I cannot say that my time at Thorpe Grange was anything other than a happy one, although one incident did concern me. I had been asked to work nights temporarily - since there had been staff shortages - and although I did not know how I would cope physically, I agreed to this.
My shift started at 10pm and, along with the other night-staff member, I was expected to check on all the residents hourly, as well as assisting those to bed who were not in bed by then. However, most of the residents were in bed, and so by 11pm I felt able to settle down and catch up with some paperwork.
“What are you doing?” the night staff queried, producing a couple of blankets from out of nowhere.
I frowned before informing her that I was going to complete paperwork in between hourly checks.
She looked at me pityingly before settling into the chair and covering herself with a blanket. Before long, gentle snores indicated that she was asleep. I completed the paperwork and hourly checks by myself, too astounded to challenge this blatant disregard for those in her care. I only worked two nights but it was a taster for what was to come. As I found out later, the phenomenon of night shift workers sleeping throughout their shift occurred on a massive scale, to the detriment of vulnerable residents. The cost to local authorities – where work isn’t being undertaken or completed in these working-night hours – should also be an issue of grave concern.
Changes abound in the care system, and Thorpe Grange became a casualty, eventually being sold and closed down, as were many other residential homes. This was a major blow for me, given that the walking distance to work was less than ten minutes and that I had settled in for what I believed would be my whole working life.
Although I did not drive, I was posted to Springfield in Edgerton. Money was still tight and so I would often get up early – around 4am – study and then walk from Almondbury to Edgerton before starting an early shift - journey of approximately 4 miles. Sometimes, I would be sent to other homes if they were short of Officers and, in and amongst this, I was sent to work in a residential home which catered for young adults with learning disabilities. I would be assisting them to learn skills which would help in rehabilitating them back into the community.
At times I had to sleep-in, although I got precious little sleep. In spite of the residents’ learning difficulties they were teenagers like all in their peer group and prone to staying up late and getting up early.
I did not find the Officer agreeable, and some of her actions caused me concern. The residents, for example, were expected to make their own meals but no allowance was made for individual tastes. Thus, each resident had to make gravy even though some did not want this and would protest at having to undertake this task and eat the results of their efforts. I did not believe that people should be forced to eat something against their will, so I raised with the Officer the principle that each resident had the right to make choices. Sadly, it fell on deaf ears.
On another occasion, a mildly disabled young adult who lived in the community was found to be staying at home by himself for one night, since his parents were going away. The Officer invited the young man around and he was happy to spend the evening with others, but when he attempted to go home, the Officer would not allow him. She insisted that he stay in the home for the night. The young man was unsurprisingly very distressed and whilst I did try to intervene, my pleading to allow the young man to return to his home – on the grounds that he was more than capable of looking after himself - was ignored.
Eventually, the young man became so frightened that he sat on the open window ledge, at which point the Officer called the duty social worker and attempted to convince the social worker that the young man was clearly not in a fit state to go home. The social worker was clearly in a dilemma and pointed out that the lad was frightened at being incarcerated. As this did not receive a response from my senior officer she eventually determined that the young lad should stay at Moorview for the night.
I still clearly remember this event. All my preconceptions - that those in charge of vulnerable people were empathic individuals and would clearly place the welfare of those in their charge as a matter of the highest priority – were instantly dispelled. What I had observed was a cruel and cleverly engineered series of actions that appeared to have no purpose other than to endow one person with more power and control over another’s life than was moral or necessary. That Officer, I believe, had no right to be working with vulnerable people. I had witnessed an inhumane and manipulative act which I hope to never to see again.
As a Peripatetic Officer, I was frequently sent to different homes - generally to cover for the absence of others - so I gained a good grounding in the different ways that homes were run and was able to evaluate what worked and what didn’t. It was essential, for example, that staff had regular meetings to air their views, pool ideas and generally feel as though they mattered. These meetings had been an essential part of the ethos of Thorpe Grange and which I had valued. It therefore came as a shock when I was asked to fill in as Peripatetic Officer for a supposedly purpose-built residential home in one of the poorer areas of Huddersfield which was two bus rides away and, as such, beyond walking distance.
