‘Care’ Home

I only tend to see the bad nursing homes. I'm not talking about nursing homes where the patients are abused in the traditional sense, but rather where they seem to have simply been… left.
I went to one the other day, run by a large prestigious private healthcare company, it is clean and looks very pretty. But I'd rather die than spend my final days there.

The patient was 90+ years old and had been bleeding from her vagina since 9am that morning. I was called at 11am. They had left her bleeding for three hours.

I met her laying on a towel on a plastic bed, there was no sheet, and the only bedclothes she had was a single sheet across her body.

Her room was clean, but was empty of anything personal – there were no pictures, no letters, no ornaments. Nothing.

I looked at her drug chart. She was on two types of painkiller, but for the past five days, those, and her other medications were marked as having been 'spat out'. I'm guessing that this was because of her advanced dementia, rather than an informed refusal.

If she was spitting out her medicines, I wonder if she was also spitting out her food and drink. There was a bottle of drink next to her bed, but there was no way that she would be able to reach it. Looking at her skin, she did look dehydrated.

The 'nurses' all walked with the speed of arthritic turtles, and I had to struggle to find one that knew anything about the previous visit the patient had made to the hospital. Actually I struggled to find a nurse that knew much about anything.

'I don't know this drug', I said to one of the nurses testing her, 'what is it for?'

I knew what the drug was for, but the nurse didn't…

One of the care assistants sat on the end of the patient's bed. The patient seemed a bit distressed at this, but it was hard to tell as she was staring at the ceiling. The carer suddenly got off the bed, and this obviously caused the patient pain as she cried out.

The care assistant left the room, and I was left trying to comfort the patient, holding her hand and apologising.

I wondered what this woman had seen, what she had lived through. I could imagine her dancing in the 1930's, being married and having children (her daughter was on the way to the hospital already), raising her children while living through the war, maybe working as part of the Land Army. I thought about her husband, probably long dead, and the friends she had also probably outlived.

It always depresses me to think that some people end up in homes like this, where the care is slipshod, and her life is now just an accumulation of numerous small acts of omission.

42 thoughts on “‘Care’ Home”

  1. My gran was in residential care her last months and they were good to her, but it wasn't a nursing home. She was able to look after herself, with some help from my mum, pretty much 'til the end.Thankfully she deteriorated relatively quickly and only had a couple of weeks in hospital before she died. Good staff DO make a difference, not just to the patients, but to the families as well.

    Not everyone can take care of their loved ones at home, no metter how hard they try or how much they want to.

  2. I'm sure most nursing homes are fine, but it's the bad ones that stick in your mind. I've had a few when it's impossible to get any sense out of the nursing staff, they think “conscious” means the same as “unconscious”, they don't know their address, they don't know what constitutes a heart complaint, etc etc. It's fair enough for members of the public to be in a flap but surely these nurses have to call ambulances all the time?The worst case I found was when the home rang up with a patient who was “having difficulty breathing”. During the call the patient stopped breathing. I asked if she wanted to do CPR, she said yes, I said that I'd need to stay on the line while she was doing it and that she was to tell me if there was any change (standard protocol for not-breathing patients). She hung up, so I rang back the home and got through to reception. I said to the receptionist “I was just speaking to one of your nurses and…” The receptionist cut in at this point, saying “hold on”, even though I hadn't told her why I was ringing back. Two minutes later, the nurse came on the line. Yes, she'd stopped resuscitating the patient to come to reception and answer the phone. I despair.

  3. The nursing home I found for my mother was relatively good — an awful lot better than the hospital whose treatment of her led to her having to go into one. But I chose it after asking people about the homes here and reading the inspection reports, and going to see it without notice (as all good homes allow, and some prefer). A lot of the staff there really did care and some were very skilled. But even so it was necessary to visit often and not always go at the same time. And they were not that well equipped to deal with dementia (but that was not their fault, the hospital hadn't diagnosed it…).My mother's room had pictures I'd taken in and some other things of hers: but I soon learned it wasn't a good idea to take in anything valuable, as it got stolen. And though that home was OK for people who didn't get visited often, it is best to visit frequently, to check up on the staff.

  4. Makes me want to weep. How hard (or expensive) would it be to provide a few cheap prints on the walls and leave a radio on for her to listen to?

  5. I remember visiting my great aunt in a nursing home many years ago. Her rooms was bare and non of her carers seemed to know or care what was going on. She had lost her memory and was totally disoriented. I was only about 10 at the time and being in the care home frightened me. I wonder if it frightened her too.TP

  6. I'm afraid this is way too common.You also have those who lie dead in their appartmenst for months, and those who go missing – exept noone reports them missing. (I'm in a search-and-rescue unit. We sometimes find them waaaay to late..)

