Johann Hari: My grandmother deserved a better ending than this

She was a brilliant and much-loved woman. The story of the final 10 years of her life reveals a shocking truth about how Britain treats its old people

Friday 14 January 2011 01:00 GMT
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My grandmother died on Christmas Eve. I know that the death of a 90-year-old woman in her sleep is not a news story, however good and kind and loving she was – but what happened to my grandmother in the 10 years leading up to her death should be a news story. It should be a national scandal. Except it is happening to hundreds of thousands of elderly people in Britain today, shunted into care homes that depress, drug and wither them. And as a direct result of David Cameron's policies, they are about to get even worse.

When she was 80, my grandmother was run over by a speeding drunk driver, and her life as a self-determining human being suddenly stopped. A woman who had always been frantic and frenetic – raising three kids on her own in the Scottish tenements, working any job she could find – had to stop and sit. It would have been hard for her, wherever she ended up, and however they treated her. She had been somebody who was always cleaning and clearing and running around, pausing only to watch Coronation Street and horrifically violent horror films. (Her favourites were Saw III and Sewage Baby.) But she ended up in a home that inflicted horrific physical pain on her – and I had to move her through two other homes until I finally found one where I felt she was physically safe.

My grandmother did not believe in moaning about anything. So when I first visited her in that first home, and found her in a wheelchair staring into space, with a cold and foul pie in front of her, she said everything was fine. Although homes are supposed to lay on activities every day, I hardly ever saw any happening. There would be rows of people in metal chairs looking into the middle distance, and occasionally a surly member of staff would give them a balloon to pat to each other. Yet if you stopped and spoke to these people, they were lucid – and agonisingly bored.

I knew something was badly wrong, but I was selfishly dashing around with my own worries – until one day I visited my grandmother and she was refusing to get out of bed. She still had some mobility in her legs, so to make sure she didn't lose it, her medical notes said she should be made to walk to breakfast each day. She had been saying for months that it was far too painful, but the "carers" told her she wouldn't get any food if she didn't do it and it was "necessary". "I'm not walking," she said, crying. "It's agony." The staff were clucking and telling her she was "misbehaving", as if she was a toddler.

This was so out of character that I immediately knew something was wrong, and I insisted they call a doctor. They hummed and hahed and only agreed when I got angry. She was finally taken to hospital and X-rayed. The doctors found that her legs could no longer support her weight – she was a big woman – and had suffered severe stress fractures and breakages that must have been there for months. They had been forcing her to walk on broken legs.

I immediately assured her she would never have to go back there, and I have never seen anyone so relieved. So I found a home in London with good inspection reports. It was still bleak and boring, but there were activities in the day she really enjoyed. She was beginning to suffer from dementia – occasionally, she would suddenly become paranoid for no reason, and think she was being secretly recorded or poisoned. The reaction of the staff startled me. Whenever she said this, they would burst out laughing, sometimes nervously, sometimes it seemed with genuine amusement. Sometimes they would rebuke her for being "stupid". Both reactions would, of course, antagonise my grandmother, only making her more paranoid. One day, in irritation, I asked one of the carers what training they were given in how to respond to dementia sufferers. "None," she said, bemused.

Then, one night, I went to visit my grandmother, and she was wheezing very heavily and having an asthma attack. A carer came in and thrust a glass of water into her hand. "They won't give me my inhaler," she said, panicking. "They just give me water." I asked the carer where the hell the inhalers were kept, and he looked at me blankly. I suddenly realised: he didn't speak enough English to know what an inhaler was. Like most of the staff, he had arrived in Britain only very recently. I didn't blame him – he seemed incredibly concerned, and almost as panicked as my gran – but the home managers who had put him in this position. I had to find the inhaler myself. What if I hadn't turned up?

It was only on the fourth home that I finally found somewhere decent. There were still lots of imperfections: there was nothing to do, and whenever any resident pushed the button to summon a staff member, a horrible high-pitched noise would echo through the whole home – so about half the time my grandmother had to live with an awful piercing sound. But the staff were genuinely kind and talkative to her, and reacted to her increasing paranoia with reassurance.

This is not an unusual story. This is – by and large – how we are treating my grandparents' generation in their final days. At best, people in care homes are left in tedium, and at worst, they are placed in physical danger. Everybody in Britain knows who Baby P was, but who has heard of (say) Parkside House in Northampton, where five elderly people were found with great open wounds of rotting flesh because they hadn't been moved in weeks? They all died. Every month, a case like this is exposed, and passes silently in the night. Only last week, two care home workers from South Wales were convicted for tormenting dementia patients by flicking their ears until they were "red raw" and terrorising them "for their own amusement". Yesterday they were given just a few hundred hours of community service.

It is about to get worse. The people who are supposed to inspect care homes – the Care Quality Commission, or CQC – are being massively cut back under David Cameron. Five years ago, there were 50,000 visits in a single year. This year, there will be a quarter of that. The Government is shifting to a model of "light touch regulation", where homes will largely assess themselves by filling in "paper reviews" – essentially a series of forms.

We saw in the banking sector that people behave much worse when they know nobody is checking on them. In 2009, a heroic nurse called Phil Brown exposed that the home he was working in was neglecting and abusing its residents. He told the BBC's File on Four that the new inspections are "absolutely shameful, because it reduces the inspectorate to a toothless paper tiger, where nobody is physically going in". My grandmother's case shows that we need to increase inspections massively. Instead, they are being slashed. There will be many more Parkside Houses now.

As I was clearing through my grandmother's few possessions, I heard Bob Diamond, the head of Barclays, on the radio, bragging about how bankers should be "rewarded". The money for multimillion-pound bonuses at the state-owned Royal Bank of Scotland, and the bank bailouts more broadly, will come from cutting many services. These include the inspectors who check old people aren't being abused. So in 2011, to reward the people who crashed the world economy, we are punishing the people who saved the world from the Nazis. Didn't my grandmother – and yours – deserve a better ending to her story than this?

For updates on this issue and others, you can follow Johann on Twitter at www.twitter.com/johannhari101

For further information on the huge cuts in care home inspectors, you can listen to or read a superb edition of the BBC's File on Four by the excellent investigative journalist Fran Abrahms here.

To campaign to make sure care homes are properly inspected, and to oppose elder abuse, support or donate to Action on Elder Abuse click here.

You can read the eulogy Johann gave at his grandmother's funeral click here.

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