It is hard to see how the home could be considered ‘purpose built’, since the bedrooms were on the ground floor and the dining- and the living areas were on the first floor. It was served by a temperamental lift - we became well acquainted with the lift engineers – but often the poor residents had to undertake a fairly lengthy walk in all weathers, through the grounds, if they needed to access their bedrooms when the lift wasn’t working. It was hard to see how this home was ‘purpose built’ unless its purpose was to expose as many frail and elderly people to the wintry elements as often as possible. This conclusion also applied to those members of staff who were reluctant to make the long journey to check on residents when they had the misfortune to be in bed when –yet again - the lift failed.
I took immediately to the Officer, who was a likeable lady, but I found the behaviour of one of the Assistant Officers somewhat puzzling. The care assistants and domestics were mainly young girls who - with no relevant training – were trying to cope with elderly residents with complex disabilities. They felt quite disillusioned with the layout of the home and the fact that no one listened to them. They did not have meetings either. In fact, there weren’t any meetings scheduled for any of the staff, so one of the first things that I instigated was a meeting for the officers.
There were only three of us and oddly, the officer who I found concerning, decided to sit on the floor and clear out a cupboard during the meeting. I gather that this was a protest at the changes being implemented by me.
The care staff, domestics and cooks just did not have a voice and so one of the items up for discussion – in fact it was the priority item on the agenda - related to this lack of representation. We resolved – the two of us since the third officer was still cleaning out the cupboard – that staff would have a weekly meeting. This was implemented straight away and the care staff and others were really appreciative of the fact that their views could now be aired on a weekly basis and, if relevant, acted upon.
During my first week – in fact, after handover on an early shift and the lift out of order once again - I made my way around the home and found a ninety year old still in bed, soaked in urine up to her hair. It took me a long time to tend to her, to make her comfortable and to cleanse her fragile skin, yet I did not want to leave this lady alone and make the long journey back up to the first floor to find a care assistant to help me. This was the last time that this would happen whilst I was at this home. There was no staff training but it was greatly needed here. The members of staff were neither bad nor uncaring, but just demoralised and untrained. I resolved that this had to be remedied, and it was!
I still had concerns about the other Assistant Officer but it was hard to pin down what these were. I had recorded her reluctance to participate in the meeting but there was little else I could do.
I had a couple of days off and when I returned one of the domestics asked to speak to me urgently. I had built up a good rapport with staff and immediately invited her into the office so she could share what was on her mind. What she told me horrified me.
Apparently, when I was off duty, the Assistant Officer had decided to squeeze an abscess on one of our octogenarian’s eyes. She had ordered some of the staff to hold down the old lady’s arms while she performed this procedure.
The officer was not qualified to carry out any medical procedure and squeezing an abscess would not be undertaken by an unqualified professional since it would simply drive the infection deeper.
The old lady’s screams had sickened everyone who had heard them - apart from the Officer – and, apparently, could be heard throughout the building. The huge purple-black bruises were still visible on the tissue-paper thin skin on her wrists by which she had been forcibly held down. I felt sick inside as the domestic related what had happened. She was quaking visibly, with her slight frame shaking uncontrollably with fear and anger.
I immediately rang my Line Manager to inform him of what had happened. A meeting was hurriedly convened between us, and the domestic was called in to relate her story yet again. I still remember the sight of that poor domestic, reliving the events of that awful night and visibly shivering as she did so. It is not easy to be a whistle-blower. God bless her!
The final major change which I managed to instigate before moving on concerned the night staff. Whilst working on late-shifts, I noticed that all the residents were being put to bed at 6pm. This puzzled me and prompted me to ask a gentleman - who was immersed in watching a favourite television programme - why he wanted to go to bed at 6pm.
“I don’t!” he replied, “but we have to.”
A quick chat with the daytime members of staff - who were only young girls - soon revealed the problem. The night staff had insisted that all residents were in bed before they came on duty. The night staff comprised older women and, I suppose, the younger care staff found them quite intimidating. Almost immediately, my mind recalled the member of staff who had brought her own blanket so that she could sleep while she was on duty.
I immediately informed all staff and residents that no-one was to be coerced into going to bed. All residents were to be allowed to stay up for as long as they wanted and need only go to bed when they wanted to do so.
The day staffs were delighted by my ruling, for it was in line with their unspoken beliefs about the rights that the elderly should enjoy. The residents were also thrilled that they no longer had to go to bed at six in the evening on a warm summer’s evening.
Those in my care were the men and women who had fought in world wars – or who had worked on the land or in munitions factories in order that I could enjoy the freedoms that I have now. I would not have allowed my grandparents to have been treated in such a manner if residential care had been the only option open to them. Only the night staff objected long and loudly to the new ruling that residents could go to bed when they wished, but their objections fell on deaf ears.
