Home from home

Sandra Simkin

Sandra Simkin of the United Kingdom is a published author and former council representative. She was elected to, and served on her Borough Council from 1996 to 2000.

I was elected to my local Council in 1996 and within the area I served there were two Care Homes. They could not have been more different from each other. The first was small and had no more than 20 elderly residents, all of them women as I recall. The home was in a beautiful, modestly grand 18th Century house, a listed building, which means that the building is protected by law, and any change to the external structure or the interior is unlikely to be allowed. It was tastefully decorated and furnished to a high level with comfy chairs and antique furniture, and both the beautiful gardens and the house were expertly maintained.

You entered a haven of sweetness, as flowers grown in the garden were arranged in vases everywhere. In the winter, garden flowers were substituted by dried flowers, fragrant stems, holly and twigs. The residents had a weekly visit from a hairdresser and they all looked beautifully coiffured and manicured and tastefully made up and always seemed to be dressed up in their best as if going out somewhere. There were bright lights and lamps to see by, and a cheery log fire in the living room in the winter. At Christmas there was always a party and no one was refused an alcoholic drink! I never saw any resident being dispensed drugs, although a local doctor did visit from time to time, and when summoned to a sick patient.

The ladies were all bright and alert and encouraged to do crosswords and play games of cards, chess, backgammon and other taxing pursuits and there was a lot of chatter and laughter. The home had a minibus, which regularly took them on shopping trips, days out and visits to the theatre. The Matron made a point of inviting the local community in to the home, and there were informal visits from local schoolchildren, the Women’s Institute and local charitable organisations. Neither the Matron, nor any of the staff, wore uniforms, and they were unfailingly cheerful and happy, as were the residents. Why should they not be? They were cared for as if by members of their own family, and it was their home.

The other home was much bigger, holding more than 100 residents, both men and women, with about a third of them suffering from dementia or Alzheimer’s. You entered into a dark panelled reception area which had a sliding window into an office manned by a uniformed member of staff. There was a pervading smell of urine and disinfectant and no flowers were visible anywhere: residents’ rooms were accessed by long, monotonous grey painted corridors. The atmosphere was more akin to a hospital than a home – by which I mean, it was clinical and unappealing. More than an acre of land was attached to the home which sloped gently down from a wide terrace, with gardens, tennis courts a lake and a summer house beyond, but even in high summer I never saw any resident on the terrace or in the grounds or even encouraged, or helped, to walk, or be wheeled, there. The television was always on loud in the lounge at any time of the day and most of the residents, (or should I call them inmates), were to be seen asleep in the chairs. Those who were alert, preferred to stay in their small bedrooms rather than go into the lounge. I strongly suspected that drugs were used as a control to keep the dementia and Alzheimer’s patients quiet.

The Matron rarely seemed to leave her office, which was always uncomfortably wreathed in tobacco smoke. The uniformed staff, likewise, seem to spend more time in their common room than they did looking after their charges, Most of them were young foreign girls, clearly not doing the job out of love, but they were also not properly directed. There was no visible evidence of a service ethos, and I formed the opinion that they did not have the proper experience or training to look after dementia and Alzheimer’s patients, and consequently all of the residents suffered. There was also not much effort given to taking the more able residents out and about, even though the home had a minibus, as it seemed to stay in the driveway most of the time. I have to say, that I formed the opinion that the home was a miserable place, even though it had a high status as a care home for respite care. Fortunately for the more able, it was a place of residence for only a short time, and I got the impression that for some of them, leaving could not come soon enough! I was affected by my visits to the home, and I vowed that I would rather suffer and die in my own house, rather than go into a place like that! The cost to stay there was in the order of £150 – £200 per week, in the 1990’s.

The owner, however, said that he was not making enough money from his business and he had an ambitious plan to extend the home to bring in more respite care places which needing less servicing were more lucrative. He planned to house the difficult dementia and Alzheimer’s patients in a new and completely self-contained wing. A pleasant enough man, I met him at the home, and he showed me the plans. This went well and I said that I could find no objection to the proposal and that I would support it. And we were about to part on good terms, when I commented on the apparent drugged state of some of the patients. This was a red-hot issue in the newspapers at the time, as care homes had been found guilty of doing this, but he was completely indignant and swore that no such thing happened in any of his homes. Unfortunately I was unconvinced.

Of the two homes, it is the second, the more formal medical model, and not the first – human and relaxed – that is more likely to be approved of by governments. Formal homes are easier to regulate and quantify, and rules and regulations can be more easily applied to them, and a uniformed staff – well, it just looks better, doesn’t it? But even for home number two, new legislation for care homes regarding the installation of lifts and ramped access, alarms and sprinkler systems everywhere, were too much to bear financially, and eventually the business was affected and the home closed. The building has since been converted into a gated residential housing complex of highly sought after luxury apartments.

The sad thing was that the same rules also applied to home number one. The house, being a listed building, could not be adapted to meet the requirements, and the home had to close, and all of those happy, lovely, ladies had to leave. The house is now a private residence once again.

I do not know whether there is a moral to be found in all of this, except that I think that a place that purports to be a home should have the look and the feel of a home, and not that of a hospital. In a home we are a person and not a number, and we don’t need to wear a wristband to identify who we are. We all react consciously, or unconsciously, to our surroundings and even, and perhaps, especially, do those who are suffering from dementia or Alzheimer’s. Make the environment fresh, clean, pleasant with bight pictures and decorations, and have a happy, obliging, staff and the patient will flourish. I cannot help believing that there is something morally wrong about making residential care into a battery farm to produce golden eggs. I think it goes against human nature and is inhumane in every sense of the word. Care and home, are wonderful words and they should mean what they say.