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Last night BBC 1 showed “Care” which told the story of Jenny a single mother and her sister Claire struggling to care for her widowed mother Mary after she has a sudden stroke which leaves her unable to communicate properly and with vascular dementia. This blog gives an AWOC take on what unfolds (spoilers ahead).
The first thing to say is that during 90 minutes, I counted 30 times where Jenny and/or her sister Claire were shown as offering support and/or care and/or advocacy. Jenny in particular is shown repeatedly comforting her mother when she’s showing signs of distress and fear, taking the time to work out what it is she wants, visiting her, and physically intervening when e.g. Mary tries to eat a tea bag. In a pivotal very upsetting scene, Jenny and Claire sit through a case conference to discuss Mary’s discharge, while Mary who can hear but can’t verbalise her thoughts makes increasingly loud incoherent cries of sadness, fear and anger. Jenny eventually grabs Mary’s wheelchair, takes her from the room and back to her house resolving to care for Mary herself.
The key thing throughout the whole drama is that Jenny is shown as caring about her mother in a way no one in health and social care does. People in the NHS and social care are shown as doing their jobs with greater or lesser degrees of sympathy for their role in the process, but Jenny is the only one who cares how Mary feels. For people ageing without children, especially those who are also without a partner, it is that that we worry will be most glaringly absent; someone who cares about us rather than for us. Yes we will get fed, bathed and dressed but who will be there to actually care how we feel? To worry if we’re scared? or sad? or angry? or to celebrate with us if we’re happy?
The other main component shown was the importance of advocacy; Claire especially is shown as arguing with the hospital and care staff about her mother’s treatment and options e.g. when they are trying to discharge Mary home, Claire points out her confusion and inability to do things for herself. As the drama plays out, Jenny cannot manage Mary’s care at home and tries to find her a suitable nursing home. Eventually she finds one which is shown in stark contrast to the urine soaked one Mary is in briefly while Jenny’s home is adapted but of course it’s far more than the local authority who are funding Mary’s care will pay.
The owners mention Continuing Health Care; the sisters take on the care services in order to secure CHC funding for Mary which they get and Mary is able to go into the much nicer nursing home. Of course without anyone to advocate for her, Mary would have stayed in the first care home, the one where the manager tells Jenny they can’t cope because the owner won’t pay for more staff. People ageing without children are 25% more likely to go into a care home as their unpaid care networks made up of wider kin and friends tend to fall away as needs increase.
A contrast is also drawn between Jenny a single mum who is shown always with a home setting and Claire her sister who we learn is childless (we discover near the end her lack of children isn’t a choice) and is often shown at work or out having fun. Claire is portrayed as being unable to cope with her mum and leaving the vast majority of the care to Jenny. In reality, people without children are between 20-40% more likely to be the carers for their elderly parents Childlessness and upward intergenerational support: cross-national evidence from 11 European countries https://www.cambridge.org/core/journals/ageing-and-society/article/childlessness-and-upward-intergenerational-support-crossnational-evidence-from-11-european-countries/56F1FF0ED1A2BD301430F8563AACAF6F and it was beyond disappointing to see childless women portrayed yet again in such a stereotypical way. The “tightrope generation”, those people caring for their parents but without the safety net of their own children really are the forgotten carers.
Overall, it was impossible to watch Care and not be left deeply worried and upset about the future for people who don’t have a Jenny or a Claire. Time and again they were shown as being able to give information that only they would know, information about Mary’s personality, interests and hobbies, how she was before the stroke, what kind of food would encourage her to eat, what things might cheer her up. Often they would offer physical comfort; a hug, stroking her hair hand, brushing her hair, something again paid for carers are unlikely to have time for or even be allowed to do. It showed how hard it is, how determined you have to be, how you have to care a huge amount of someone to be willing to go to the lengths they went to for their mother.
The care system is underfunded and unloved and hard enough if you have someone caring about and advocating for you. Without that, it is almost unimaginably difficult.
We have to do better; for people with family, for people without, for all of us. This cannot be the social care future we want.