Furthermore, I had simply informed all, including residents, that if it wasn’t adhered to then I was to be informed immediately.
Imbued with latent power, the residents no longer felt intimidated by the night staff and simply refused to go to bed until they were ready to do so. The first morning following this new directive, I sat down next to the gentleman who had originally informed me that the residents had to go to bed at 6pm. I asked him how things had gone. He beamed at me. “Much better,” he informed me. “I didn’t go to bed until after 11pm as there was a programme I wanted to watch.”
I felt very humbled by this, but also troubled. What is happening in society when individuals, who have braved the horrors of events such as World Wars, become unwillingly compliant and subject to the selfish whims and fancies of others who have little regard or respect for the life of another human being?
My time at this home was coming to an end. The other Officer who I had been covering for had died, and I was asked if I wanted the vacant position. If I had been able to drive my response would have been an immediate ‘Yes,’ but I did not drive and I had three small children to think of and an alcoholic husband to try and be one step ahead of. Reluctantly, I turned the offer down. On the day that I left, staff lined up along the path and, as I walked down the short route, each leaned forward and hugged me. ‘Please stay,’ they pleaded. I had tears in my eyes as I shook my head. They were such lovely people and it took all the energy I could muster to move on but move on was what I had to do.
The final home which I worked in was also in Edgerton, and so, in spite of it being two bus rides away, it was also, like Springfield within walking distance. This was another of those large, non-purpose-built, residential homes which boasted a wealth of character, large rooms and a steep, and sweeping staircase. When new residents arrived they were normally ambulant and therefore occupied the upper rooms. When time eventually imposed its frailty upon them, they were allocated the next vacant ground floor bedroom as it became available.
As my working life moved through residential care, it was noticeable that there was a marked deterioration in the physical and mental health of those who were admitted. Residential homes were no longer establishments for the independent - but socially isolated - individual. Somewhere along the line our clients had become EMI - that is, elderly, mentally infirm - and so it was not unusual to find us working with those with schizophrenia or manic depressive psychosis, the dementias in all their forms, Parkinson’s disease, stroke. Of course, such conditions do not come without concomitant conditions, so Mrs X may have Parkinson’s disease but may also have lost a breast through cancer as well as suffering from rheumatoid arthritis. It was a challenging situation which I adapted to well. I loved my job!
In truth, this was not a happy home, although it took some time to figure out why. Many of the residents had challenging behaviour, indeed a far greater proportion than I had found in previous homes. A number of the residents were aggressive in manner and the staff appeared intimidated by them. One resident with dementia had chronic bronchitis and constantly spat out green sputum onto the hallway carpet. The domestics were unable to clean this up without retching, so I took on this task. I was a ‘hands on’ Officer and did not expect staff to undertake tasks I would not take on myself.
I was still fairly quiet and reserved but I had been very well organised and so could complete the admin quickly in order to assist the care staff. I always made sure that I interacted with every resident, no matter how difficult, on every shift.
My time working in residential care was really the first time that I had been exposed to individuals with dementia, and I began observing them. One lady, whom I shall call Vera, was a particularly challenge for the staff. Vera had Alzheimer’s disease and, at the time that I met her, she hadn’t spoken recognisably for three years. ‘Pom, pom, pom!’ she would utter as she marched up and down. Often she would wind the telephone wire around her neck before pulling away. Frankly, she was aggressive and care staff did not want to care for her.
One day I decided that I would make coffee and biscuits and invite Vera to have morning coffee with me at 11am and afternoon tea at 2pm. It was difficult to get Vera to sit in the quiet spot I found under the stairs but she eventually sat down. ‘Pom, pom, pom!’ she uttered aggressively.
I talked about my family, about my hobbies and asked her about hers. I did not expect a reply for she hadn’t spoken conventionally for over three years. Yet this was not a one-sided interaction, even though her dementia was well advanced, and besides, can there be such a thing?
Over the next few days, Vera started following me around. She knew instinctively when it was ‘our’ time. I carried on my conversations with her. Some staff complained since I was spending less time doing their jobs for them. This I ignored.
One afternoon when my shift had finished, I turned to Vera who had been following me around and said, ‘I have to go home now, Vera, my shift has finished.’
Vera caught hold of my arm and quite clearly stated, ‘Don’t go, please don’t go.’
