/ Health

Why is elderly care failing? Older people have human rights too

Images of person getting older

The Equality and Human Rights Commission (EHRC) has reported on care provided to older people in their own homes, and it doesn’t make pretty reading. Why is society allowing older people to be treated like this?

Examples emerged from EHRC’s report of people being denied basic rights, such as access to the toilet and the food in their own fridge. For those who have worked in the care sector, as I did for many years, this is sadly not altogether unexpected.

But it’s difficult to identify villains in a system that’s failing so many. Is it about care agencies and poorly-paid workers; is it about poor commissioning of care from private agencies by under-funded councils; or is it about could-do-better regulation?

Older people are human beings too

At first it seemed odd to me that this sort of inquiry came under the banner of ‘human rights’, but actually I now think it makes perfect sense.

Isn’t the real problem that – as a society – we’re prepared to let the social care system for older people bump along the bottom? It’s just about good enough, but it’s nowhere near the funding (or expectations we have) for younger people’s services.

We’ve become immune to care workers rushing in and out for 15-minute visits and driving at top speed to the next person, all because they’re not paid for their travelling time.

And our research shows that councils are increasingly rationing what they provide. In 2009 we found that 66% of councils met only critical and substantial needs. But our latest analysis for 2011-12 shows that 71% of councils are now excluding those with low or moderate needs.

Yes, there are bad home care agencies and poor commissioners, but I think the EHRC is right in bringing the debate back to the issue of treating older people like human beings.

The system is creaking at the seams

Until we admit as a society that we need to up our game on what care we give older people, we’ll never move away from a system that encourages care workers to prioritise a list of tasks, rather than thinking about what the human being in front of them really needs. Or ensure care workers are paid well so we routinely get well-trained, high calibre staff.

I’m not sure what the answer is, but I do think the system is creaking at the seams. The danger is that it could fall apart. And as the EHRC quite rightly showed, it is our elderly relatives bearing the brunt.

Comments
Guest
Karsam says:
24 November 2011

I think it is a disgrace and an abuse of human rights of the way the elderly are treated. Once you reach 50+ you seem to disappear and are largely ignored by the government, councils, management, and in particular by the so called ‘caring NHS/Social services’. I am astounded that doctors and nurses need to be told that they have a ‘duty of care’ towards their elderly patients. Surely if you are a part of the ??’caring profession’ it goes without saying that you have a ‘duty of care’ to all your patients no matter what age they are. It’s frightening, I’m sure most older likeminded people are now very afraid to become ill and/or incapacitated, and are especially terrified of going into a hospital or a so called care home. Personally I want to stay at home and I think I would rather die there than enter any of these places. I was always taught to respect my elders and a civilisation is judged on they care for the old and vulnerable. I think the UK government and society in general has failed miserably.

Guest
Mikhail says:
25 November 2011

I see two problems – young people don’t believe that they will get old; the government didn’t expect the life expectancy to be over 70.

Guest

You are probably right about young people. I can remember even in my 40’s being totally disinterested in the question of getting a pension – but I was not very money-minded as I assumed the welfare state was there to take care of me (that’s what they said when they took my health and national insurance contributions).
But the government has no excuse. Statistical predictions about the increasing proportion of elderly people in the population have been around for years. One of the problems is that ‘the elderly’ have never been a united pressure group, so it was easy to ignore the facts. That plus the endemic ageism in our society.

Guest

The treatment of elderly people in a lot of homes is a total disgrace. No-one would like their own parents treated shabbily but a lot of ‘carers’ don’t give two hoots about the people they are supposed to care for. An additional problem is that a lot of these carers are from abroad and do not speak english very well which is ofcourse a huge problem for elderly frail and sometimes confused people. The same goes for hospitals, often a doctor or nurse barely speaks english which is very annoying when you are at your most vulnerable.

Guest

i do sympathize with the Elderly but as you cannot recruit enough of the local English nurses as most of them do not want to take on a physically and mentally “unpleasant” job, hence the NHS had for centuries has to go abroad to recruit foreign nurses who are lured to the promises of good pay and a attraction of a Nursing qualification. In reality, they are “Modern Day” Maids and may I say slaves because the local people are not prepared to do this most unpleasant demanding job!!!

I’m speaking from my own experiences as I’m a nurse for 38 years.

