There has been quite a bit on the news recently, about the plight of the home care industry – both employers, who are finding it difficult to operate on the fees paid by local authorities and the hard working and very underpaid professional carers themselves.
As a country, we are living longer and in towns such as Rye – attractive as it, and a lot of the South Coast, is as a retirement area – the average age of those over 65 is probably quite a bit higher than in some other parts of the country. We need, therefore, to think of the time when we may, perhaps, need some help in our daily lives, that cannot necessarily be provided by family or friends.
I have had some experience of this: a few years ago it became apparent that my mother – in her nineties and until then an intelligent and highly active person (still driving and daily dog walking until 92) was beginning to show the first signs of dementia and, as an only child, with no other family available, it became my job to look after her. I then discovered how difficult being a carer can be. The personality of someone you have known all your life can change, moods can fluctuate for no particular reason, short term memory goes and one has to sit and listen to the same thing many times over without showing impatience and boredom. As dementia increases its hold their ability to move and control their movements is affected until they eventually become totally infirm and need everything done for them.
In addition, one has to learn to sleep with one eye and ear open, waiting for the sounds that would indicate that someone has fallen out of bed, or got up without turning lights on and then got lost and unable to find their way back into bed. In my mother’s case, as the dementia became worse, so she became, without realising it, more and more demanding and her care became more and more time consuming.
Eventually, her doctor decided that, if she was to remain in her own house, professional carers were required and would be provided through the local council and the NHS. We were allocated two visits a day of 30 minutes each. The first would be at 7am and they would get her up, washed and dressed (I would often go for a run, get back as the carers left and then give her breakfast). The second visit was at 1pm. As time went by she reached a stage where she couldn’t be left alone and so I had exactly 30 minutes to do any shopping, banking or other errands that had to be done away from the house.
And this was the problem: the carers were on an impossibly tight schedule. They might be booked for 1- 1:30pm, but their next booking, which could be – and frequently was – several miles away would start at 1:30pm, so they were given no time to travel between the two. Inevitably, therefore, they either had to arrive several minutes late or leave several minutes early. This, in turn, meant that they were rushed while doing their job and that meant that sometimes things were missed or that the patient didn’t get the very particular attention or type of care that their individual circumstances required.
This is not to blame the carers. The vast majority of those that we had were kind, patient, skillful and incredibly caring, but they simply did not have the time to do their job to the standard that I know most of them would have wished, and because we – like most people in these circumstance – were being funded by a public body, we were going to get only the bare minimum amount of time that they could get away with.
So why not hire the carers privately? Well from time to time, when I needed a break, I did. But an evening out – say, 4 hours would have been £60 and the occasional weekend away (night cover, therefore, also being required) was over £600, so not something that was going to happen too often. (These are costs as at 2013, so undoubtedly more today).
Our system of care for our elderly and infirm needs to be re-thought. More and more of us are going to need it as we start to live longer. And it is not just the patients but also those, usually close family members, on whom the bulk of the work and responsibility of caring falls, that have to be considered. As I have tried to explain above, caring is both physically and emotionally exhausting. It is a 24 hours a day and 7 days a week job and the inability of many families to be able to cope with this (for how can you provide this sort of care for a parent, say, if you already have a full time job?) is undoubtedly the cause of some (but, I accept, not all) of the current bed blocking problem in so many hospitals, when patients cannot be discharged because they need care at home and there is no one to provide it.
So what is the answer? Frankly, I don’t know but it is a problem that needs to be addressed or the care system in general, but particularly for the elderly, will break down completely.