‘My wife always swore she would never let her mother go into a care home. You hear such terrible stories about those places,’ my cab driver informed me while driving me home the other day.
Care homes did not have a great reputation before but the battering that they received during the pandemic more or less finished them off. Old people were incarcerated, isolated from their families and cared for by the least trained members of the health and care workforce, generally armed only with a bottle of bleach, a flimsy mask and a kind heart.
On the opening day of the sixth part of the UK COVID-19 Inquiry the barrister for the campaign group, COVID-19 Bereaved Families for Justice UK, asserted that there was ‘generational slaughter within care homes’. Over 46,000 people died in them in the early months. Speaking from experience, despite the plethora of contradictory guidance, or perhaps because of it, care home operators resorted to making up their own policy to deal with the invisible and deadly enemy.
My proudest moment was our policy of allowing visits to our homes to continue. Even so, I wrote personally to the relatives of the 142 residents who died from any cause during that first wave. I offered them the opportunity to ask questions about what happened. A few people replied. Some were sceptical about whether COVID-19 was the real cause of death, citing the somewhat cavalier attitude of GPs during the pre-testing period. They were adding ‘suspected COVID-19’ to every death certificate. All of them said that they were relieved that their relative had died. They were suffering with dementia and for them, death came as a blessed relief.
It did not take long for the GPs to stop coming to our care homes at all. One late Friday night the home manager had to call the emergency services to verify a death because the GP refused to attend. After that we trained our social care nurses to provide the verification.
The media revels in bad news. No amount of ‘Care Home Open Week’ or cheery Facebook pictures, campaigns and positive stories will make much of an impact on society’s negative attitude to care homes.
Let’s face it, no one likes the idea of finishing up in an institution. But we are not very good at facing up to death either. The period of ill health in later life, followed by the inevitable, seems to take us by surprise. Planning for your old age? No fear! Why can’t we get to grips with end of life? Is it terror or guilt or are we just a little bit selfish when it comes to looking after our old folk?
Back to the cab driver. Helped by his wife’s determination to support her, his mother-in-law ended her days in the house next door. Social services had been ‘very good’ and provided by way of equipment and care at home. She lived with dementia and died aged 102. Not a bad innings as they say. Their resolve to keep their mother living in her home is one that some families will want to emulate and others not.
Care homes are not all bad. The majority are well run and comfortable. They deal with all manner of clinical needs. They care about nutritious food and social activities. They step up when individuals are at end of life and they look after them, often as if they were a member of their family. I am not planning on ending up in one, but if I do, I am confident that I will find a good one.
Sara Livadeas is a social care expert and Founder of Social Care Works. Email: [email protected] X: @saralivadeas