But when illness struck she was forced to go into a nursing home, where she died a few months ago. The damning report published this week by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting on standards in private nursing homes, comes as no surprise to my family.
It was in January last year that she was taken ill with heart failure during her regular winter stay with us in London. Combined with her severe arthritis and failing sight, this made 24-hour nursing care necessary. My parents took her to a nearby private nursing home, recommended by their GP. The cost was pounds 474 a week (funded partly by the Government).
My mother soon became uneasy about the care offered there. No one seemed to have the time to give my grandmother the regular movement she needed to stay mobile, except her family and the physiotherapist we suggested and paid for.
One day we arrived to find the place so short-staffed that a desperately overworked nurse was cooking the meals. The food was so poor that we constantly supplemented it. After six months we decided to try another home.
Nursing home number two, where my grandmother spent the last six months of her life, charged even more than the first, but at least we could see where some of the money was going. It was freshly painted with unstained carpets and no pervasive smell of urine, had well-kept gardens, florist's displays, a hair salon, attractive public rooms and a proper reception. Her bedroom had a balcony, small bathroom, phone and television, and bed linen was changed at least once a day. The cost was pounds 560 a week.
These were certainly better facilities. But a good nursing home ought to offer more than a hotel - a caring community in which the individual needs of patients are understood and where rehabilitation is as important as maintenance and containment. Once food, medication, cleaning and changing had been dealt with, it seemed the only diversion for patients confined to their rooms was a fortnightly hairdo and television, which some watched from dawn until the early hours.
My grandmother took her radio and talking books, but encouragement to listen and help in finding programmes was left to us. She eventually lost interest and began to sink into an uncharacteristic depression, treated with drugs. She was never taken into the garden except by us and we were not often available during the day. Again we had to insist that she was made to exercise and point out that with help she could use her lavatory rather than being put on the commode - always quicker for staff.
Patients lying alone for much of the day should at least be able to look forward to meals. All three courses were served at once, an obvious turn-off for those with weak appetites. Bread and cakes were usually stale and jacket potatoes undercooked. Granny's one request - for a boiled egg at breakfast - defeated them. It invariably arrived cold and bullet-hard and, once, like a salad egg, to be eaten with fingers. She gave up asking. The fresh orange juice promised never materialised.
Christmas cheer arrived on the conveyor-belt. We found my grandmother, whose appetite was bird-like by now, with a tray of untouched food, a glass of wine (she hated wine, but no one had asked if she might prefer sherry) and a dismal cracker. What fun in pulling a cracker on your own, even if you have the strength?
Most worrying of all were the frequent staff changes, reliance on agency substitutes, poor communication and inefficient handovers which meant that serious changes in my grandmother's condition were often left to us to point out - always at the risk of being made to feel we were interfering and over-protective. Several times the doctor was called only at our insistence and each time an infection was diagnosed. The week she died an unknown nurse tried to give her an extremely strong antibiotic when she had already completed the course - luckily my mother was there to intervene.
Although several of the staff nurses were competent and caring, they always had so many patients to cope with that daily care was left largely to young, untrained care assistants. All addressed my grandmother by her first name, something her generation reserved for close friends and relatives.
In her final hours, the only familiar faces there for her were ours. The agency nurse in charge was badly briefed and unaware of the presence or name of the physiotherapist attending her. Although they were kind in letting us stay overnight, after her death we were kept standing in the corridor while doctor and nurse argued over the necessary formalities. The final straw came the next morning when my mother returned to collect her mother's belongings, having requested that they be left untouched overnight. They had all been packed into plastic bags.
Why did we leave her there? With home nursing and private hospitals prohibitively expensive, the only alternative was moving to yet another nursing home, which might well have left her worse off. At least she had a pleasant room, was fond of a few of the nurses and family, and friends could visit daily.
But without those visits I hate to think what would have happened to her alert and active mind. And I hate to think of the patients still there, many of whom never appeared to receive a visit. Yes, there are worse places to die. But is this really the best care money can buy?
The letters of complaint that my mother wrote to the manager before and after my grandmother's death remained unanswered for six weeks. She then heard from the head office. They admitted that the care was not up to standard, and that the manager of my granny's home was 'no longer in his post'. For my grandmother's sake, how we wish they had been aware of that while she was alive.Reuse content