Introducing a series of posts from the front-line of dementia care
It had been twenty years since I’d last dealt with bodily fluids that didn’t belong to either small children or one of the dogs. But here I was at 7am on a Saturday morning helping to wash and dress a chap called Ted. Ted has severe Alzheimer’s Disease. He cannot walk or talk, and needs constant assistance to do just about everything.
Before this, my last encounter with Alzheimer’s had been twenty years ago. I was training to be a Registered Mental Nurse and what was then known as ‘Psychogeriatrics’ really wasn’t the most popular placement for students. Hardly surprising for a specialty sounding like a David Lynch movie and promising little more than a seven hour shift full of old people’s bits and an ocean of human waste. But I finished my placement through gritted teeth and carried on toward a career with mentally disordered offenders and far, far away from the ravages of dementia.
So wiping Ted’s bum on a Saturday morning while normal people were having a lie-in could reasonably be described as a culture shock for one who normally earns a living travelling up and down the country running courses, or sitting at home bashing away at a laptop. But in six months as a relief care assistant I’ve learnt an incredible amount. About life. About death. About people. And a lot about dementia.
There was a time when dementia was, as it seemed to us student nurses, the unfashionable, unseen and unmentionable of health care. But more recently the blogosphere, social media, a smattering of telly and a renewed interest in the harm that can come to a group of people who are just about as vulnerable as it’s possible to be has made dementia a great deal more visible than it has been in the past. It is now something most people are aware of, even where they haven’t been touched by it themselves.
But there remains one perspective pretty much invisible to the dementia story. Not those of the sons and daughters of sufferers, many of whom have provided moving and hugely educational accounts of Alzheimers, Vascular, Lewy Body and all the other conditions which form the umbrella of ‘dementia’.
There are around 18000 nursing and residential care homes in the UK. They will be staffed by a team of mainly unqualified care assistants, primarily female and paid minimum or near minimum wage, In many cases they will have had just about enough training to tick a box and satisfy the CQC inspector, and may often have little command of English.
Theirs is pretty much a silence broken only by the odd hidden camera expose of physical abuse, verbal hostility or theft, or the ever growing focus on care home scandals where residents are left starving, dehydrated and rotting in their own excrement. If they work in people’s own homes as domiciliary carers, they don’t turn up, or when they do, spend barely any of the allotted (and paid for) time with their clients. We hear some pretty terrible stuff, but how often do we hear the care assistants’ side of the story?
Most people working on the front line of dementia care aren’t big on talking about what they do. From my own experience, this certainly isn’t because they’re inarticulate or have nothing to say. They’re just too busy putting in enough minimum wage hours to pay the gas bill. So this is a carers-eye view of a degenerative brain condition which ranges from the mild early-stage to the severe, terminal condition we rather clumsily lump into the term ‘dementia.’ It won’t always be easy reading and there will be mention of things we British would never normally mention, but I’m lucky to work in the sort of home where good things happen as well.
Next Time: CARE HOME DIARIES PART 2: ‘The Good, the Bad and the Ugly’ where I get a job at Hill View House just as I start to think of social care as the new slave trade. Well, I still do. A bit.