New BBC series shows the increasing difficulties in caring for older people
Protecting our Parents reveals multiple issues with the fragmented systems of health and social care
Time – or rather money – is running out for 83-year-old Betty in the temporary care home placement where she’s spent a few weeks recuperating after a fall.
This resulted in her being admitted to Heartlands hospital in Birmingham, but she now urgently wants to go home. Her niece Rhonda watches as a social worker tries to persuade Betty to agree to the council clearing her house of some of the possessions she’s built up over decades. These will now, it’s suggested, prove a health and safety hazard when she moves back in, increasing her risk of another fall.
“We’ll need to get in touch with the environmental health people” says the social worker, as if the house clearance is a done deal. But Betty, furious and upset, wrestles back control.
“What possessions I have kept for my own pleasure is my business” she insists angrily, before suddenly being engulfed by sobs.
It’s been hard for Betty to agree even to a short stay in a care setting to convalesce; the idea of professionals interfering in her private affairs at home is clearly intensely distressing. “I don’t want to hear the words social services ever again in my life”, she finishes, closing her eyes as tears slide down her cheeks. The social worker looks on with a mixture of sympathy and frustration.
Betty’s plight is just one of the life stories illustrated in the new BBC series Protecting our Parents, which scrutinises in discomforting detail the question of how we are going to care for older people and protect our own futures as the number of pensioners continues to rise.
There are, the first programme explains, more pensioners than children living in Britain today: the intimate personal crises filmed at Heartlands hospital demonstrate the myriad ways the health and social care systems attempt to treat and support people despite not being designed to cope with the rapidly increasing demand.
Allowing a documentary team to film elderly people when they are at their most vulnerable is a big deal for any healthcare provider. Consultant geriatrician Peter Wallis, clinical lead for elderly care at Heartlands hospital, was a mixture of keen and cautious when the BBC approached them for access.
“The media focus tends to focus on extremes of care, which [can be] demoralising for staff and frightening for patients and carers,” he says. “The idea was to product a realistic and honest view of caring for older people and people working in the sector.”
Consent was a serious issue that had to be resolved: legal advice was taken and individual assessments made in consultation with family when patients were unable to give consent themselves. Because the care of most older people is done in the community, Wallis explains, initial meetings with the documentary teams encouraged the BBC to extend the series’ remit to follow people as they were discharged, to look at how well they coped with the community support available.
There is a need to balance the benefit of an older person staying in hospital against the risks of infection, disorientation and institutionalisation, as well as what Wallis calls the “withering” of their support networks at home. Then there is the contentious issue of how caring for elderly people is paid for – and the bills fought over – by health and social services, and what happens when you can no longer stay in your own home.
By the end of filming, series producer Alice Perman says that she and the team felt “pretty despondent”. This was not because of the quality of care they observed, but because “there isn’t enough discussion across society as a whole about what we want to happen to us as we get older,” she explains.
“What we felt,” she continues, “was that if you have support, pushy family members who can interrogate decisions and corral the professionals, you can get somewhere. But if you’re on your own trying to hold your ground, and getting to know what you do have access to and what’s available, it’s a much trickier process.”
The system as experienced by the patients she filmed over the course of a year appears, she says, to be “really fragmented: health doing one thing, social care another.” The House of Lords report Ready for Ageing underscores her point that the system as it stands is not going to cope.
“It is one of the big issues of our time” agrees Wallis. “My concern is that people are only just beginning to become aware of it. We need to plan for older age. You only have to find yourself a little bit disabled to realise how hard everything is.”
The scale of the demographic change – there will be 20 million pensioners in the next 20 years – means there has to be an urgent switch in how we approach caring for elderly people in our society, he says. “We need to do all that we can to promote healthy ageing to avoid a frailty crisis. And the health service is reactive – it needs to become much more proactive in terms of health and prevention.”
http://www.theguardian.com/social-care-network/
