Adult Social Care for the 21st Century

Argentine sailor Juan Manuel Ballestero appeared in a recent Serendipity blog. Why?  Because he had sailed halfway round the world from Argentina to the UK to visit his elderly father. He is not alone others have gone to extreme levels in order to be reunited with families during this epidemic.  When flights were cancelled to Greece student Kleon Papadimitriou rode his bicycle  on a 48-day trip to Athens to get home. Garry Crothers was determined not to miss his youngest daughter’s wedding, so when flights were grounded, he decided to make the 6,500km journey home by sailing solo across the Atlantic. I get this.  When crisis hits one wants to be with one’s loved ones.

While I never thought I would hear myself say this in some ways I am pleased that my parents are no longer alive. It takes some of the concern from my life. Right now, it is just me I have to keep safe.  And sadly, it is my age which apparently puts me at the highest risk.  I am now considered elderly.  I have never ever thought of myself as elderly and it’s not a nice feeling.  I remember sitting in the doctor’s surgery when I was just 50 and the doctor telephoned another consultant to make an appointment for me. She said, “I have this fifty-year-old lady with me….” and I looked around – where was she?  Who is she talking about?  Before realising that it was me!

In the UK there are around 15.5 million people aged 60 or over, making up 23% of the UK population. The number of “older” old people is also rising – there are now 3.2 million people aged 80 or over, and almost 600,000 of these are aged 90 or over.

And I am one of these.   With care homes much in the news right now I am reminded of just how much I do not want to end up in one. So much so that in the Will which has finally be signed – yes just yesterday — there is a codicil that says that if my children put me in a Home then my entire  estate will go to dog and cats’ homes.  I guess this comes from the experience I had with my mother and my aunt and a few other relatives.

When Mum moved  from Leicester to London because she had early dementia, she was determined she wanted to go into a Home. She lasted 8 days before I yanked her out, found a lovely 2 bedroom flat near me, and installed a Philippian carer.

This is by no means a criticism of carers who are paid badly and do fantastic work. COVID has shown just how amazing are these carers but what it has also shown is what low priority are the care homes in the pecking order.   Current residents have worked all their lives, fought in one and sometimes two world wars, paid their taxes, their national insurance but are then considered not worthy of enough funding to keep them safe and in some cases alive.

old age

We all know that finance is key but along with this is a different way of thinking about adult social care. We need a new model for the 21st century.  Within days of my mother entering the Home she started to become institutionalised.  One minute she was living on her own, making her own food, cleaning her flat, choosing her clothes, bathing etc and the next she apparently needed a helper to guide her to the dining room.

One day 2 when they had finally chucked me out of the Home saying this wasn’t helping my mother having me sleeping on her floor!  I returned next day  to see my mum walking slowly like an old woman with a nurse holding her hand. “Why are you holding my mother’s hand,” I asked.  “Because she might get lost finding the dining room.”  “Well she could ask directions,” I said. “She has a tongue in her head and her speech is working just fine.” Maybe unfair, the carer was most likely just following protocol. And I guess in some ways it is easier to control situations this way.

I was definitely their worst visitor. Actually, I am usually everybody’s worst visitor. When mum was in hospital after a stroke unable to move, the nurses used to hide when I arrived.  Word got round quickly “Mrs Felstein’s daughter is here.” And they would scurry away hoping not to have deal with any of my demands.  Not   unreasonable demands. Just please can my mother be fed her food while it is still hot.  And would be better for my mother’s health if she could get a commode rather than wet herself because it has taken too long for someone to  check her, or yes she is a bit dehydrated because no-one has bothered to  give her any water. Eventually I paid someone to sit by her bed until I could get there after work.  Over protective me? No just a lioness looking after her pride .   My friends say should they get sick they want to be in my family.

So following  mum to the dining room we met a fellow resident.  “So how is it here,” I asked. “Don’t judge a book by its cover,” he said  and carried on eating. What did he mean? I soon found out.  Outwardly the home was beautiful with fresh flowers, clean and most important no smell of urine. But inside the book the pages were empty.   One would think that for £1000 a week – which is what it cost back then, one could do a bit better.

Admittedly this was 15 years ago, and I know there have been changes. But we do need to have a radical rethink about caring for the older adults in the 21st century.  We need to look at Denmark, Sweden and Holland for guidance. And some  Care Homes are now trying to model themselves on the Dutch Dementia Village.  Inspirational and apparently no more expensive than a regular Care Home.

dutch dementia

 https://www.dementiavillage.com

One UK Care Facility is Castle Brook. It runs a similar programme to the Dutch facility.    No plonking residents in front of the incessant drone  of the tv which they can’t understand anyway. Never understood why they did this. Playing music has been proven to have a far more positive effect on dementia.  I suppose it is a bit like putting children in front of the tv to give mums some breathing space.  The Castlebrook  Home  is designed around six households of 14 people. They have their own kitchen and the concept like in Holland is ensure that the Home is really a Home with a semblance of normality offering shopping, cooking, general housework etc all geared to the residents wants, needs and how they feel and where possible leaving them with a feeling of independence. There is a sense of freedom rather incarceration.    And this is key. Bad enough that you are leaving your home but then also losing your independence must be so very demoralising. I know Tod hated it  when he deteriorated and had to rely on me and lost his independence.

I had  no intention when I started today’s blog  to go on this journey into Adult Social Care.  Anyway  I am going to be going out with a bang. Its Jenny Joseph’s Warning – The Lady In Purple  all the way for me.

lady in purple

“Let’s be careful out there”

Author: ladyserendipidy

Journalist, event planner, mother, animal lover, not very good bridge or scrabble player, hopeless housekeeper, ex social worker, radio producer, tv executive, hater of almost all insects especially the eight legged ones. And if I am ever allowed out of my house, intrepid traveler.

3 thoughts on “Adult Social Care for the 21st Century”

  1. absolutely love this one. coming to your house when I get ill. although bet my mum would be a good option too. let’s hope I dont get ill. Love you

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  2. There’s lots of talk in Ireland too about the need to re-assess the current nursing home care model, the current one having been exposed as sadly lacking during the pandemic. My mother had always insisted she did not want to live with any of us, that we had our own lives to live etc. And so she moved to an independent but slightly sheltered living situation, then got a stroke and ended up in the attached nursing home, which she had grown to dislike. She was so disabled that, even had we wanted to, none of us could cope with her needs. She lasted for 5 miserable years. I would take the same view that I would not want to burden either of my children with looking after me, especially if I developed dementia or any serious physical disability. Your solution for your own mother – a full-time carer – is financially prohibitive for most people. It seems to me that a mixture of the Castle Brook model – supported by the state – and an alternative state-supported home care system is what’s needed. Here we have a thing called the Fair Deal, which allows homeowners to use their houses as collateral to pay for their nursing home care. The state pays the nursing home, and gets that amount back when you die and your house is sold. However, the system does not allow you to do the same thing to pay for home care, which, I think is a far better option. Most of us would prefer to stay in our familiar surroundings, I think.

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