Guest
Gerald says:
31 October 2012

I have worked in Care Homes now for nearly 30 years and I have met nearly all types of people from all parts of the World and this leads me to believe that you really haven’t a clue about what you are talking about, In English Nursing Homes it is obligatory to staff 24/7 with a Qualified Nurse who must be Registered in England with the Authorities. All Nurses from abroad must be vetted by an existing Trained and Registered Nurse over a 6 Months period to ensure they are able to carry out their duties in the Care Home.
I am not aware of the regs. in the NHS but I believe many Nurses who have passed through our doors have subsequently worked in the NHS
.Please try and get out of your “Island” mentallity and understand one simple fact ie WITHOUT NURSES AND DOCTORS FROM ABROAD THE WHOLE SYSTEM IN THE NHS WOULD HAVE COLLAPSED YEARS AGO.
Perhaps the above concept is to large for small minds to understand but hey we keep on doing this thankless job of ours.

[This comment has been moderated for breaking our commenting guidelines. Thanks, mods.]

Guest

Hello Gerald, please do not make your comments personal, and especially don’t insult other commenters. Read our commenting guidelines for more info: https://conversation.which.co.uk/commenting-guidelines Thanks.

Guest
Gerald says:
25 June 2013

Dear Patrick,

Glad you are keeping your eye open wouldn’t want to upset people would we , even if they are demeaning and insulting to us .

Guest

This is not my experience. My, thankfully brief, stay in a care home which I was told was very good (I was unable to check this out before as I was an emergency),was only made bearable by the presence of 2 foreign nurses, both from Rumania and both speaking excellent English. The otherwise English staff were indifferent and sometimes quite unpleasant. I could see them chatting over coffee in the office and totally ignoring the board registering bells calling for help.
Also, when I’ve been in hospital I found the foreign nurses excellent and very humane. Perhaps because they come from countries where elderly people are respected and cared for at home. Stop blaming foreigners ; we are responsible for this mess.

Guest
Lucia says:
29 November 2011

The blame cannot be totally put upon the paid Care Worker. I believe the MAIN problem should be put upon the Management of organisations ( and many of them advertise themselves as being Non-profit organisations) which employee the paid Care Workers who care for the elderly in our society.

The main issue is TRAINING. How well trained are the paid Care Workers before they are sent out to care for the vulnerable people in our communities. From experience one Care Organisation continually attempts to send paid Carers to help my father with dementia without prior dementia awareness training, or attempt to send unknown paid Carers without first coming along with an experienced carer of my father. Fortunately, I am able to speak up for my father to ensure he receives the best care. We are at present happy to have three main carers who are excellent. The only problem is when they go on holiday and their Organisation attempts to send us carers not known to my father.

The other issue is PAY. We obviously do not think much of our vulnerable people in society when the paid Care Workers and not paid a decent wage and not paid travelling expenses and not given enough time to care for these vulnerable people.

Another main issue is INSPECTION. Who checks the Organisations that provide paid Care Workers?

As for carers that come from abroad that can be useful for older people who have lived in the UK but originally come from other countries. For example due to his dementia my father has returned to speaking his native language, thus a paid Care Worker who spoke his language and understood his culture would have been very good.

Guest

I agree with Lucia. Until this or any Government looks at how to limit profits on any care company and others for that matter, we will not see them investing in ‘TRAINING, PAY or INSPECTIONS’.
I am sure if the PAY levels were much more realistic that this encourage more indigenous (English speaking) people to join the the Caring Profession. There are plenty of people on the ‘dole’ who would be prepared to be offered the opportunity to work, if going to work didn’t mean them losing benefit money.

Guest

Care assistants, auxiliary nurses and the like may get
what may appear to be small beer to many of us but
repatriated back to their countries to their families in
the likes of the Philippines, goes a very long way
indeed.

Little wonder they keep coming and being here, like to
stay on.

Old folks’ homes for one are quite dependent on their
services and as someone quite correctly points out,
local-educated people are not minded to take
on jobs perceived as of low status and having poor
pay and working conditions.

Likewise in the hospitality industry and a few others.

Guest
Gerald says:
16 November 2012

We have employed Philipinoes (Mainly Qualified Nurses) for many years , becuase of the lack of British Nurses willing to do this work. They are also now being employed more and more by the NHS.
We have always found them to be hard working and pleasant people who come miles from Home solely to provide for their families at Home. Surely this attitude should be applauded and not ridiculed.

