulling up her roommate by the hair. Wrong drugs. Stolen medical support devices. Stolen clothing, handmade blankets, coin purses, you name it. Refusal to keep her from smoking, doctors orders, and when she smoked they gave her inhalation medication that was never ordered for her. So it opened up her alveoli and caused more damage since they let her smoke. They provided the cigarettes and lighters.
My gawd, I don't want to hang myself, or shoot myself and wouldn't know how to inject heroin (or where to even find it!). I vomit from things like vicodene so pills are not an option.
I hope you reply if you have a good plan, as I'm right there with you, not today, just someday.
Another person I know, the nurses didn't want to give her pills all day long, so they ground them all up and fed them to her at once every morning, and she'd spend the rest of the day throwing up. These places can kill you, even the expensive ones.