Caring for the Vulnerable

Discussion in 'ARCHIVE FORUM: Support discussions' started by pegasus, Jun 21, 2008.

  1. pegasus

    pegasus Registered User

    Nov 17, 2007
    1
    The number of incidents of elderly people sadly passing away (prematurly by many news reports) in the care of those paid to look aften them in privately run institutions is quite alarming. Without referring to specific cases, it must be stressed that those elderly (and therefore extremly vunerable) who are abused and neglected, due to their inability to defend themselves, are victims of abuse in exactly way as innocent children who suffer at the hands of those supposed to be caring for them and should be dealt with by the courts by being placed on an abuse register for the rest of their lives too.
     
  2. helen.tomlinson

    helen.tomlinson Registered User

    Mar 27, 2008
    541
    Hi Pegasus

    I quite agree. Abusers should be monitored and a National Register and an International Register would be a start. I am not up to doing anything about it though!

    Love Helen
     
  3. Brucie

    Brucie Registered User

    Jan 31, 2004
    12,413
    near London
    As a basic statement I'd say you are correct.

    However:
    I'd be asking what news reports from which source, and how accurate is the data.

    It is only alarming in the sense you mean if it is true that the number is large. Any such occurrence is alarming in its own right, of course.

    Nobody would fault what you have written - in the same way as nobody would fault me saying "people shouldn't give children cigarettes but lots do".

    In my experience of my wife's care home, deaths are very infrequent, despite [other than my wife] an aged population of residents who have advanced dementia - the oldest in their late 90s.
     
  4. Tender Face

    Tender Face Account Closed

    Mar 14, 2006
    5,379
    NW England
    Hi Pegasus - think you raise a hugely important point ...... with a recent incident (this time under the NHS) where I believe my mother has been abused I have been scouring resources ... my local council quote this on their website:

    "In recent years several serious incidents have demonstrated the need for immediate action to ensure that vulnerable adults who are at risk of abuse receive protection and support. Unlike child protection where there is a statutory duty upon local authorities to investigate under Section 47 of the Children Act 1989, there is no such statutory duty to intervene where the abuse of vulnerable adults is alleged or suspected"

    I cannot recommend highly enough Action on Elder Abuse - who have offered me both legal and practical advice along with psychological support ...... and I have consented to supporting their 'Media and Research' function as a minimum .....

    I absolutely agree ..... long involved in child protection issues ....... the 'other side of the spectrum' is hideously unacknowledged and unsupported ...... There are many, many more vulnerable people in society besides children ..... some of whom are better able to articluate their concerns for themselves than some of our loved ones with dementia!

    Love, Karen, x
     
  5. jc141265

    jc141265 Registered User

    Sep 16, 2005
    836
    Australia
    This topic has also concerned me, and not only when it leads to death, for I feel that if children received the same level of care that I see older people receiving in many homes, their would be an uproar in society, yet its seems to be acceptable for our aged.
    Even simple things like my father being left in wet nappies for hours on end, until a puddle formed around his chair...food not being wiped from around his mouth after lunch time so that it was still there at dinner time, the staff forgetting to feed him, seeing inmates locked outdoors or tied to chairs (though I don't know how to avoid that one when freedom can lead to danger), others moaning and crying for hours without being given any attention.. I know I know they are very busy and understaffed with many needy...but it always gets to me that this would not be accepted as sufficient care for children, so why is it accepted for the elderly, or not so elderly for some adults who have nowhere else to go but to an old folks home.
    But then again maybe this is the kind of care children receive in institutions too, when they are out of the public eye?
    Whatever the case, it is currently accepted, but shouldn't be, perhaps governments should be spending more of their defence budget on addressing issues like this instead.
     
  6. Tender Face

    Tender Face Account Closed

    Mar 14, 2006
    5,379
    NW England
    A friend kindly sent me this advice which may be of interest to others in the UK with similar concerns:

    " I just wondered whether you knew about the "Safeguarding Adults" procedures, which in our case locally were then called "Adult Protection Procedures". Of course, there are no guarantees in this, I know - and the procedures are there to investigate 'after the event', or rather 'after the suspicion of a possible event'. Anyone can make a referral to the Adult Protection Coordinator, and in our case it was via social services.