Guest
nurse gladys says:
10 January 2012

Ive been an RGN for 24 years & have worked for the main part in nursing homes, however I have finally had enough. The standards have dropped, attitudes have changed & no one in authority seems to care. Training is none existent, new staff are counted in the numbers from day 1. The majority only had a basic grasp of english(boy did the owner exploit that one!) If you pay staff the minimum wage, work them to death & completely disrespect them, how can you expect 5 star service & care. I regularly worked 18 hour shifts without a break(even though an hour was deducted each day) My wages were usually short, rarely was this fully remedied. On the weekends roast chicken was on the menu the owner deemed 1 x 4lb chicken enough for 38 residents. The kitchen & stores were locked around 5pm & if people were hungry overnight its a good job we all took plenty of food with us. I could write a book but I’ll stop there. I am ashamed to say I resigned but would have dearly loved to take a few of the little oldies with me. The attitude to older people & their care & welfare really needs to change. We owe everything to these people.

Guest
Retired Nurse Kathy. says:
19 March 2012

I trained as a S.E.N in 1979, then much later converted to R.G.N. My experience over the years was mostly care of the elderly in hospital. I also spent many years as a Community Nurse which again was mostly elderly care. When I was being trained in College/ University we were taught to nurse at a high standard. My experience on the wards was a complete contrast, there was never enough staff, days/night shift, many patients didn’t get the care they deserved such as personnel hygiene, help with feeding, and finding time to communicate and help with mobility. Myself and many other members of staff/ team were just as frustrated, we had been trained to a high standard but felt we were failing our patients needs and there family’s needs, it was impossible to maintain such high standards when we had a shortage of staff, which was often I might add. I became disappointed and frustrated and I felt a failure. I moved jobs and became a community nurse which was so much more satisfying.

The care of our elderly loved ones is a disgrace, be it in hospital, residential care and nursing homes, I have from my own personnel account of this as my elderly aunt aged 91, and my friends elderly relative have both had a recent admission to hospital, both relatives were not fed or did they not have access to their drinking water, both were continent before admission, but shortage of staff made this another problem and caused extreme loss of dignity despite there age. I would also like to add that the meals they were offered was discussting, and we were taking food in. We were both told that they didn’t have time to feed relatives and we would have to go in and do this our selves. My cousin works full time and so does my friend, we had to sort this out our selves. This is disgusting!

The standard of care has dropped due to the fact that there are so many people being employed by the fact that they are holding the title of health care assistant, or personnel assistant and yes they have minimal training and are CHEAP!!!! Compared to a trained nurse.

Guest
gerald says:
30 October 2012

Dear Gladys,
Nursing homes, as you know, are run by nurses if they are as bad as you say why have you and your colleagues not done anything about it in all the 24 years you have been working there. The nhs were in charge of nursing homes at this time and could have easily closed them down if they had wished.
Maybe nurse kathy’s memories of the hospitals might explain the problem which i had to deal with in trying to improve care in the private sector over the last 30 years.
The situation is still not perfect but and it never will be due to under funding of the private sector (cost of care home placement one quarter of the price of a hospital placement)
When condemning a nursing home please be so kind as to compare with the hospital equivalent which is four times the price.

[Hello Gerald, we have edited your comment to make it ‘sentence case’. Please try not to write in all Capital letters as per our commenting guidelines. Thanks, mods.]

Guest
Jasmine says:
8 May 2012

I have been campaigning for continuity of care and experienced carers that have been trained in moving and handling. The care is for my 81 year old mother who has a spinal injury and associated problems. A year ago social services farmed out long term care to the private sector, I had meetings with care provider, abandoned by social services, complained to social services,complained to Quality Care Commission.. Whilst care provider was under review with the Quality Care Commission Mum had continuity of care and carers that knew there job. Once the care provider had all their ticks from the Quality Care Commission they informed social services that they could no longer cover Mums care for 4 hours a day.
I am not sure that complaining about the poor care that Mum had received has done us any favours, social services have now placed her with an care provider that have the same if not worse issues.
Social services said that we had to proceed or we would be left with no care, it was the only option, the only provider that could cover the 4 hours a day.
I looked at a list of approved care providers and emailed a reputable one to see if they could fit in 4 hours care a day, they said they could with notice.
Why we had no choice could be that this particular care provider was the only one in the price range that social services were prepared to pay
. A young girl was sent in today she could not roll Mum or use a slide sheet. She did not know what a night bag was or how to connect it, her partner was not competent enough to instruct her. Just one story of many we have gone from bad to worse.
Do I let it end here or carry on?