Any illness has an environmental and genetic influence. Genes can be turned on and off by environmental influences. There is a person hidden deep with the layers of Alzheimer’s, if we only have the time, the love and the belief to help that person find themselves, again. Never give up. Never give up!
It was one of my deepest wishes to continue what I had started with Vera and one of my deepest regrets that I was unable to change the way that people with acquired brain injury are treated. So often the answer has been medication and more medication when it would be better if it was time and more time. The former is a failure and the latter a recognition of how loneliness impacts the frailty of the human spirit. The more Vera cried out to be helped the more carers interpreted this as an act of aggression and moved away from the pain of a tormented spirit.
Look inside, look inside and find the real person.
I did find the majority of care staff here much less approachable than those working in the purpose built one. Many appeared to resent their work and I wondered if many had just applied for caring as the only option open to them. I did not think that caring for those with dementia over a period of eight hours with only limited breaks was fair to the staff, though. It is an extremely stressful job which the pay does not appear to recognise or reflect.
One morning, when I had just started my shift and was still in my office, I heard a huge thud and a resident immediately crying out. The resident, my investigation revealed, was a frail 87 year old who hadn’t wanted to get up when a member of staff had deemed that she should. Trying to get away from this member of staff, the resident found herself near the bottom of the stairs, whereupon the carer had grabbed hold of the lady’s arm and swung her into the staircase. The bruising the lady sustained could be seen from her head down to her hip: purple, black and blue. The staff member was immediately taken off the floor and never worked again as a carer.
It later transpired that I had been placed in these homes as Peripatetic Officer to weed out the abuse because although many knew that it was going on, no one wanted to be the whistle-blower. In this home it wasn’t so much the case that staff raised concerns but more so the residents, and I followed up every concern. I did not necessarily think that because someone had dementia, they were making things up. Why should they? Even in non-verbalising individuals, behaviour is a very good indicator of relationships, so anyone wishing to work with the vulnerable should observe and reflect.
These two skills – observation and reflection – are the ones which I would wish to see on the CV of anyone applying for a caring role. However, I do not think that in all the time that I have been involved in interviewing job applicants, I have ever seen these qualities listed on CVs.
copyright Lynne D M Noble
This is a partial chapter 6 of Where the Blackbird Never Sings and the book is available in kindle or paperback form on Amazon worldwide
My shift started at 10pm and, along with the other night-staff member, I was expected to check on all the residents hourly, as well as assisting those to bed who were not in bed by then. However, most of the residents were in bed, and so by 11pm I felt able to settle down and catch up with some paperwork.
“What are you doing?” the night staff queried, producing a couple of blankets from out of nowhere.
I frowned before informing her that I was going to complete paperwork in between hourly checks.
She looked at me pityingly before settling into the chair and covering herself with a blanket. Before long, gentle snores indicated that she was asleep. I completed the paperwork and hourly checks by myself, too astounded to challenge this blatant disregard for those in her care. I only worked two nights but it was a taster for what was to come. As I found out later, the phenomenon of night shift workers sleeping throughout their shift occurred on a massive scale, to the detriment of vulnerable residents. The cost to local authorities – where work isn’t being undertaken or completed in these working-night hours – should also be an issue of grave concern.
Changes abound in the care system, and Thorpe Grange became a casualty, eventually being sold and closed down, as were many other residential homes. This was a major blow for me, given that the walking distance to work was less than ten minutes and that I had settled in for what I believed would be my whole working life.
Although I did not drive, I was posted to Springfield in Edgerton. Money was still tight and so I would often get up early – around 4am – study and then walk from Almondbury to Edgerton before starting an early shift - journey of approximately 4 miles. Sometimes, I would be sent to other homes if they were short of Officers and, in and amongst this, I was sent to work in a residential home which catered for young adults with learning disabilities. I would be assisting them to learn skills which would help in rehabilitating them back into the community.
At times I had to sleep-in, although I got precious little sleep. In spite of the residents’ learning difficulties they were teenagers like all in their peer group and prone to staying up late and getting up early.
I did not find the Officer agreeable, and some of her actions caused me concern. The residents, for example, were expected to make their own meals but no allowance was made for individual tastes. Thus, each resident had to make gravy even though some did not want this and would protest at having to undertake this task and eat the results of their efforts. I did not believe that people should be forced to eat something against their will, so I raised with the Officer the principle that each resident had the right to make choices. Sadly, it fell on deaf ears.
