Elder abuse is still hidden

13/09/2007

We have all seen media coverage of elder abuse. But, says June Clarkson, there are other forms of abuse that go completely unheeded or hidden. This is not the kind of abuse that causes bruises or fear in the people being looked after, but it is abuse nevertheless.

Until 2005 I was a nurse in a very senior position, working in a large nursing home. It was considered to be the most advanced, if not the best, in the area.

Yet, sadly, it was guilty of forms of abuse, though its staff were well trained in identifying and dealing with abuse. How can this happen? Very easily! But nursing homes are not the only abusers – so are hospitals, which can be even worse, and the efforts of social work departments who, it seems to me, work along lines of fantasy and “do-gooding” with little realism.

I have worked in both the NHS and private health care establishments, and have witnessed, and argued over, what I am about to tell you. In this article I mention just a few examples of this abuse. If you have a relative in a nursing home or hospital, observe carefully and do not hesitate to shout loudly – often the only advocate will be you.

Most nursing homes cope well, but shortage of proper fees diminish what they can do. Instead of having sufficient staff to cater to all needs (the optimum), they must make do with the lowest level possible (the minimum). All Homes work to this minimum staffing level. This is because the government does not pay enough for residents to be kept in a proper manner. Inevitably, this leads to many shortcuts, which lead to abuse.

For example, in one Home, the owner knew he had a big problem with the electricity supply and the boilers. But, he refused to put them right. Instead he cobbled together circuits that were overloaded. So, the electricity supply often cut out. It was not unusual for staff to rush to a chip shop to buy fish and chips, or to just give them whatever was in the larder, cold.

On occasions the fire alarms went off because of electricity problems. In one period of about a year this happened several times each day and each night. Every time, residents were scared out of their wits and had to be calmed down. But, as the owner refused to put things right, I count that as abuse.

 

The lift was very old and broke down several times a week, so food could not be taken upstairs (another two floors), very ill patients could not be moved to an ambulance and funeral directors had to precariously carry the deceased down stairs.

The boilers worked when they felt like it, and most weekends saw carers boiling water with kettles and carrying bowls of hot water around the building. Or, residents were cleaned using cold water. None of these things were known to the Inspectors!

Because there is always minimal staffing, there are usually sufficient nurses, but only a few carers. They are stretched, running around throughout their shifts, and only have time for the most basic of care. For this reason, once residents are up from bed and put into chairs, that is where they stay. Most of them were constantly soiled or wet. Many times they were in this condition because carers did not have time to take them to the toilet - or stand them up to prevent pressure sores developing.

Most residents have too little fluid and are dehydrated to some degree. This in itself can cause several conditions and illnesses. And most do not eat as they should. There is a dietary regime that deals with all these problems, but I do not know of any Homes that use it.

 

The majority of residents are on too many medications. Many take medication that is either not appropriate, or pointless. Sleeping tablets are only efficient for a short period of time, yet they continue to be prescribed. And the more medications an older person takes, the more prone they will be to many more problems.

Those taking Digoxin rarely have their pulse taken (to see if it is under 60 or above). Therefore, it is not unusual for them to become toxic, which can be fatal. Other medications should not be taken because they cancel each other out, or do not mix, with nasty results. But few nurses bother to check.

Recreational activities are rare. Not because owners do not provide anything, but because what they provide is not appropriate… the emphasis is not on making lives more bearable, but on cheapness and keeping the Inspectors quiet.

Inevitably, in most Homes, residents sit forlornly around the edges of rooms, so they sleep a lot, don’t chat to each other, and are virtually alone. Research shows that most residents do not perceive anyone who is more than three feet away from them. That means each resident is, in effect, in total isolation, from getting up to going to bed… which is often their only relief.

Residents are usually brought out of bed far too early – many Homes start getting them up at 5 in the morning! This is all to suit the staff, not the residents.

But things are hardly better in hospitals. It might sound ludicrous, but it is true – when an old person enters hospital, he is only treated for whatever he went in for. Why is this significant? Well, if they only have a broken leg when they go in, they will usually come out with massive bed sores, MRSA (or worse) and dehydration or loss of weight. Families have told me many horror stories of this kind of neglect.

Overall, the elderly are not put into hospital until the last moment, if at all, so as to save on acute beds. Once in hospital, their care is often the lowest possible. Then, they are usually sent to a nursing home just in time to die. So, by the time they reach a Home they are already well on the way to demise. The key is money, and social services think it belongs to them!

Until more money is given, and a more caring attitude is fostered throughout society, it will continue and get worse. As it is, vast sums are squandered on dubious causes by the NHS and social services, but denied to the elderly.

As for Inspections – it is very easy to get around these! And that is why unannounced visits, carefully planned like a military campaign, must become a reality.

The author has adopted a pseudonym to protect his identity. If you would like to challenge or supplement this comment piece, write to

editorial@maturetimes.co.uk