    There is also a POVA (Protection of Vulnerable Adults) list - people are placed on that list and (in theory!) never allowed to work with vulnerable adults again. Similar, I guess to the paedophile register - and the POVA list is meant to be checked by every employer of people working with vulnerable adults and/or children.

    http://www.dh.gov.uk/en/SocialCare/Deliveringadultsocialcare/Vulnerableadults/index.htm

    My experience of it is only in a social care/care home setting - as opposed to NHS situations. Google for the "No Secrets" policy on the DHS website: try the link below.

    http://www.dh.gov.uk/en/AdvanceSearchResult/index.htm?searchTerms=No+Secrets+2000+Guidance "

    Karen, x
     
  7. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    I have seen both good and bad care homes in my area. Thank God Ken, my husband is in a 'good' home with caring workers. I visit every day and spend many hours there. Thankfully the staff are well coordinated, well motiviated, and well led by the Home Manager.

    Neglect and abuse is a very emotive subject and I agree wholeheartedly with all that has been said on this thread. The problems which I encounted when viewing particular care homes was twofold:

    a) the level of staffing. Kind and caring people trying to deal with just too many residents whose needs were too great. I saw more office staff than carers in some privately run homes - run by large, well known Private Health Companies.

    b) the environment for both residents and staff. Too many homes have wonderful bedrooms with en suite toilets etc., but only one room/corridor in which to spend their waking hours. Surely this would be classed as abuse if a children's home was laid out in the same way? Residents should have the choice to move between at least two/three separate day rooms, especially when bedrooms are kept locked by staff for security of personal belongings. There should be a room where residents can sit in peace and quiet without the ubiquitouse TV blaring away with no one watching. When 20 residents are all forced into one room or the ambulant residents can only escape by wandering along a sterile corridor - surely this is not right! Such homes were brand new or at the most only 10 years old! Minimum space levels imposed by Governemt/Local Planning authorities take no account of basic human needs and the freedom to be able to move from room to room.

    Sorry to open up other avenues on this thread but to me, our regulations regarding care home facilities are poorly served at present by CSCI reports. At best they supply a list which can be used to investigate each home for yourself but are certainly no good guide to finding a good homeEMI unit. The only way to be sure that you know what attention your loved one is receiv ing is to visit often and complain loudly if what you see is not good care.

    xxTinaT
     
  8. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    3,725
    North Derbyshire
    Karen, interesting point re abuse. You may know that I had need to question mum's care home a while ago re her allegation that she had been pushed to the ground by a member of the night staff. To my mind the allegation was fully investigated, a report submitted by the staff and to the manager, and I forgot about it.

    Yesterday I was updating myself on the CSCI reports on the web, and under my mum's care home, the report in 2006 stated that "allegations of abuse were appropriately investigated and dealt with". Fine. But when I reported my mum's allegation of abuse I was told that there had been no previous reports of abuse. Hmm.

    I looked at the report for other homes in the area, and none had any mention of reports of abuse. Just makes me wonder why mum's home had the fact of proper approach to reports of abuse when others had NO reports of abuse. Should I be concerned about this?

    Margaret
     
  9. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    3,725
    North Derbyshire
    Dear TinaT

    Nice idea to have residents able to move between different day rooms, but my mum just about manages to find her way from her current bedroom to the current dayroom. On one occasion, she had to move bedroom, and chaos ensued as a result. I don't really want any changes for my mum at all, although another small sitting area on the same floor might be nice, but then you would need the same to be provided on all three bedroom floors - not practical.

    Margaret
     
  10. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    69,594
    Kent
    On my mother`s EMI Floor was a large sitting room, TV on at one end CD player on at the other end, a dining room, and a quiet sitting room.
    But none of the residents found the quiet room. It was always empty.
     
  11. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    In John's home, there are quiet areas on the residential and nursing floors, but only one lounge and the dining room in the EMI unit.

    I think that's sensible. The residents are mostly either immobile or wanderers, and it makes good sense to have them where they are under constant obsevation. There's always someone watching the lounge, and they couldn't possibly monitor two lounges.

    There are still falls, that's fairly inevitable when people need to wander, but at least tthe staff are on the spot.
     
  12. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    Homes have to encompass the needs of a variety of residents and this should be reflected in the layout. If the staffing level is adequate, there should be no problem with staff popping in and out of rooms. The routine of the home should ensure that drinks trolleys are regularly taken round, toileting is regularly completed, staff do not have to sit within sight of each other to give good care but can be of much more value to residents if they are not always 'in pairs' as they then do communicate and interract more with residents etc., etc. In my husband's home daily writing of reports is completed in the various rooms when staff sit alongside residents, or just sitting on the arm of a chair and chatting regularly take place.

