Tag Archives: domiciliary care

What is this thing called care?

It makes me angry to read the BBC report that Ken Maitland, who had dementia, was visited in his own home by 106 different care workers in one single year.  Jeannette Maitland started to write a list of the names of the assorted care workers so that she could get to know them.

I did exactly as Jeanette Maitland did when my own relative with dementia began to receive so-called support in her own home.  She lived alone then, so I hoped that if I got to know the names of the people visiting her, I’d be able to talk to her about them and encourage her to accept their support.  Before long, I was distressed to find that – within the space of just 2 weeks – she was visited by 14 different ‘names’.   She had been allocated just two daily visits from one carer at each visit.  I could only imagine how distressed she must have felt too.  I spoke to the local council but they weren’t interested.  The social worker did nothing to help.

When she moved into extra-care sheltered housing, the social worker assured me that the problem would be removed, because the Housing Group that owned and ran the housing also owned and ran the on-site domiciliary care agency providing the on-site support 24/7 to the residents, each in their own flat.

By this time, she was in need of 4 visits per day.  She was still paying for her housing and for the visits by the support workers.

The problem was not removed – it was made worse.

“I’m fed up with all these different people coming into my flat” she said to me.

She withdrew.  She started to refuse them access to her flat.   She started to retreat to the bathroom.  She just withdrew.

I spoke this time with the on-site manager of the extra-care sheltered housing.   She said there was nothing she would do because “we like our staff to gain experience”.

I objected to my relative suffering so that the staff could gain experience.

What I didn’t know then, though, was that all the staff from this so-called ‘on-site 24/7 domiciliary care agency’ owned and run by the Housing Group were all acquired from numerous and different agencies, on an ad hoc basis, with no training, no job security, nothing that could be called care.  They were just casual labour.

It was in 2006 and 2007 that my relative encountered the same problems that Ken and Jeannette Maitland experienced far more recently.  Plus ҫa change plus c’est la même chose.  Have we learned nothing about dementia care in the intervening years?  Have we learned nothing?

What kind of animal have we unleashed and allowed it to be called ‘care’?

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Filed under abuse, care, dementia, dementia care, domiciliary homecare

In the best interests of the parties

Over the last few days politicians of all colours of the rainbow have come out with the phrase ‘in the national interest’.  I am still not convinced that they are talking about anything other than their own interest, the longevity of their particular party and their personal role within that party.

Then I remembered a similar phrase from the world of care: ‘in the best interests’, enshrined now in the Mental Capacity Act.  Everyone involved in the care of a person without the mental capacity to make a particular decision on their own has a duty to demonstrate that each and every decision they make on behalf of that person is ‘in the best interests’ of the relative, friend, patient or resident in their care.  And yet, in my experience of those ‘best interests’ decisions, few decisions made by the professionals were in the best interests of my relative.

With apologies to all those good people working in the care industry (and I know there are many – just that we were not fortunate enough to meet any).   The GP failed to care enough.  The social worker’s favourite phrase, when asked to solve a problem or even just to answer a question from family, was “I’ll see what I can do” which usually resulted in the most amazing period of inactivity.   The local authority failed to do anything at all in the best interests of their tenant, leaving a vulnerable person to live for weeks without central heating, without hot water and even without access to the outside world when the lift broke down.  It’s a tall order to expect an 81-year-old to walk down from the 5th floor and then back up again, day after day.  The extra-care social housing operated in the best interests of the domiciliary care agency owning the premises and running the service.  The mental health team spent more time caring about their own best interests than the best interests of their patients, and made major decisions without even bothering to inform family or to call a best interests case conference.  The legal advice they took to enable them to wash away all traces of their dirty dealings is staggering.  Their assessment unit couldn’t assess the best interests of a pea, let alone a desperately sick person.

And then, the care home.  The dénouement.  The final disgrace in the name of care.  It’s hard for me to use the words care home now, but neglect home doesn’t sound right, so I’ll just call it a home run in the best interests of Care UK.

I may be suspicious  when I hear our almost-elected almost-representatives talk of decisions, deals and pacts all being considered and discussed ‘in the national interest’.  But I will be watching, with interest, to see how they manage to overcome their failure to understand the message sent by the electorate.  A loud and clear call was sent out for change, perhaps even for a coalition government based on cooperation.  In the best interests of the electorate.

Now is the time for all good men to come to the aid of the party.

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Filed under care, care homes, Care UK, dementia care, domiciliary homecare, growing older, neglect, responsibility, sheltered housing