On another occasion, a mildly disabled young adult who lived in the community was found to be staying at home by himself for one night, since his parents were going away. The Officer invited the young man around and he was happy to spend the evening with others, but when he attempted to go home, the Officer would not allow him. She insisted that he stay in the home for the night. The young man was unsurprisingly very distressed and whilst I did try to intervene, my pleading to allow the young man to return to his home – on the grounds that he was more than capable of looking after himself - was ignored.
Eventually, the young man became so frightened that he sat on the open window ledge, at which point the Officer called the duty social worker and attempted to convince the social worker that the young man was clearly not in a fit state to go home. The social worker was clearly in a dilemma and pointed out that the lad was frightened at being incarcerated. As this did not receive a response from my senior officer she eventually determined that the young lad should stay at Moorview for the night.
I still clearly remember this event. All my preconceptions - that those in charge of vulnerable people were empathic individuals and would clearly place the welfare of those in their charge as a matter of the highest priority – were instantly dispelled. What I had observed was a cruel and cleverly engineered series of actions that appeared to have no purpose other than to endow one person with more power and control over another’s life than was moral or necessary. That Officer, I believe, had no right to be working with vulnerable people. I had witnessed an inhumane and manipulative act which I hope to never to see again.
As a Peripatetic Officer, I was frequently sent to different homes - generally to cover for the absence of others - so I gained a good grounding in the different ways that homes were run and was able to evaluate what worked and what didn’t. It was essential, for example, that staff had regular meetings to air their views, pool ideas and generally feel as though they mattered. These meetings had been an essential part of the ethos of Thorpe Grange and which I had valued. It therefore came as a shock when I was asked to fill in as Peripatetic Officer for a supposedly purpose-built residential home in one of the poorer areas of Huddersfield which was two bus rides away and, as such, beyond walking distance.
It is hard to see how the home could be considered ‘purpose built’, since the bedrooms were on the ground floor and the dining- and the living areas were on the first floor. It was served by a temperamental lift - we became well acquainted with the lift engineers – but often the poor residents had to undertake a fairly lengthy walk in all weathers, through the grounds, if they needed to access their bedrooms when the lift wasn’t working. It was hard to see how this home was ‘purpose built’ unless its purpose was to expose as many frail and elderly people to the wintry elements as often as possible. This conclusion also applied to those members of staff who were reluctant to make the long journey to check on residents when they had the misfortune to be in bed when –yet again - the lift failed.
I took immediately to the Officer, who was a likeable lady, but I found the behaviour of one of the Assistant Officers somewhat puzzling. The care assistants and domestics were mainly young girls who - with no relevant training – were trying to cope with elderly residents with complex disabilities. They felt quite disillusioned with the layout of the home and the fact that no one listened to them. They did not have meetings either. In fact, there weren’t any meetings scheduled for any of the staff, so one of the first things that I instigated was a meeting for the officers.
There were only three of us and oddly, the officer who I found concerning, decided to sit on the floor and clear out a cupboard during the meeting. I gather that this was a protest at the changes being implemented by me.
The care staff, domestics and cooks just did not have a voice and so one of the items up for discussion – in fact it was the priority item on the agenda - related to this lack of representation. We resolved – the two of us since the third officer was still cleaning out the cupboard – that staff would have a weekly meeting. This was implemented straight away and the care staff and others were really appreciative of the fact that their views could now be aired on a weekly basis and, if relevant, acted upon.
During my first week – in fact, after handover on an early shift and the lift out of order once again - I made my way around the home and found a ninety year old still in bed, soaked in urine up to her hair. It took me a long time to tend to her, to make her comfortable and to cleanse her fragile skin, yet I did not want to leave this lady alone and make the long journey back up to the first floor to find a care assistant to help me. This was the last time that this would happen whilst I was at this home. There was no staff training but it was greatly needed here. The members of staff were neither bad nor uncaring, but just demoralised and untrained. I resolved that this had to be remedied, and it was!
I still had concerns about the other Assistant Officer but it was hard to pin down what these were. I had recorded her reluctance to participate in the meeting but there was little else I could do.
I had a couple of days off and when I returned one of the domestics asked to speak to me urgently. I had built up a good rapport with staff and immediately invited her into the office so she could share what was on her mind. What she told me horrified me.
Apparently, when I was off duty, the Assistant Officer had decided to squeeze an abscess on one of our octogenarian’s eyes. She had ordered some of the staff to hold down the old lady’s arms while she performed this procedure.