    My grandfather lives on the oter side of my country, and since my mother died I have trusted my aunts to “look after him”. Three weeks ago i got a phonecall from one of my cousins. My grandfater was hospitalized with malnutrition and dehydration.

    A quick phonecall to my aunt confirmed my suspition. They never held him company at dinner. The just gave him the food and left.

    My cousins and I have now arranged for him to go to a nursinghome and made a scedule for visits. Hopefully this will turn to the better for him. I will personally make sure he get his favourite decorations on his walls, and a radio.

    And yes, he was dancing during the war, worked on the reailroad all his life, and have some wonderful stories to tell. I collect them for the future.

  7. That is tragic – what awful awful places you must see. Recently in Ireland there was a case where a 102 year old woman was left to sleep in her chair because the nursing staff felt she was more comfortable there. When it was pointed out to them that she wasn't lucid enough to actually tell anyone what she wanted, the home changed it's tack to “she seemed more comfortable”. Thankfully the home was reported for this and numerous other breeches of health and safety, and the management team was thrown out and replaced by a team from the local health authority.Please god, when I get that old, I'll never have to darken one of those places.

  8. That scares me.I really hope I'm able to do what my late great-aunt did – as she became more and more infirm, and with no family nearby (she lives in Germany), she realised a care home would be on the cards, so she spent a few months investigating several and chose herself which one she would prefer. Eventually died in her 90s, peacefully in her sleep, with her pictures and whatnot all around her, and was found the next morning.

  9. It is really depressing to think that this is going on. My family are all worried about my gran at the moment. She is blind, cannot walk unaided and has to have oxygen on had at all times and has problems with her liver. At the moment, my grandad (not in the best of health himself) is caring for her along with help from neighbours and social services.They live a long way from us and so it is not easy to pop over and check on them everyday, although we all phone all the time and we do try to get down there as often as we can. It is just worrying to think that if anything happens to my Grandad, my Gran may well have to go into a care home, as both my parents and aunt and uncle work full time, my aunt and uncle have two kids and none of us would be able to cope with the amount of care she would need, which is a shame as I really do not want her to end up in a home, especially when something like this can so easily happen.

    It always amazes me why some people go into “caring” if they seem not to care about people.

  10. I'll second Paul Fitzgerald on that. I visited such a home a few months ago, and the experience made me very sad and angry. It isn't that I saw people actively mistreated – it was the thoughtlessness, the sheer lack of courtesy. Nice to read these posts and know that many other old folk are loved and looked after.

  11. Here in the US care homes are commonly termed 'nursing homes' and are most often concerned with the financial bottom line and not with humane and compassionate care.My husband has worked as a night nurse in several different homes in our area. He tells me the usual ratio is one nurse per 35-40 patients and roughly 2-3 assistants for the same ratio of patients. He tells me that in 'skilled facilities' is the ratio 1 nurse to 15 patients.

    Warehousing of the elderly & infirm is repulsive. Unfortunately, here, there is little choice unless you are able to afford long term care insurance or your family is able to take you in.

  12. A very sad story, and sadder still, how easy it seems to be to stop thinking of the elderly as “real people”

  13. Having worked in such homes as Reynolds has described, I too was appalled by the lack of care given by staff. I cared for one woman who they said to me 'watch her, she'll bite and pinch you'. Went in to help the woman eat her dinner, and yes, she called me a bitch and tried to pinch me. So I held her hands, looked her in the eye and said to her 'now, what have I done to deserve that? I've brought you your tea, here'. And I made the EFFORT to listen to her (she found speech really hard), gave her a drink when she needed one, chatted to her, and she ate her dinner. And I left her and she was smiling, and when I came out all the other care assistants were going 'did she really eat all that? She never normally eats anything'. All it takes is a bit of human compassion.Later I found that the reason the girls were carers there was becuase they had come from overseas and were trying to get in to train as nurses here. But their English was so poor that none of the old people could understand them. In fact, half the staff couldn't even understand ME, and I speak very good (but not so posh that I am unintelligible!) English.

    Grr. Couldn't do that job any more. I thoroughly vetted the place where my grandparents live now. People who are nice who work in care homes are worth their weight in gold.

