The other day I was visiting my Grannie at the care home where she lives. It’s a residential home about 10-15 minutes drive from us which has a newly constructed annexe providing nursing care primarily for those with dementia. Grannie, thankfully, hasn’t suffered from mental degeneration aside from short-term memory loss and occasional disorientation, and at almost 95 years old she still completes the Guardian quick crossword every day. And usually a few more out of her puzzle book. She is visited by either Mum, Dad or me every day.
The other day while we were sat together in the lounge, two care assistants came in to help a male resident to the toilet. We have all noticed a distressing decline in this man recently – while never particularly animated, he used to greet me with a wink, and would share toffees with another resident whom he sits next to in the lounge and eats with in the dining room. But lately he has seemed increasingly depressed; he appears more confused and is more agitated when asked to do something. When his son comes to visit, my heart breaks for them both as they exchange pleasantries and then are left unsure of what else to say.
As this man, R, was helped to the toilet, one c/a asked him how his day had been. He replied, “Not too bad,” before adding with a slight smile, “It could have been better.” The c/a smiled and said, “Oh, but that’s what we all say, isn’t it?” Then she looked at me and laughed, “I’d love to swap a day – sit and do nothing all day.” I smiled back because there was no malice in her tone, just exhaustion. But I remain acutely aware that her conception of “doing nothing” is very different to R’s reality.
For most of us, a day doing “nothing” means a day in we have a choice of what to do. And even if we consciously opt to do “nothing”, that might consist of lying on the settee watching TV, or a film, or curling up with a book, or playing excessive amounts of Scrabulous, or going for a walk, or spending some quiet time with friends or family. It feels like “nothing” in comparison to our usual routine, but we’re almost always doing “something”. For too many – in fact probably for the majority – of care home residents, “nothing” really means “Nothing”. It means sitting in a chair alternately dozing or staring into space; perhaps exchanging a few words with someone passing by; or staring blankly at a TV screen that blares incomprehensible nonsense day in and day out, and which is always switched on to provide some semblance of activity, attempting to disguise the fact that the daily lives of so many of these people are virtually empty.
The home owner recently employed an activities coordinator, but the fact that she is contracted for no more than ten hours a week belies the primacy of profit underpinning the whole enterprise. As it happens, this makes no real difference to my Grannie who exists quite contentedly in her own company (though I have no doubt she would decline rapidly were it not for our daily visits) and doesn’t hold much truck with organised activities (and it’s crucial that individual choices and personalities be respected when it comes to activities, rather than assuming that all old people enjoy bingo, or that simply because the coordinator is there, everyone will automatically want to join in with what’s offered). But for other residents the activities are a real high point of the week and they will continue to talk about them for days afterwards.
Care homes differ markedly in the amount and variation of activities they offer to their residents (and this is clearly reflected in their prices), but all of them could and should offer more. Mental, social and - where possible – physical stimulation is absolutely essential if care homes are to provide an environment in which residents are encouraged to thrive (and that will be interpreted differently for each individual) rather than just expected to decline.
