Tuesday, 14 May 2013

Ring a bell for dignity

Lois writes: It’s frightening how quickly you can become accustomed to things that perhaps you shouldn’t get accustomed to. I guess its part of our survival; we adjust, familiarise ourselves, become desensitised and then begin to accept our circumstances.

Prior to moving into a Care Home my father-in-law had a series of agency carers looking after his physical care needs. The first time the implications of this really hit me was when we were visiting I witnessed his regular ‘put to bed’ time of 7pm at night - earlier than my 3 and 8 year old children. Of course I recognise that the over-stretched, under paid carers have to select someone to go to first - but it still felt so uncomfortable. This was a man who given the choice would stay up to 10pm before falling asleep in front of the tv or listening to music. Instead he lay rigid on his back all night till 8.00 or 9.00 in the morning worrying about accidentally knocking his catheter. So how is it that I became desensitised so quickly? Is it simply the powerless we feel in face of the enormity of caring for older infirm people?

I’ve been considering again this sense of frustration and powerlessness recently whilst working in a Care Home. On the surface this care home looks very smart, big open plan dining area, even cloth napkins on the table. The staff are friendly and helpful and interested in our activities there. But everything is dogged by constant noise. The big open planned dining hall - two floors of it, echoes with sound-and we aren’t there when the residents are eating…

We’re used to noise in our venues (and at home I have two noisy children) but some noises are really intrusive. Every staff member carries with them a pager, and they are constantly going off, echoing round the space high pitched ringing. The staff explain to us that they all get accustomed to the sound, they ignore it after a while, but as a visitor I feel the noise makes the home feel like a impersonal, posh hotel… not a home. The noise sets my nerve endings on edge, what effect does this have on an older person, one with a condition such as dementia?

“Of all the senses, hearing is the one that has the most significant impact on people with dementia in terms of quality of life. Noise that is acceptable to care staff may be distressing and disorientating for a person with dementia.”  Social Care Institute for Excellence. http://www.scie.org.uk/

What’s going on when we can so readily acclimatise ourselves to an un-healthy environment? When the policies take over the real caring?

Two thirds of older people living in care homes have a form of dementia, while only 60% of them are staying in accommodation specifically designed for their needs. This makes it harder for carers to provide good personal centred care, and provide activities. There are people researching into this area and suggesting simple changes that can improve our care environments, such as the wonderful ‘design for dementia’ http://www.hhc.rca.ac.uk/

Contrast this with another Care Home we are working in, it’s not so smart, and there’s plenty of loud sounds; banging doors, of daily choirs, but all this brings laughter or a raised eyebrow- this particular home feels like a home, just one with a very big family in. 

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