  14. I spent my A-level years working part time in a Nursing home, then a year full time after that. whilst working in these various care/nursing homes I witnessed both amazing compassion and love for patients, some wonderfull memories and many happy times. For three years I worked Christmas day and it was fab!However… I have also witnessed down right abuse. there is no other word for it.

    Working as a Care Assistant it would have also been usefull to have been able to understand the launguage of some of the 'nurses' who's care I would regularly question in my mind.

    How worrying that they dispense drugs without knowing what they are/for/do! – I wouldnt dream of it!

  15. That article really struck a chord with me. I'm not elderly (I'm 23) but this year I am housebound a lot of the time, and it's amazing how many of those people I used to go out with and visit and meet up with suddenly don't have time for me any more.Luckily my home is all on one level, and I have a phone line and the internet, and I have family close by, so I've retained a lot of independence, but loneliness is just about the worst part of long-term illness or dependency.

  16. Am doctor and know how bad these care homes can get. The fact is though all these patients need are TLC and you can't buy that sort of thing. I don't expect knowledge about drugs from the care assistants, but the nurses should know the function of common drugs.Different nursing specialities attract different kinds (and quality) of nurses. Nursing home nurses are the bottom of the heap unfortunately because “the work is easy”.

  17. A 93yr old man from a 'care' home lying in a soaked bed with just a pad stuffed into his pants – no pj bottoms and his top all done up wrong. Weak and shaking – and the 'carers' – I use the term loosely – handed over two old carrier bags tied in a knot. One had his drugs and one had a crumpled dressing gown. Ashamed.

  18. I've seen vets administer more compassion to my cat than the carers in my grandmothers care home. I loved my grandmother but was so relieved when she finally died due to the fact she didn't have to suffer any more indignities to her person. She suffered a series of strokes which meant she couldn't speak or swallow or move at all. We visited her as much as we could and in a short space of time during one visit I established an alternative way of communication with her – eyebrow lifting and blinking for yes/no etc. None of the carers could believe it and even though they spent every day with her for years they had written her off as senile and therefore repaid her silence with their own. The worse thing was that because she couldn't swallow it transpired that they had stopped trying to feed her. I'm sure she basically starved to death – it was so awful to see and so painful to watch. So incredibly depressing. I hope the lady in the post receives better treatment and care in hospital.

  19. I'm so angry and upset after reading the post and comments. One thing that is very much needed in my opinion is education on what “senility” actually is. It's such an umbrella term, but covers a huge variety of conditions.It's too easy to just write someone off as being “old and going a bit dotty”, and not bother trying to find out the exact reason they are unwell and fix it. Life could be improved for so many people who are just as deserving if not more so than any other person.

    For example, a better understanding of conditions like Alzheimers disease would improve the care of the people suffering from it – AND make life easier for their carers. There are books available written by people who have had periods of lesser symptoms and remission in the disease who give a massive insight into what it feels like and what works for them and what doesn't in terms of care and the attitude of other people. If the nurses could just take the time to read just one of those books it would help.

  20. Uuurgh.I know I'll probably change my mind at some point in my life, but I think I'd quite like to live a healthy and active life at home until I'm about 80, and then quietly pass away in my sleep one night or something….

  21. My sister works in a care home just now and doesn't like it any more. She's had numerous run-ins with the matron for criticising the nursing staff for their lack of patient care and compassion, but has been told she's “just a care assistant” and that the nurses are highly trained and know what they're doing. She does the best she can to make people comfortable, but she can't keep working there. She's just got a job at the blood donor centre, but she feels awful about leaving the residents with no-one on their side.Vikki.

  22. I worked in one as bad in many ways. “Nurses” who, despite a nursing shortage, would not find other work. Admin who cared about the money, and had posh offices, with bare bones patient rooms. I was fired when I got into nursing school, I think because they thought I would report them. For gross violations of various health codes. ( I certainly would have.)I worked as an RN in a skilled facility, and although much, much better, it was still largely dependent on the aides. The good ones, usually putting themselves through college, didn't need much supervision. The bad ones, often older and unskilled and bitter- were un-supervise-able, wouldn't follow any kind of direction honestly.

    I personally wish we were as humane with our ill and elderly as with our animals. If I no longer have a joy in life, give me a nice overdose of anesthetic. I understand that it's not that simple, but I would want it for myself.

  23. You have done it again. Given me hope in the system of medical care and that is not an easy thing to do with me.There is one thing everyone is missing. This little old lady may be laying in that bed, but on this day she was given a gift. A gift of a kind and caring person who took the time to care and comfort her. To think about her and to let her know about it. That is a precious gift when your ill and alone.

