Home care

old-hands

This story has been on my mind over the last few days.

Increasingly, old people in this country are cared for at home. In some ways, we can be proud of this- people no longer go ‘into a home’ as they become more needful of care, unless they need ‘nursing care’ (which is often a rather ambiguous distinction however.)

This means that increasing numbers of older, frail people are living in their own homes, dependent on electronic monitoring systems and visits by care workers to assist with meals, toileting, even transfers from bed to chair.

And here is the problem. The cost of all this care is squeezed so tight that care workers have tiny slices of minutes before rushing on to the next home. Home care workers have long stopped all activities that are not deemed to be entirely necessary for physical care (cleaning, socializing, sitting with a cup of tea for a chat, shopping.)

Leonard Cheshire care have said that they will no longer participate in any contracts that slice care into 15 minute slots. Good for them. However, the real issue is the degree to which we allow care for our elders (the carriers of wisdom, learning and knowledge) to default to such a low common denominator.

Most home care is now provided by private or voluntary agencies whose workers are probably the lowest paid people in society. Councils are constantly trying to find ways of driving costs down, by re tendering or raising the thresholds for what they will provide. They describe the very real economic factors that force them to do this- reduced funding from central government, increased numbers of older people requiring care etc. These are complex, difficult times for social care provision and let no one pretend that the fault lies with the people trying to manage the front line of care. Some of the people (almost exclusively women) who do the hands on work are, in my opinion, only one step removed from sainthood.

But, forgive me for making a rather cliched simplistic point- Trident nuclear submarines cost about £2.5 billion per annum.

And another one- would an extra pound of tax per month from your wage slip make that much difference?

These are economic decisions that our government regards as politically unacceptable.

Yet we can live with the loneliness and isolation we inflict on our elders.

Home Care

.

The world has become these walls

Covered in pictures of what we once were

Before your heart stopped beating

Some days she hears him whispering

Pulling her closer

No regrets my love-

Just all our memories

Cradle to the grave

.

Each morning she waits for chemical relief

The meat of her is in rebellion

Each joint swollen like wet wood

Each vein pumping pitch black blood

Skin like a stone dressed in lichen

.

There is the rattle of the key from the keysafe

She stiffens, steels herself for dependency

As a stranger in a green tabard clamours in, high on bonhomie

The clock starts

.

How do I use of my fifteen minutes?

A hot meal or a warm bath?

That commode is unmentionable

What was it they said about having to pay for domestic care?

How did it get to this?

.

Then the girl is gone

And she sits alone again

Before her wall of memories

Fractals…

old-hands

 

Fractals;

One often cited description that Mandelbrot published to describe geometric fractals is “a rough or fragmented geometric shape that can be split into parts, each of which is (at least approximately) a reduced-size copy of the whole”;[2] this is generally helpful but limited. Authorities disagree on the exact definition of fractal, but most usually elaborate on the basic ideas of self-similarity and an unusual relationship with the space a fractal is embedded in.[2][3][4] [6][29] One point agreed on is that fractal patterns are characterized by fractal dimensions, but whereas these numbers quantify complexity (i.e., changing detail with changing scale), they neither uniquely describe nor specify details of how to construct particular fractal patterns.

Memory

Leeched like lime from this soil

The grains of me are gone

Fractalled

And falling away

 

Numbers swirl and tumble

Names all interchange

Heads of friends are hooded

Keys each night re-cut

 

In 66 we went to Spain you told me

The year before Charlene was born

Our wedding day was cloudy

Some song suggested

You

 

Am I portable?

Is there a jar somewhere to catch what is left?

Or do these memories become minerals

Feeding some darker place?

 

Hold me softly my love

For I am leaving

Square world…

I went for a meeting today in a posh new hospital. Everything squeaked as if in disapproval of my polluting presence.

I was there to chair a meeting about one of the patients, who had been transferred there recently to receive more specialist care. She had previously spent most of the last 40 years of her life as a resident of the local psychiatric hospital. Things went wrong after the death of her husband, and she somehow lost herself in the grief of it all. The whole range of psychiatric science was rolled out for her benefit – drugs that greyed her vision, Electric Shock Therapy that blew holes in her memory then finally psycho surgery in an attempt to cut grief out of her brain with a scalpel.

And here she remains – toothless, but given to scratching. Occasionally abusive but still with sense of humour intact.

She used to be a worker, a wife, a mother. She used to go on picnics and loved to dance. She enjoyed holidays and gossiped with her friends about the comings and goings of the village.

But that was 40 years ago.

Today we met to discuss her future care – a likely move to a specialist nursing home, and the legal issues around that given her lack of capacity to understand or to give consent.

But in the middle of this, she looked at the ceiling and said;

I hate those squares. Everything is square in here. Put me outside next to the beech hedge. Just put me outside.

And I looked out at the brown beech hedge, with dry leaves still rattling on the close cropped branches.

Through the square window.

And I wanted to wheel her out there, and sit her under the winter sky, wind waving her long grey hair in a curve of protest against all those bloody awful squares.