My father-in-law recently died in a hospital ward where he had developed appalling bedsores. Patients were often to be found wandering confused and unattended, the nurses seemed more interested in their computers than their patients and – on the two occasions we finally managed to speak to a doctor – we got conflicting stories of whether he was dying or being cured.
This is not an unusual experience. The elderly are being let down in large numbers, the Commission on Improving Dignity in Care for Older People has concluded. Compassion needs to become central to nursing. Well, there's a revelation.
Still, it needed saying, because there is an epidemic of abuse. Since Gransnet launched last May, this has probably been the most frequently discussed issue on our forums. Many of our users have elderly parents alive, or have seen for themselves (for example) the patient in the next hospital bed called an "attention-seeker" by nurses for asking to be propped up.
Individually, the examples are relatively trivial; together, they amount to a systematic reducing of older people to less-than-human. The father whose hearing aid was removed because its whistling bothered hospital staff: immediately rendered less than competent. There was the mother left for an hour and 40 minutes after she asked to go to the toilet; eventually, she wet the bed. When a nurse finally turned up, she said: "We all have these little accidents." But this woman wasn't incontinent, just humiliated.
Some, no doubt, will mutter that the Commission's insistence that no one should be allowed to say "old dear" is political correctness gone mad, the thought police at it again. But, as so often, dismissive language is a symptom of deeper fear and hatred. Ageism seems to be in a similar state to what sexism was when I was a child, or homophobia in my teens: so ingrained that, most of the time, we don't even notice it.
"Do you walk with a stick at home, dear?" one of our members was recently asked as she made her way down the ward after an operation. No, she said tartly, "at home, I ride a bicycle". Another advises: "Always take a photo of yourself surrounded by your grandchildren to put by your bed." Give people half a chance and they'll objectify the older patient, see them as someone without identity or personality.
So, are nurses to blame? Have they, as is suggested, become "too posh to wash"? This argument holds that things have gone downhill since nursing became a degree subject and Matrons disappeared, along with their strictures to young nurses who dared to look under-occupied.
The draft report, which was put together by the NHS Confederation, the Local Government Association and Age UK, goes some way to endorsing this view, pointing out that the NHS would do well to learn from John Lewis and recruit people who have the right values, then give them the skills. A degree is no guarantee of empathy, sympathy or, that most unfashionable virtue, kindness.
It's not simply that a cohort of go-getting nurses has lost interest in paying attention to people, or got too grand to sit and talk to the patient who has no visitors. The Royal College of Nursing has found that older people's wards typically have one registered nurse to between nine and 10 patients, whereas adult general and surgical wards have one to six patients.
This is completely the wrong way round. It ignores the fact that older people's needs are much more likely to be complex. It's the little things that get overlooked as a result – like forgetting to give people their spectacles, or getting patients out of bed to change the sheets then not getting round to it all day, so they have to take their nap in a chair. Small things, perhaps, but they add up to a pervasive air of neglect and disdain.
These too-few nurses are overwhelmed by administration. To transfer a patient from hospital to a care home, it is necessary to fill out a 70-page form. It's no wonder that so many of us have stood at nurses' stations waiting for someone to look up – and, when they do, to behave as if we might have something useful or interesting to say.
There is, of course, nothing wrong with inspections and setting standards of performance (just as there is nothing wrong with nurses taking on responsibilities that used to be managed by doctors), but it's human nature then to deal with the more measurable things first. Hospitals assess
how many people fall over on their wards but not the quality of patients' experience.
Most old people aren't in hospital for months on end. The long-stay geriatric wards of the past are gone; these days, older people are shipped out to care homes. This is not inevitably a bad thing – hospitals with their 50-bed wards and lack of calm, quiet rooms to talk to relatives are not well-designed for the old. But care homes, even where publicly funded, are privately run, and there is no requirement to employ qualified nursing staff even if what is really needed is nursing care.
Increasingly, we are warehousing people in large care homes, tended to by poorly paid (though sometimes devoted) staff where we can do our best to forget abut them until our turn comes. It is inhumane, and it's small wonder that most people dread the prospect.
This latest report is not the first broadside against the dreadful care of older people. It follows other well-researched protests by the Patients' Association and the Care Quality Commission. Last week, the National Pensioners Convention published a not dissimilar set of Dignity In Care guidelines.
What they're all saying shouldn't need to be said. Why wouldn't nurses and carers look after people properly, when it's their job? If similar cruelties were visited on children, the stories would never be off the front pages. But we inhabit a world in which speed and youth and the ability to earn money are prized above all qualities, where an ageing population is seen as a burden as well as, more viscerally, faintly disgusting. Until we can censor ourselves and stop thinking about "old dears" rather than vivid personalities, about a drain on resources rather than people who have something to teach us, there is no hope.
Geraldine Bedell is the Editor of Gransnet: www.gransnet.comReuse content