Can Sir Gerry fix it? Not while no one is listening
17/12/2009
Having watched both programmes on Sir Gerry Robinson's attempts to improve dementia care, nothing I saw there surprised me. In fact, there are even worse matters hidden away some of which will never be brought out into the glare of publicity.
The first point that caught my eye was 'dementia care homes'. There is no such thing; care homes everywhere have some dementia patients and all of them could benefit from some of the good things we were shown at that Warwickshire home, Merevale House, Atherstone. Nowhere have I seen such amazing and wonderful driven enthusiasm for providing such all enveloping care and enjoyment. What a superb example for managers, owners and staff in every other home.
Some of the homes I have visited and spent time in have shown a part of that care, commitment and result but in every case I have been aware of two restrictions:
1. Insufficient availability of suitable staff and the extra pressure that staff turnover creates.
2. The continual pressure from local authorities to 'force' homes to take residents at a fee that simply does not meet the total cost per resident. This has a corrosive impact in that it leads to the costs to other residents being higher than they could otherwise be; this means in practice that some residents are effectively subsidising others and that overall the effectiveness of the home is endangered as they endeavour to cut overheads for the wrong reasons.
In answer to the main question it is quite clear that Sir Gerry cannot fix these care homes. The attempt to make just one home adapt to the best practice of Merevale House clearly demonstrated the extremely wide gap in thought and the rut that so much of care home management is well and truly stuck in. There is the additional problem of home ownership.
Unfortunately most care homes are now owned by companies, some of them very large companies. For every company the objective of ownership is profit. There is nothing wrong with the concept of profit; profit only becomes wrong when it is the driving force behind ownership. That should be obvious to all, yet many directors have been shown to make all their decisions either on the cost to the bottom line or on diverting resources from other areas, all in the effort to maintain a certain return on capital. Yet some of the homes in private ownership have shown that profit comes as a direct result of good management and a determination to provide a good standard of care.
I am particularly concerned that so many care homes are owned by companies; I have found, generally, a much better approach to every standard where the owner(s) are directly involved in the day-to-day management. Perhaps no-one should be surprised at this for care is a very personal need - a human need not a service. Where the rest of the world is moving closer to a mechanised and robotised existence the need to retain a simple human approach to personal care should be seen as not just essential but also important for our future sanity.
In the programme we learnt that one home was closed under a very nasty police investigation. We saw the residents being moved out and split up around other homes despite the recognised facts that the very action of moving them out will shorten some of the lives involved. This alone is a travesty; we need a legal way of providing new management to secure the continuation of any home so forced to close. Once closed such homes are lost forever and in the particular home shown we were told and could see the results of a very substantial capital investment in the recent past. What a waste of money! What a way to treat all those residents! What a shambles!
Peter Bray
The BBC programme was as brilliantly revelationary as it was daunting. It pinpointed the need for education is essential and urgent.
Too often, dementia is the butt of cartoonists and sketch writers who fail to see the very real sickness of the sufferer and pain of those who are witnessing the disappearance of the loved one.
Until all look on dementia with the same awe, horror and fear engendered by cancer, we will never overcome the curse that is the diagnosis of Alzheimer's Disease.
A year ago I lost a very old and dear friend to this insidiously creeping disease that robbed a family of a wonderful wife, mother and grandmother. A brilliant needlewoman and cook who was reduced to a confused shadow that disappeared into a shuffling stranger.
As a participant in a befriending scheme, I have seen the devastating effect, the diagnosis of the early stages of Alzheimer's Disease has had on the already chronically ill invalid I visit. Apart from her carers and family, she is afraid to tell neighbours or friends in case they stop visiting her because they may be afraid they'll 'catch' the disease!
This is just one example of the ignorance surrounding this accursed illness.
We desperately need to educate the public as much about Alzheimer's as
we have done about sexually transmitted diseases such as AIDS,
infectious diseases such as Tuberculosis, and other developmental
diseases such as Cancer.
M. Jenner, Carmarthenshire Older People's Partnership (COPP)