Care for Older People

It can’t be an easy occupation, being a nurse in today’s troubled and threatened Health Service. The political battle about reforms of the Service continue – and whilst a ‘listening’ period is taking place, the government’s legislation is still likely to be passed in Parliament with only moderate changes, despite its wholesale rejection across the country and amongst most medical authorities. Recent reports about the inadequate care of elderly people in hospital can hardly have helped morale in the profession or its reputation in the country.

The Care Quality Commission which aims to regulate care in hospitals and care homes, have given a summary of the first twelve hospitals which they have examined against this criteria. Inspection teams observed examples of excellent care delivered by nurses and other healthcare staff who took the time to explain every aspect of a patient’s care to them in a way they could understand.

But recurring examples were found where people were not given the assistance they needed to eat and drink and their nutritional needs were not being assessed.

In one case – much publicised in the media- a member of one hospital’s clinical staff described having to prescribe water on medicine charts to ensure patients got enough to drink. Another criticism was that some staff were not treating patients in a respectful way. One man said that the staff talked to him ‘as if I’m daft’.

I have met that attitude many times when visiting people in hospitals. There is a brisk ‘no nonsense’ cheerfulness in hospital culture that no doubt has to do with efficiency and self-control (there are few harder or more demanding jobs), but can so easily come across as indifference to the needs of the patient. I have seen the same sort of thing in some Care Homes with the older person less able to speak for themselves, and their families reluctant to complain in case it affects the way their loved one is treated after they have gone.

The Report is temperate in the way it outlines its concerns, but a report published yesterday by the Age UK charity, ‘Care in Crises’, is more hard hitting. It claims that out of 2 million older people in England with care-related needs, 800,000 receive no formal support from public or private sector agencies. With spending cuts underway the figure is likely to pass one million between 2012 and 2014. Spending cuts are projected to reduce spending on older peoples’ care by £300 million over 4 years. Age UK’s ends it report with ten principles for change, the first being a guarantee of sufficient quality and quantity of care for low income older people: the charity’s ‘highest priority’.

The thought occurs to me that our legislators and our professionals forget that one day they too will be old.