Helen Martin: Relatives just don’t get how care homes operate

Not everything in the care home industry is as black and white as it appears

Not everything in the care home industry is as black and white as it appears

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THE Care Quality Commission in England (which regulates care homes) has recently advised the industry not to “punish” relatives who complain about the care their loved one receives.

It follows several allegations that relatives who did had their visiting times limited or their resident asked to leave and find a new care home.

So far that doesn’t seem to be a similarly widespread concern in Scotland, though it’s not completely unheard of. And on the face of it, these “penalties” seem brutal.

But having been involved with and studied parts of the care home industry for several years, especially when my mother was in care, I know the issue is not as black and white as it appears.

Admission into a care home is often a rushed and traumatic process when family can no longer cope, but the lack of preparation for relatives in understanding how homes work and what to expect can lead to misunderstandings and misplaced anger.

The goal for every establishment, and the Scottish Inspectorate, is to provide a real home-from-home. Yet that has to be balanced with the need for rules, practices and documentation, and the impossibility of even high ratio staffing levels providing one-to-one care, every minute of every day and night.

Some homes work hard to deliver personalised and group activities and individual development (for which my late mother’s home recently won a national award), and create a happy, communal atmosphere. But it is a shared home, with shared routines – a different lifestyle with professional care, and for many a better one than being home alone with or without family support. Relatives aren’t always able to accept that.

Nor do they always understand how professionals respect and preserve residents’ choices and preferences.

One new and distraught relative, told me she was upset and felt her mum was being neglected because she wasn’t changed immediately after her “wee” accidents – as she had been at home. It transpired that changing her in the past always involved an angry struggle but the determined daughter accepted the fury, pinches and slaps and got on with it. Daughters can do that, of course. Carers in a home can’t as it would amount to assault and bullying – and over-ruling the resident’s choice – so it would sometimes take an hour or more before her mother could be persuaded to co-operate.

My own mother would pull out and throw away her hearing aids and mangle her spectacles when staff weren’t looking. I’ve heard other relatives complaining about similar “losses” as if the staff were responsible. Yet that was mum’s choice and the only way to prevent it would have been putting her in a straight-jacket.

Yes, I did have the occasional complaint, though I preferred to see it as tipping-off the manager that something wasn’t quite working as it should and on each occasion, I was met with an apology and an immediate solution.

The worst complainers were those who over-reacted, yelled at staff and grumbled spitefully to other relatives about how unhappy they were.

The problem is that no-one, including care homes, the Inspectorate or the industry as a whole is in a position to depart from official scripts and offer candid and realistic guides to new relatives. To understand, one must have walked in the moccasins.

Sally is going up a blind alley

DAME Sally Davies’ report into the health of 50 to 70-year-olds recommends people work into their late sixties and over to stay fit.

And if like her, they are a highly-paid chief medical officer, that might be true. For those whose jobs are physically tiring, boring or servile, it’s not an option.

In fact, it’s not an option for most of us if Bank of England Governor Mark Carney’s predictions are correct – that robots and technology are on track to wipe out around 50 per cent of jobs.

Hate to say “I told you so” but last month I raised the need for global discussion into how humans could survive a full-blown technological revolution that would make the historical agricultural and industrial versions look like minor blips.

Global warming will simply become an irrelevance if we can’t find a way to put the brakes on technology.

Should we admit defeat and give up on kids reading?

EVERYONE in my 1962 Primary 5 class could read fluently. During sewing class we all took it in turns to read classics aloud while the others stitched.

Now only one in 17 teenagers in Scotland is a “top” reader and one in five leaving primary is “functionally illiterate”.

Texting, social media, the internet, teaching methods, a lack of discipline, the avoidance of tests, the abandonment of books as a main form of childhood entertainment . . . all sorts of factors could be to blame.

And that includes the refusal of successive governments to look to the past for advice rather than dream up another new-fangled educational policy with an aspirational name such as Curriculum for Excellence.

Maybe it’s time to admit defeat and look forward to the day when all books are in “audio” and reading is about as vital a life skill a spearing a bison.

The cost of trams will haunt us

THE more financial black holes that open up, such as the £244 million needed now for schools in Edinburgh, the more the cost of our trams will haunt Edinburgh. It’s the civic folly that will always come back to bite us on the bum.