    She honestly mattered to someone today Mr. Reynolds and believe me she knew it. Your her Hero today and for many days to come in her memories. That is hope for better days Mr. Reynolds and you gave her that.

    You may yet become my hero,

    Sassy

  24. Hi”written by people who have had periods of lesser symptoms and remission”

    Can you recommend a title I could look out, please? Mu mum has Alzheimers and I'd love to be able to understand more. Thanks

  25. Tom: great post. None of this fancy literary embellishments – just the random act of reality communicated clearly, with attention to detail. Showing us what you see. What sadness though – to have gone through an entire life to then be left alone, just waiting to die I guess. Something wrong there. Thanks for the insight. Office worker.

  26. so, may i ask, as you personally witnessed the abuse and lack of appropriate care to the elderly residents, what did you do about it? i really hope you were able to report it to the manager and further if necessary. The only way we are ever going to make a difference for our parents, grandparents aunts and uncles is by not brushing these issues under the carpet but acting on the unacceptable levels of 'care' we come accross. I hope you were able to do this.

  27. We do have, and some of us on our station have used, referral forms for child, elderly and vulnerable adult abuse. I did think about putting one of these referrals in, but couldn't think what I would actually write as the description of the abuse.No pictures on walls?

    The only thing that I think I could have 'got' them on would have beenon the lack of a sheet, and their excuse would have been that they were changing the bed when I turned up (seeing as she was bleeding).

    So while I didn't put in anything formal, I did have a power-moan at the nurse in charge of the floor, letting her know that it just wasn't good enough.

    The referral form has been used with great effect before, but in this case it just didn't warrant it…

  28. This reminds me of a harmless 'scam' me and my friends did when we where kids. There where several old folks homes nearby and we used to fetch news papers, small shopping or plain play chess or checkers with old folks. We never asked for anything but where always given small change or sweeties. Beats washing cars and old people always have great stories to tell! puckman who is to lazy to register again.

  29. That's not a scam! But I guess thinking of it as a scam may make kids a bit more inclined to do it than thinking of it as Voluntary Work.

  30. That last sentence sums it up for me; “…an accumulation of numerous small acts of omission.” It's not that the staf are actively malevolently bad, but the lack of skill, or the lack of thought, or the lack of the application of the skills brings hurt to the patients. The problem of the water bottle being laid out, but being out of reach is sadly all too common. It's all to easy for staff to assume even elderly patients have the same level of mobility as they do.

  31. I work for a large pediatric hospital system (I say system as we have 2 hospitals and a network of urgent care centers) and our nurse patient ratio is 1/4 for the regular patient care areas, and either 1/2 or 1/1 in the ICUs, depending on which unit it is. We win awards in customer service and quality of care all the time, and we just won an award for being one of the best places to work in Atlanta (Atlanta, Georgia, in the U.S.). Our nurses are the most compassionate people you will ever meet in your life, and they really care. They care about their work, they care about making a difference, and they care about their patients. The local newspaper often jests about us in articles saying we have the happiest little sick kids around. I was in the hospital recently for 4 agonizing days after a motorcycle accident and was appalled at the lack of care I received. My pain medication IV alarm would be going off for an hour, and despite calling the nurses station, no one would come attend to it. I also was prepared by one nurse for a sponge bath, but she walked out of the room to get something and never came back. She left the door to the room wide open, with me sitting there helpless and naked. It was only when a man from food services came to deliver my meal tray that anyone was notified of me being left there. It was humiliating to say the least. My question is, why do we live in a society that seems to only value the care of children?

  32. The thought of that poor women bleeding and nobody helping her is heart wrending. Makes you dispair about humanity.My mom used to work as a CNA (certified nursing assistant) at an convelescent hospital in the San Jose, California. There was way too little staff, too much to do, dangerous tasks for employees to perform (like being expected to lift, or dress, or help severly overweight people get out of bed, get dressed, or get showered–a 1:1 ratio that didn't work in most of the workers' favor). The pay work conditions were so horrible that the turn over was high and most of the employees were working 2+ jobs on the side to make their financial ends meet.

    My mother finally quit when she was severly injured by a male patient. A nurse, a real gem, was taunting one of the patients. She wouldn't stop and the patient became so enraged he charged after her, fists flying. Unfortunately one of his blows threw my poor mother into the wall, and she loss consciousness, slumping to the floor. Did she get any medical attention by the nursing staff? Oh no. They waited for her to come round and then let her drive home. We were furious. She was in no condition to be behind the wheel of a car–she could have harmed herself or some other poor soul if she had had another blackout. She should have been sent to the hospital for a medical exam.