The officer was not qualified to carry out any medical procedure and squeezing an abscess would not be undertaken by an unqualified professional since it would simply drive the infection deeper.
The old lady’s screams had sickened everyone who had heard them - apart from the Officer – and, apparently, could be heard throughout the building. The huge purple-black bruises were still visible on the tissue-paper thin skin on her wrists by which she had been forcibly held down. I felt sick inside as the domestic related what had happened. She was quaking visibly, with her slight frame shaking uncontrollably with fear and anger.
I immediately rang my Line Manager to inform him of what had happened. A meeting was hurriedly convened between us, and the domestic was called in to relate her story yet again. I still remember the sight of that poor domestic, reliving the events of that awful night and visibly shivering as she did so. It is not easy to be a whistle-blower. God bless her!
The final major change which I managed to instigate before moving on concerned the night staff. Whilst working on late-shifts, I noticed that all the residents were being put to bed at 6pm. This puzzled me and prompted me to ask a gentleman - who was immersed in watching a favourite television programme - why he wanted to go to bed at 6pm.
“I don’t!” he replied, “but we have to.”
A quick chat with the daytime members of staff - who were only young girls - soon revealed the problem. The night staff had insisted that all residents were in bed before they came on duty. The night staff comprised older women and, I suppose, the younger care staff found them quite intimidating. Almost immediately, my mind recalled the member of staff who had brought her own blanket so that she could sleep while she was on duty.
I immediately informed all staff and residents that no-one was to be coerced into going to bed. All residents were to be allowed to stay up for as long as they wanted and need only go to bed when they wanted to do so.
The day staffs were delighted by my ruling, for it was in line with their unspoken beliefs about the rights that the elderly should enjoy. The residents were also thrilled that they no longer had to go to bed at six in the evening on a warm summer’s evening.
Those in my care were the men and women who had fought in world wars – or who had worked on the land or in munitions factories in order that I could enjoy the freedoms that I have now. I would not have allowed my grandparents to have been treated in such a manner if residential care had been the only option open to them. Only the night staff objected long and loudly to the new ruling that residents could go to bed when they wished, but their objections fell on deaf ears.
Furthermore, I had simply informed all, including residents, that if it wasn’t adhered to then I was to be informed immediately.
Imbued with latent power, the residents no longer felt intimidated by the night staff and simply refused to go to bed until they were ready to do so. The first morning following this new directive, I sat down next to the gentleman who had originally informed me that the residents had to go to bed at 6pm. I asked him how things had gone. He beamed at me. “Much better,” he informed me. “I didn’t go to bed until after 11pm as there was a programme I wanted to watch.”
I felt very humbled by this, but also troubled. What is happening in society when individuals, who have braved the horrors of events such as World Wars, become unwillingly compliant and subject to the selfish whims and fancies of others who have little regard or respect for the life of another human being?
My time at this home was coming to an end. The other Officer who I had been covering for had died, and I was asked if I wanted the vacant position. If I had been able to drive my response would have been an immediate ‘Yes,’ but I did not drive and I had three small children to think of and an alcoholic husband to try and be one step ahead of. Reluctantly, I turned the offer down. On the day that I left, staff lined up along the path and, as I walked down the short route, each leaned forward and hugged me. ‘Please stay,’ they pleaded. I had tears in my eyes as I shook my head. They were such lovely people and it took all the energy I could muster to move on but move on was what I had to do.
The final home which I worked in was also in Edgerton, and so, in spite of it being two bus rides away, it was also, like Springfield within walking distance. This was another of those large, non-purpose-built, residential homes which boasted a wealth of character, large rooms and a steep, and sweeping staircase. When new residents arrived they were normally ambulant and therefore occupied the upper rooms. When time eventually imposed its frailty upon them, they were allocated the next vacant ground floor bedroom as it became available.
As my working life moved through residential care, it was noticeable that there was a marked deterioration in the physical and mental health of those who were admitted. Residential homes were no longer establishments for the independent - but socially isolated - individual. Somewhere along the line our clients had become EMI - that is, elderly, mentally infirm - and so it was not unusual to find us working with those with schizophrenia or manic depressive psychosis, the dementias in all their forms, Parkinson’s disease, stroke. Of course, such conditions do not come without concomitant conditions, so Mrs X may have Parkinson’s disease but may also have lost a breast through cancer as well as suffering from rheumatoid arthritis. It was a challenging situation which I adapted to well. I loved my job!
