Get every D4Dementia blog post delivered into your email inbox - Sign up here:

Wednesday, 23 October 2013

15-minutes of shame

As a light was shone, yet again, on the huge inadequacies within our home care services as the issue of 15-minute visits hit the headlines, I decided to time my morning routine. Just how much could I as an able-bodied thirty-something, fairly fit and known to be someone who is constantly on the go, get done in 15-minutes?

Well, the answer was that I couldn’t get out of bed, make a cup of tea, cut, toast and butter my breakfast bread, use the loo, have a wash and get dressed within my 15-minutes. Something had to give for me to make my target, in fact quite a lot had to give in the end, as I like a shower rather than a quick rub over with a damp flannel, I needed to blow-dry my hair, and we’d run out of butter for the toast, so I had to pop to the shop.

It will come as no surprise to my family that it took me more than 15-minutes to get ready for the day ahead, but I hope it provides a sobering thought for anyone who believes that 15-minutes is long enough to fulfil the care needs of an older or disabled person.

This may be a person who will take most of the 15-minutes just to be helped to get out of bed. They potentially then have to choose between having a hot drink, something to eat, visiting the loo or having their incontinence pad changed or catheter checked, having the sort of wash that they would want (imagine never having the chance to enjoy a bath or shower because there is no time to help you with that), getting dressed and having their medication. Even something as simple as a hot-water bottle may not be filled in time to help keep you warm.

All that is before we even get onto the personal interaction (a chat in other words) that so many vulnerable and isolated older people crave, or the care worker addressing any unexpected problems of a personal or domestic nature (health problems, heating breakdowns or water leaks for example – things that cannot be ignored as they could put the person in danger). You cannot possibly even begin to tackle all of these needs within a 15-minute window – it is degrading to the person who needs care to even try, and insulting to the care worker to expect them to hit that type of target.

We need to understand that care isn’t a luxury. It’s not a Gucci handbag or a Ferrari parked on your driveway. It is the most basic, fundamental thing that we all need. Most of us take care for granted because we can care for ourselves without any assistance, and then we have children and naturally find ourselves caring for them without giving it a second thought.

Imagine trying to give a baby all of the care it needs in the morning within a 15-minute window. We have maternity and paternity leave not just so that parents can bond with their child and establish their family, but because that child will need a lot of care. Many adults need similar levels of care and support, in a different context of course, yet many councils believe that it is achievable within 15-minute timeframes.

Our social care system is broken at the point in which we place a stopwatch on care, and why is that stopwatch there? Time is considered to be a useful way in which to price work, and the price on care is being continually squeezed. Public money either isn’t available, or hasn’t been made available, to fund the increasing care needs of our ageing population who are living longer but with far more complex long-term conditions. Even most people who privately fund their care do not have a bottomless pit of money and are still subjected to 15-minute care visits.

I fear as a nation we simply do not understand what care involves. The complexities of it and the fact that it cannot be rushed. We don’t place enough value of the importance of human interaction and the joy and comfort that it can bring. We don’t see care as an investment a compassionate society should be making, but rather see it as an annoying drain on resources that must be cut back to the bone. We bypass basic human rights, we tolerate the fact that it is undignified and lacking in compassion, and ultimately ignore the reality that it’s dangerous to try and provide care within 15-minute windows. We effectively treat prisoners better.

Yes social care needs more money, and sadly I don’t hold the purse strings, but it also needs an overhaul. Councils, commissioners and care agencies need to look at themselves and be honest – are they really proud of the work that they do? Can they achieve what they expect the average care worker to achieve in 15-minutes, and have they ever put themselves into the shoes of the person needing care?

I challenge you – time yourself. How much can you get done in 15-minutes that involves your personal care, basic nutrition and hydration, and caters for your need to be kept warm? Then consider how mobility problems, reduction in your sight and/or hearing, or any other medical problem might affect your ability to fulfil those needs. Then factor in having someone to help you so that you can overcome the limitations your body places on you. Then check your watch. I guarantee that you will need far longer than 15-minutes to achieve this.

Until next time...
Beth x






You can follow me on Twitter: @bethyb1886

5 comments:

  1. Very valid commentary Beth and this whole care situation is very frightening. Some days my mum can't even get to the loo and back in 15 minutes. Our experience of home care was not a good one even without a 15 minute limit.

    ReplyDelete
  2. Actually 15 mins is enough for some of the care visits my Mum needs - I've seen that regularly when I visit. She is a self payer and we've scheduled longer visits when those are needed. But my fear is that this campaign against 15 min visits will either inflate her bills even more than the enormous sum they are also already or will result in her needing to have fewer, longer visits which I think would actually be worse.

    ReplyDelete
  3. It's what happens when care is a business and not .... well ..... care :(

    ReplyDelete
  4. Thank you Beth for your recent blog. I can relate to your experience with your Dad as a I had a very similar experience with my Dad.

    What I would like to say about care generally is that it is being privatised by central government. This government holds the purse strings. There is a gross shortage of care places in commercial specialist homes and for those needing specialist care in their own homes. In my experience the only care offered was from agencies, private agencies. The responsibility for overall care of its citizens should be from the state. Fair taxation (which is not happening) would adequately fund those in need. More doctors, nurses, carers and proper funding is absolutely vital - this should be seen as investment and not a burden so as to create a caring and compassionate society towards its elders.

    If my Dad had realised what was happening to him in the care system after he gave six years of his life in WWII he would surely be appalled. He was an exceedingly generous man, giving time in his retirement to others in need. He was a fantastic listener and contributed to the wellbeing of others. To be subjected to a care system that robs people of their savings and having to be dependent on the financial market would indeed pain him. It seems in this society if you have money and power you can claim anything. Private agencies operate in a market environment so if they can get away with 15 minutes care for someone they will.

    I say, keep care public and properly funded - it can be done if there is a will.

    ReplyDelete
    Replies
    1. Thank you for sharing your family's experiences Janet. I agree that there are huge structural and funding issues in relation to care and support.

      Delete