  33. Sassy – you're right, Reynolds is a hero to that woman. But I wish I shared your conviction that the hospital is a better place for her. In my experience hospitals fail our old people as much as care homes do – beds on geriatric wards are scarce, older patients are often shunted around side wards, and even trained nurses have very little understanding of dementia, stroke and other conditions.My grandfather had Alzheimer's and when he was admitted to hospital for an acute condition, it took around a week for the nurses to mention to us that he had been 'refusing' his medication. So for an entire week, he had been in hospital and yet was recieving no treatment at all.

    In the end we took to feeding him (the staff didn't have the time) and administering his medication (they didn't have the patience). We wondered what he was getting out of hospital at all. Probably a superbug.

    So we have hospitals that are happy to let illness go untreated, and care homes that no longer care.

    I'm at least a little heartened that there seem to be many people here that are appalled by this situation. Can I ask that people think a little about what they can do to change this? Charities for older people are always unfashionable – perhaps we don't want to admit that we may have to rely on them one day. If we're unlucky, we get cancer. If we're lucky, we get old. Help the Aged, Age Concern and the Alzheimer's Society could do with a bit of support.

  34. I felt a similar dread when earlier this year, my grandad had to go into a home. We looked around a few for him, ranging from a small chaotic cheap home, to a large generic, bland type, and then finally a small-medium attractive building with large landscaped garden, some chatty inhabitants, a caring senior nurse and advanced nutritionally aware cooking programs. We chose the latter and my granddad was there for a month or so before he died. I am certain he would not have been unhappy there however he was lucky to have a) enough money for a reasonably expensive home, and b) family to take enough time to choose a good one.In cases of neglect / shoddy care, the family (if there is one) must take a lot of the blame for not better picking, and monitoring the care given to their loved ones.

    As to the people in caring – most of the homes we saw all employed immigrant workers, presumably for reasons of cost and availability.

  35. batsgirl, your mention of loneliness, and your age got me thinking. I'm doing a PhD in computer science, I'm working on a system for older people (or elders as we call them) to make some of the things on the internet easier to use. The group I'm part of identified loneliness as the major problem, and so we've concentrated on communications, starting with instant messenger, and moving on to some other apps. The hope is that this will help older people reestablish their social networks. Of course, the average computer is basically impossible to use for most elders, so I'm designing systems that are much much simpler.But the reason I bring all this up, is you're the first young person I've come across who seems to be in the same predicament. I'd love to get some of your thoughts, and find out what you find makes life better online, so I can see if I can provide some of that for older people.

    If you're interested you can email me…. pete at surfaceeffect dot com.

  36. Hey Anon, sorry I didn't check this for a few days…hope you come back and look.Books:

    For carers such as yourself I'd recommend,

    “The 36-hour day: a family guide to caring for persons with Alzheimer Disease, related dementing illnesses, and memory loss in later life: 3rd Edition”

    ISBN: 0-8018-6149-7

    It's available in the normal places but I can recommend where to get it much cheaper. Don't want to say here in case it looks like advertising so please email me, pinklefish at gmail dot com.

    The book written by a person experiencing Alzheimers is:

    “Dancing with Dementia: My Story of Living Positively with Dementia” by Christine Bryden

    ISBN: 184310332X

    I hope this is helpful.

    Might be useful to visit http://www.alzheimers.org.uk also.

    Pinkle

  37. a good source of information about Alzheimer's or other dementias is your local Alzheimer's Society. You may find they have a support worker who could also give you some support/info. If you cant find out who/where local group is, I have managed to find out through the local Mind group (you should be able to find them!)helping a relative with dementia is hard on you too. if anyone offers you help, even if only a listening ear, take it!

  38. This is no surprise. i worked as a care assistant for 8 years . the first home was a local authority one.The standard of care we had to provide was very very high. Which I may add these people deserve. i really loved my time at this home the residents were fantastic and i can truly say I was dedicated to my job. There were staff though that were there simply for the money and not for the love of the job. The second home was a private sector nursing home and the care that was provided was awful. Pillow cases were rolled up and used as incontinent pads.There was never enough staff on duty. Many were inexperienced and nearly all the residents had bed sores . I lasted 6 weeks at this home and when i left i put in a massive complaint to social services. To this day it is still open. I always say after I have worked in them i would never ever put any of my relatives in one. At the moment i dont work as i have 2 sick children , one day i hope to be back out there knowing that I am caring for someone else's family the way that I hope to be cared for.

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