In truth, this was not a happy home, although it took some time to figure out why. Many of the residents had challenging behaviour, indeed a far greater proportion than I had found in previous homes. A number of the residents were aggressive in manner and the staff appeared intimidated by them. One resident with dementia had chronic bronchitis and constantly spat out green sputum onto the hallway carpet. The domestics were unable to clean this up without retching, so I took on this task. I was a ‘hands on’ Officer and did not expect staff to undertake tasks I would not take on myself.
I was still fairly quiet and reserved but I had been very well organised and so could complete the admin quickly in order to assist the care staff. I always made sure that I interacted with every resident, no matter how difficult, on every shift.
My time working in residential care was really the first time that I had been exposed to individuals with dementia, and I began observing them. One lady, whom I shall call Vera, was a particularly challenge for the staff. Vera had Alzheimer’s disease and, at the time that I met her, she hadn’t spoken recognisably for three years. ‘Pom, pom, pom!’ she would utter as she marched up and down. Often she would wind the telephone wire around her neck before pulling away. Frankly, she was aggressive and care staff did not want to care for her.
One day I decided that I would make coffee and biscuits and invite Vera to have morning coffee with me at 11am and afternoon tea at 2pm. It was difficult to get Vera to sit in the quiet spot I found under the stairs but she eventually sat down. ‘Pom, pom, pom!’ she uttered aggressively.
I talked about my family, about my hobbies and asked her about hers. I did not expect a reply for she hadn’t spoken conventionally for over three years. Yet this was not a one-sided interaction, even though her dementia was well advanced, and besides, can there be such a thing?
Over the next few days, Vera started following me around. She knew instinctively when it was ‘our’ time. I carried on my conversations with her. Some staff complained since I was spending less time doing their jobs for them. This I ignored.
One afternoon when my shift had finished, I turned to Vera who had been following me around and said, ‘I have to go home now, Vera, my shift has finished.’
Vera caught hold of my arm and quite clearly stated, ‘Don’t go, please don’t go.’
Any illness has an environmental and genetic influence. Genes can be turned on and off by environmental influences. There is a person hidden deep with the layers of Alzheimer’s, if we only have the time, the love and the belief to help that person find themselves, again. Never give up. Never give up!
It was one of my deepest wishes to continue what I had started with Vera and one of my deepest regrets that I was unable to change the way that people with acquired brain injury are treated. So often the answer has been medication and more medication when it would be better if it was time and more time. The former is a failure and the latter a recognition of how loneliness impacts the frailty of the human spirit. The more Vera cried out to be helped the more carers interpreted this as an act of aggression and moved away from the pain of a tormented spirit.
Look inside, look inside and find the real person.
I did find the majority of care staff here much less approachable than those working in the purpose built one. Many appeared to resent their work and I wondered if many had just applied for caring as the only option open to them. I did not think that caring for those with dementia over a period of eight hours with only limited breaks was fair to the staff, though. It is an extremely stressful job which the pay does not appear to recognise or reflect.
One morning, when I had just started my shift and was still in my office, I heard a huge thud and a resident immediately crying out. The resident, my investigation revealed, was a frail 87 year old who hadn’t wanted to get up when a member of staff had deemed that she should. Trying to get away from this member of staff, the resident found herself near the bottom of the stairs, whereupon the carer had grabbed hold of the lady’s arm and swung her into the staircase. The bruising the lady sustained could be seen from her head down to her hip: purple, black and blue. The staff member was immediately taken off the floor and never worked again as a carer.
It later transpired that I had been placed in these homes as Peripatetic Officer to weed out the abuse because although many knew that it was going on, no one wanted to be the whistle-blower. In this home it wasn’t so much the case that staff raised concerns but more so the residents, and I followed up every concern. I did not necessarily think that because someone had dementia, they were making things up. Why should they? Even in non-verbalising individuals, behaviour is a very good indicator of relationships, so anyone wishing to work with the vulnerable should observe and reflect.
These two skills – observation and reflection – are the ones which I would wish to see on the CV of anyone applying for a caring role. However, I do not think that in all the time that I have been involved in interviewing job applicants, I have ever seen these qualities listed on CVs.
copyright Lynne D M Noble
This is a partial chapter 6 of Where the Blackbird Never Sings and the book is available in kindle or paperback form on Amazon worldwide