Guest
gerald says:
30 October 2012

This is happening all over the country, don’t blaim the care provider blaim the council and goverment for underfunding

Guest
Jasmine says:
31 October 2012

After reading the above comment I felt the need to comment further. Yes I do blame the “system ” for many of the failings in our situation. After social services placed Mum’s care with the private sector she had 35 different carers in 15 weeks, she had to instruct everyone on how she should be handled. At this stage she had been paralysed for 16 years she had more knowledge than a carer who had been working for a few weeks with little training.
After the initial 15 weeks she became exhausted and attempted to take her own life, one of the triggers was her care situation. We required support from social services this did not happen.
On the whole many of the “carers” are lovely people failed by the ” system “.
Mum’s care has settled into a workable package with approx 10 carers meeting her needs. Continuity of care has been a problem which has led to important tasks being neglected etc. etc. I am here to pick up the pieces, I fear for the people who do not have that luxury.

Guest
Gerald says:
31 October 2012

The whole “system” is TOTALLY under the control of The Social Services Department of the County Council. The Fund, Specifiy services obtain tenders and place Contracts to Providers .
They are also repsoncible for monitoring and vetting the service and for removing any unsuitable Provider. The only other agency which has just recently been involved is the CQC which as others have pointed out doesn’t really get that involved as yet in vetting the Care at Home System.
Before even properly starting the Public Sector through various avenues have begun to blame the CQC for the mess that the “Care at Home” system is in >As usual the Public sector blames everyone (particularly the Private Sector) for the mess THEY have caused.

Glad to hear that mum is getting a workable pakage from your new Provider, some problems cannot be dealt with overnight.

I personally do not think that this system will ever work properly without the correct level of financing Bearing in mind the whole idea is that it should be cheaper than a the Residential Care Home which it’ s supposed to replace at £500 per week for 24/7 Care

Guest

Native carers in our caring establishments is in the low %’s, because we refuse to work within establishments for minimum pay to the profit of indifferent care companies and as Care assistants in the community visiting elderly people in their homes for a pittance and too short a time to make any difference.
We have allowed Carers from newly inducted eastern European countries to take up many posts that were once held by Peoples from the Indian sub-continent. From my experience as a home manager those workers from India and its environs were prepared to give attentive caring and professional service to the elderly client group, but they are now banned from working to our detriment.
All this as a result from ignorant Governmental and Whitehall officials without a clue other than to be the only country to abide by European RULES..
As a singularly proven heartless Nation who are not prepared to care for their own elderly relatives as the do on the continent of Europe we shall reap what we failed to sow: Nothing except the lonely unhappiness of our elderly parents.

Guest
Gerald says:
14 January 2013

Dear Anthony,
I have been involved with Care of the Elderly for nearly 30 years and I have met many different people from all over the world and to say the least I am amazed to read your comments degrading your colleagues and the rest of this Country, you obviously haven,t visited other Countries and seen the appalling conditions out there.The main reason we have found for “Native workers” not taking up jobs is that the dole system encourages them not to.
In the Group I work for Good Caring “Native ” workers are by far in the majority maybe it’s your own employment policies (as a manager) you should be looking at

Guest
Gerald says:
21 January 2013

General Question

Has anyone had any help or assistance form either Help the Aged or Age Concern????

Guest
Gerald says:
7 February 2013

This question now needs urgently asking to the NHS doesn’t it??????? or doesn’t WHICH realise they are the largest Organisation involved in care of the Elderly??

Guest

Social services are responsible for the allocating of Community Care resources and work within a budget set by Government. The people that they employ to deliver Home Care services to the elderly in particular are expected to work within time lines of service delivery which do not allow for more than is prescribed on the individual care plans. The result is that many elderly have to manage on brief visits from efficient staff who deliver the care prescribed. Most Home care delivery staff on the ground do a satisfactory job. Only People of independent financial means can afford the levels of care that should be expected by everyone in an ideal world.
Social Services are forced to constantly raise the Criteria for receiving Home care services as budgets shrink leaving those who are unable to adequately represent themselves with poor services.
The Government refuses to say the words that are required to solve the problem: WE MUST ALL NOW TAKE RESPONSIBILITY FOR THE CARE OF OUR OWN ELDERLY FAMILY MEMBERS.
The state can no longer afford to do this for us.