    I'm not asking for the amount of rooms such as Buckingham Palace has, just a few rooms which enable residents to feel in a smaller, more 'homely' environment, rather than what I have seen when residents have only one large room to call their 'sitting/living room'. Surely it is better for residents to feel they are living in some semblance of a normal home environment than in what to my mind seems to be one room which has all the appearance of an 'institution'.

    I visit my husband every day and have seen not the slightest problem regarding supervision of the rooms. As to falls, how on earth can having one room make a difference to this unfortunate aspect of dementia? I was within a foot of two elderly residents when they bumped into each other and subsequently fell to the floor, as was a care worker. Neither of us could have stopped this fall. I have never seen rooms unsupervised for long periods of time. As I say the routine of the care workers is based around the fact that there are several rooms to be supervised.

    It may not be priority for some residents who are immobile to have the choice of sitting in more than one room - not sure about this as if I was immobile I would still like to be able to be moved to another room away from, for example, a noisy resident who is constantly shouting out, or a resident who I felt was threatening in some way towards me, or even just to see another view out of the window! Residents are INDIVIDUALS with individual needs for space, dignity and privacy. Many homes I have visited have layouts which completely disreguard this basic human right.

    As a daily visitor to my husband's Care Home, I personally appreciate a little space and privacy. It is wonderful to be able to chose a fairly quiet room for us to sit in for a few hours, or to go into the dining room where activities are taking place, or to watch TV in another room if there is something on which I feel my husband would enjoy watching for a few minutes. It is OUR choice, not something imposed on us by lack of space.

    xxTinaT
     
  13. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    Tina, my point was that falls cannot be prevented without curtailing the freedom to wander, and no-one would want that, even if it were permissible.

    But the fact that all residents are supervised means that they receive immediate help, and treatment if needed. Very important considering the devastating effect a fall can have on someone with dementia.


    Yes, I agree that where residents are fully mobile that's an advantage, and as I said, other floors in John's home do have several quiet areas.

    But there is no-one in that condition in John's elderly frail EMI floor. I could have privacy if I chose to visit when he is in bed in the afternoons, or asked for him to have his meals in his room, but I prefer him to be in the lounge at meal times. I enjoy the buzz of activity, and I'd certainly rather have him sitting under supervision in the lounge, than spending all day in his room.
     
  14. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    Dear Hazel,

    As I tried to say in my post, with a proper routine and correct staffing levels, no room is left without supervision. Staff are constantly moving along the corridor and there is always staff in attendance. All rooms have a larger than average door and the doors are always open. In the three months I have been visiting daily, I have not seen a lack of supervision anywhere. There is no more incidence of falling and residents are immediately attended to if a fall does take place, I'm sure no differently than in any one roomed home. What about night time? Are patients to sleep in one large room, in case someone falls and is not immediately attended to?

    Sorry but I will never be persuaded that a 1 living/sitting room home is the best possible arrangement for residents, even in an EMI home catering for severely disabled residents. There could be no more severely challenging behaviours and disabilities than I saw in the hospital where Ken was held for such a long time and where there were several rooms (in theory) available for patients.

    xxTinaTY
     
  15. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    Tina, I am happy with John's care home, and the treatment he is receiving. You are happy with Ken's.

    Isn't that what matters?
     
