Thursday, 12 November 2009

Who will do the caring?

The BBC has reported on a government report which claims that around 2,000 people's deaths each year are contributed to by the innappropriate prescription of anti-psychotic drugs for patients with dementia. The report claims that:

"But the expert review - commissioned by ministers - said the treatment was unnecessary in nearly 150,000 cases and was linked to 1,800 deaths."

This is all well and good, but when one sees the prescription of anti-psychotic drugs in the context of a care system that has been almost entirely privatised and ground down to the very bare bones, then the government's sticky plaster of a response is nothing but pissing in the wind.

The government wants better access to other kinds of therapy, more training for care workers, more monitoring and a new national director. I wonder where all the money for this will magically appear from given the NHS' budget crisis?

Also it is strange that the government has done so very little to regulate the care industry in the UK in recent years. It used to be largely publicly owned, but after the last twenty years or so of destructive reforms, it is largely privately run for profit. This also means that the government cannot force changes upon the system anymore, as the private firms hold all the card in terms of ownership and lobbying power, they have been very resistant to proper regulation in recent years.

This has meant that many care homes are dangerously short staffed and the staff present are invariably not sufficiently trained for the jobs they do, the government watered down regulation changes a few years back that would have forced a maximum number of patients per staff member. No wonder anti-psychotics are being dished out like smarties, there simply has not been the right number of properly trained staff to adequately manage the most tricky patients with dementia.

The privatisation of a service that should be accountable to the public has led to it being run down in the name of profit. This government and previous governments have caused the care of our elderly to be so woefully neglected, they simply don't want to pay for people to be cared for properly to the grave. This report is yet another dishonest piece of spin designed to take attention away from their own failings.


Nikita said...

I am a RMN and have worked in care homes since the mid nineties. I have worked in four homes and only one offered basic care, that is, care without affection. Even so, I did not see deliberate ill-treatment or over sedation. I have worked in my present home for nearly nine years and feel privileged to work there. The home is run for the residents and not the staff. I regard the residents as my employer and I work for THEM.

That said, I am sure there are a FEW homes were care is minimal and over sedation is the norm.

I quote JD here and his article in Pulse that "Dementia is a terrible thing" and indeed it is. For a ?lucky few, they will be pleasantly confused and/or apathetic. For the most of those with age related dementia, life will be a living nightmare - this was a descriptive term used to me by a resident a few days ago - of confusion, anxiety, agitation and profound distress. Why should this not be addressed and treated, purely because they carry a diagnosis of dementia? If antipsychotics shorten a lifespan by two years, why not if the remaining years are bearable?

Some years ago, perhaps five, a limited survey (in numbers) was carried out nationwide on a few selected homes, mine being one of them. Three people were deemed not to require them, this decision overiding the presciber. One man suffered no ill-effects. One lady from enjoying a relatively happy life became incontinent, ceased to walk and talk and became aggressive and remains so now. The third person, a gentleman, returned to his previous state of constant agitation and existed in this living hell until he died three years later, It was not fair!

When I do the hourly night time checks I look upon some of these good people and think that this is the only time they are truly at peace. Daytimes are different with hour upon hour of agitation and distress.

I would not like to walk in their shoes, but there is no guarantee that I won't. If this is the case. I really hope I am medicated!

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Anonymous said...

i have seen some absolutely shocking standards of basic nursing in many care homes,

massive pressure ulcers down to bone, unclean and malnourished patients etc

now they are all privatised the government has to regulate them properly or the elderly will rot as they currently are in many of these substandard homes

Nikita said...


In what capacity did you see all the above mentioned and what did you do about it?

If you are a nurse and were employed in these homes, why did you allow bad practice to continue? If you are an agency nurse, why not did you not report them to your agency?

If you are empolyed as a carer for the home or by an agency - the same applies.

The 'basic' home I worked in many years was visited by the JIU as it was then, after an agency carer reported bad practice to her agency. The result was that night nurse and three night carers were sacked, and rightly so.

I do agree with you regarding the laxity of announced and unannounced visits from the CQC - it is now laughable, yet deeply worrying. The rating system is also pretty stupid as a purpose built home that provides poor care can receive an equal or better rating than a home that offers excellent care, but exists in a non-purpose built home. Crazy!