Guest
Ariadne says:
14 February 2014

1. Demographic changes will mean the problem will become much worse.
2. The UK does not have the financial resources to deal with the problem adequately.
3. The solution lies within society itself.
4. There has to be better cross-generational relationships.
5. Young people want their own accommodation.
6. Working parents want third party childcare.
7. Many older people suffer from loneliness.
8. Older people have skillsets.
9. It is wrong or too radical to suggest that – rather than concentrate on leaving an inheritance for those that follow – there should be some kind of cross-generational understanding/arrangement whereby the older members of society are cared for by the younger members in the final years in return for “the inheritance”.

Guest

The only way to improve the lot of elderly people needing care is to look to the people who should be providing it. The relatives or children. If all offspring were required by law to have made arrangements for their elderly relatives from whom they hoped to inherit, then this problem would hardly exist. Families in this country have a history of passing on wealth to their members. if this was only allowed following adequate and proper care packages being purchased and put in place by the inheritees for the people whose money they hoped to get. Those elderly folk who unfortunately don’t have relatives or whose relatives fail to make provision, would be served by a
government dept set up for this purpose and thus denying inheritance to take place. ‘This is a fair and just way in which our elders, many who have worked hard all their lives, would be better served in old age. The British people should be ashamed of the care system as it is now.

Guest
Ariadne says:
22 February 2014

I have heard that the legal position in Germany is that adult children are responsible for their parents in old age and that the state can look to them to fund care home fees.

Guest

I agree – where the elderly have children it should be a family responsibility to help in their care when they need it. For those without family help, and lack of finance, then the socially-run care system should look after them. This would relieve pressure on an overloaded system, but more importantly provide loving and considerate care. For most of us, our parents looked after us when we needed them – payback time (hopefully for most of us a willing, if maybe inconvenient, act of love and respect).

Guest
Ariadne says:
23 February 2014

I wonder what the majority of the population would say if that were to become the law in the UK? If one of the main political parties were to put it in its next manifesto, would it be regarded as a vote winner or a vote loser? Presumably, it would attract the votes of the older generation. Would it lose the votes of the younger ones? Would this be a new political divide? I wonder if anyone has ever done any research into it and, if so, what was the result. Perhaps, if there were one of those 100,000 petitions it would achieve a debate in Parliament. Should we ask “Which” to look into it?

Guest

@ Ariadne

‘I have heard that the legal position in Germany is that adult children
are responsible for their parents in old age and that the state can look
to them to fund care home fees.’

Singapore has similar laws too but it is rarely if at all enforced coming
from a legal practitioner or lawyer there well-versed in such matters.

Guest

I can’t see this ever becoming a political issue, Ariadne. I just don’t believe any of the mainstream parties would include it in their manifesto. Maybe German people are more accommodating to this kind of rule han I think the UK’s citizens would be. I gave your potted summary of the situation earlier a thumbs-up as I think you have consisely identified the key issues that need to be taken into account.

There is a prevailing feeling in this country that society’s general norms more or less achieve the most satisfactory outcome in terms of support of the elderly by younger relatives without any degree of compulsion. It depends on goodwill, tolerance, a sense of obligation, plus time, ability and financial resources of course. In that complacent state of affairs bask the public authorities, both national and local, who have somehow lost sight of their priorities. Having enabled us to live longer and have our bodily weaknesses ameliorated by various bits of apparatus, an outcome from which the state derives immense pride, the authorities have neglected to put in place a decent support mechanism for those who need it most. How can massive tax credits be available for having children but virtually no financial support be to hand for those whose parents are barely surviving in any dignified sense?

I see the main problem at the moment is the advanced age of the generation next below the elderly. We know several relatives in their sixties and seventies who are now looking after, to a greater or lesser extent, their mothers or fathers – or both [or all four] in some cases and not always together – and finding it a real struggle. Just getting the help and support supposedly available from ‘the system’ is a major exercise, especially when large distances separate the relatives and they are dealing with local authorities and hospitals with which they have no other relationship and do not even understand their priorities