  16. jc141265

    jc141265 Registered User

    Sep 16, 2005
    836
    Australia
    #16 jc141265, Jun 27, 2008
    Last edited: Jun 27, 2008
    I agree with Tina. In Dad's home there was just one room in his section to sit in, that room was both the meals room and the lounge room with a TV and a radio. Otherwise there was one long corridor along which all the bedrooms lay. Worse yet, Dad did not have his own bedroom but shared it with another man, so we couldn't even sit there in privacy, nor could his sharemate have any privacy if we were sitting in there. In Dad's home in otherwords, there was no place where he could have his own space, there was no variety, there was no escaping other inmates. If you wanted to watch TV you had to hope that you weren't upsetting the other residents, or you would have to watch the channel it was already on...if the radio was on, you had to listen to it. I tried to make Dad's tiny little allocation of room his space by giving him his own coloured bedspread, but the staff told me it was too much trouble to wash and put on...for a while there I had a little war going on, where I would go in and put the bedspread on and the next day I would arrive and it had been removed again. The only thing he had that was his alone was a pinboard where we stuck up photos for him.
    As for supervision, I could spend an hour in the one big room with Dad at nights and no staff would be visible as they were too busy putting people to bed to supervise, so I would find myself being the supervisor and coming to the aid of people who would slide out of their chairs or fall over, hoping to God that Mr Macdonald wouldn't strip off again or ask me to help him to the toilet, apologising to the lady who was crying telling me she just wanted to go to bed.
    I know I know Dad's home was apparently not the norm...but as I've said before it was the best his area could offer, so I'm guessing that there are many others living in similar places.
    The only escape Dad had was my visits for then I could take him for walks throughout the rest of the home (he was in a locked section) we could sit and have coffee or tea in quiet rooms in other sections he didn't usualy have access to and I think if I was him that would have been a godsend for me, to get away from it all, to have a little space.
    Nonetheless until the final year when caring got so lax, I too could say I was 'happy' with Dad's home...happy because it was the best there was available for his condition but there was no choice however, not happy because I thought it provided all that a human being should have access to.
    People in homes should be able to have their own private space, they should be able to go sit in a variety of rooms, so that they can avoid people that they don't like if they want to, so that they can sit in rooms with people they do like or who watch the same tv shows or listen to the same kinds of music, or so that they can actually find a room that is empty of people. Dad was a 60yr old, either stuck in a room with other people all with their own crazy habits or otherwise being forced to lie in his bed and stare at the ceiling (for there was no space for him to sit in there) or pace the corridors. If the lady wanted to slap him she could, if the man wanted to come dribble on him he could, if another lady wanted to yell at him she could and they all had to suffer my Dad yelling at the world. It was enough to drive anyone crazy...and I sometimes wondered if you weren't crazy when you went in, whether you'd end up crazy anyway!:eek:

    Now as you can imagine when I post something like this, I am opening my heart, re-invoking a whole lot of pain, a lot of sadness, a lot of unhappy thoughts about my inability to make things better for people who don't have a voice of their own. So I can be told that ideas like Tina's or mine are not sensible in someone else's opinion, I know that there is nothing but goodwill in such a suggestion and rationally I can accept that my opinion may be wrong or just differnt. But on this topic I am highly emotional (and no doubt it is highly emotional for others too) and I can't explain it Hazel, I am very sorry because I am certain it is not your intent, but your insistence that everything is okay just as it is, just doubles my pain. It makes me want to scream with anger, sadness and frustration. I am trying to heal by venting and I feel like you are putting a lid on my chimney. Can you understand that?

    That you are happy with the care your husband is receiving and that others are receiving isn't all that matters, there are a lot of other people not receiving that good care. And I thank anyone who acknowledges that.
     
  17. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    Nat, I have never said that everything is okay just as it is. In fact I spend a lot of my time visiting hospitals and care homes, and talking to medical professionals in an attempt to make things better.

    I know there are bad care homes, just as there are general hospitals where the staff have no idea how to treat people with dementia.

    But in my opinion it is not helpful to condemn all care homes because of some bad experiences, or because a good home is not perfect. I prefer to look for the positive, I find that's the best way to encourage improvement.

    I am not trying to put a lid on your chimney, or to prevent you from venting. You now have your father at home, and are doing a wonderful job of caring for him, but honestly, what experience do you have of care homes in the UK?

    Perhaps it would be more helpful if you made clear to our members that your venting is against an Australian care home.

    Do you deny me the right to show the other side of the picture? I would hate members to think the treatment you experienced is the norm.
     
  18. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    I do not chose to write about the number of forums, committees and so forth to champion the cause of dementia I am on and which take up a large amount of my time, nor of the number of people who get in touch with me because of their concerns regarding care homes.

    I'm afraid it is not just an Australian situation described on one of the posts on this thread (with the exception of single bedrooms which are now mandatory in England in all care homes - wonder if this would have been changed if people did not 'speak up'?) I have almost word for word heard of mirrored experiences here in England!

    I too praise 'good' homes and hold them up as a shining example of what can be achieved. I do not base my thoughts on care homes just on my own personal experience but on what I have encountered both for myself when looking at homes and on behalf of others who relate their expeiences to me.

    All I ask, as you do, is that we have the best possible environment for our vulnerable loved ones who cannot speak for themselves. I'm sure that we can agree on that.

    xxTinaT
     
  19. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    Absolutely, Tina.

    Of course there are bad homes, and there are many improvements to be made.

    I just think that we should at the same time be celebrating the good.

    I'm sorry this thread should have degenerated into personalities. We are both working working for the same end.
     
  20. Tender Face

    Tender Face Account Closed

    Mar 14, 2006
    5,379
    NW England
    I am going to dare a ask a difficult question ...... why is that time not spent with John? Could the campaigning not wait?:confused:

    I know it's been hell with restricted visiting for mum just recently .......

    :confused: Karen .....
     

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