Care homes: no way to treat the elderly?

Social services are intent on bundling into care homes as many of the elderly as possible. Olga Craig reports.
Rosemary Skelt was never the easiest company. ”Not even when she was a much younger woman,” her daughter, novelist Bernadine Kennedy, laughs affectionately. ”She could be pretty abrasive. She wasn’t a shy and retiring little old lady. She had been widowed, and living alone for a long time, and her independence was very important to her.”

So in a spirited fit of pique, not uncommon in a 95-year-old, Rosemary simply decided one day that she wasn’t going to open the door to the care assistants who had been calling daily while Bernadine, who lived nearby, and helped look after her mother, spent a much-needed week on holiday in Egypt. Irritated by another visit, Rosemary shouted from the window that she was fine and didn’t need any help that day.

”I was standing in the middle of the Sinai desert at the time, marvelling at the stillness, when suddenly my mobile rang,” Bernadine recalls. ”An extremely cross woman from social services yelled: ‘Why aren’t you with your mother?’ ”

Bernadine was stunned. She had left her telephone numbers in case the carers needed to speak to her. She had no idea there was anything wrong.

While she was being harangued and accused of ignoring calls from the carers to say they couldn’t get in – calls that had never been made, a lie for which social services later apologised – two police cars and an ambulance were rolling up at her mother’s Southend-on-Sea home to take her to hospital.

”That was really the start of it,” says Bernadine. ”That was when the pressure started to cart her off to a nursing home. And it never let up. Social services were determined she was never going to return to her own home again. Sadly, my mother died within months.

”Even though I lived a few doors away and Mum was easily able to look after herself with family support, they wouldn’t give in. They held meetings without me and even spoke to the owners of a local care home to find her a place. When I told them there was no way she was going anywhere without my approval, they overruled me and tried to push it through.

”All they were ever concerned about was how much her home was worth and how much she had in savings. They wouldn’t countenance home care – they would have had to pay for that. They insisted she should be in a home even though I said I would sleep in her house every night.

”It was my mother’s nightmare that she would end up in a home. In the end it was almost a relief that she died of natural causes before they forced her into one: I know she would have been begging me to bring her home.”

Bernadine’s experience at the hands of over-zealous social workers who were determined to incarcerate her mother in a nursing home – even though she had been given the routine testing for dementia and passed with flying colours – is worryingly reminiscent of the shocking story of Betty Figg, highlighted by the Sunday Telegraph last week.

Police armed with a battering ram and clutching a search warrant arrived at the home of 86-year-old Betty’s daughter Rosalind, manhandled the old lady into a car -tossing a tea towel over her head in the process – and drove her back to the nursing home from which her daughter had removed her. Yesterday social services were still refusing to allow her to take her mother home or to offer any explanation for their actions.

In the past week several readers have contacted this newspaper with similar stories. While none was subjected to a raid on their homes, all felt railroaded into putting a parent into a nursing home.

But help may be at hand for the families who feel they are denied a say in the care of their elderly relatives. One couple, Jill and Steven (not their real names, which cannot be used for legal reasons), who won a legal battle to keep an autistic relative with them, will this weekend speak to those who have found themselves in a similar situation in the hope that they can use the forthcoming Deprivation of Liberty guidelines to ensure elderly parents are not put into nursing homes against their wishes and those of their family.

Twelve years ago the couple, who cared for a young autistic man known only as HL, obtained a court ruling that he had been ”detained unlawfully” at Bournewood long-stay hospital after he was removed from their home. He had been taken there simply because he had been disruptive on a bus. Although the ruling was overturned a year later, the couple took their case to the European Court of Human Rights five years ago and won what is now known as the Bournewood Judgment.

In essence the ruling ensured that Deprivation of Liberty safeguards, under which a family can challenge a local authority’s right to insist that an elderly person must be placed in a nursing home, were put in place. The guidelines, which are an amendment of the Mental Capacity Act 2005, came into force in April, with full commencement early this month. They ensure that the authority must carry out six assessments and prove that a nursing home is ”in the best interests” of the individual.

”We were stunned when we saw the footage of Mrs Figg being forcibly taken from her daughter’s home, and without her daughter’s consent,” says Steven. ”It was almost a carbon copy of what we went through with HL. He was dumped in a secure unit and we were not even allowed to see him. When we finally won the right to have him home, we were shocked at his condition. He had deteriorated – physically and emotionally – so badly. But within months of being back with us he had regained his confidence. He’s such a happy chap now. In fact, right now he is lying on his bed, watching the sun stream through his window and listening to Handel on his CD player.”

What concerns Steven is that the guidelines have received little publicity. ”But from this month anyone who feels their family member is being held in a care home against their wishes should ask for a copy of the guidelines at the nursing home,” he says. ”Inside is a standard form they can fill in. This means a ”best interest” assessment must be made and that is the family’s opportunity to prove that their own home is the right place for their relative. It is one of the few ways in which they can influence their local authority. Admittedly, it is a long process – and expensive for the authority – but it is the one weapon we have.”

The Bournewood Judgment came too late, of course, for Bernadine Kennedy, whose latest novel, Shattered Lives, deals with a dementia sufferer. Her mother first came to the attention of social services when she was admitted to hospital suffering from diverticulitis. While there, Rosemary had a geriatric consultation that deemed her sound of mind. When she returned home, social workers offered day care, which Bernadine readily accepted. It was then, when Rosemary refused to open the door to carers, that she was taken back to hospital.

”After that I knew I was never going to get her back,” says Bernadine. ”The pressure to put her in a home was tremendous. The clear implication was that I didn’t want her to go to a nursing home to protect my inheritance. It had nothing to do with that. Mum dreaded a nursing home.”

After a lengthy spell in a hospital bed, Rosemary deteriorated swiftly. ”I was devastated when Mum died. But part of me was glad,” says Bernadine. ”Glad that she never ended up in a home. Because that was where they were determined she would go. No matter what I – or she – wanted.”

Jim Jones, 44, from Bellerby, North Yorkshire, knows exactly the sort of pressure Bernadine had to endure. His father, Ron, 76, who lived with him, was diagnosed with Alzheimer’s a year ago.

”Of course I knew that, eventually, when it became really bad, Dad would have to go to a nursing home,” Jim says. ”But even now he is nowhere near that situation and has responded well to medication. But I am fighting an uphill battle to keep him in his own home with me.

“And, frankly, I am at my wit’s end. I have been shocked at how swiftly, once social services become involved, one is raced down the nursing home route. I feel so guilty. I feel I have sleep-walked into a situation where they have taken over the role of being my father’s kin. Stolen it from me.”

Last November social services began pressing Jim to try a nursing home. ”They badgered me so much that I feel I took my eye of the ball and said OK. To my amazement, they said he could go in the next week.” Ron was admitted to his local nursing home, but when the family visited it was clear he was deeply unhappy.

As the weeks progressed, Ron became more and more morose until, eventually, Jim took him home. Before long, social services were back. ”No one forced me into anything but the clear implication was that if I didn’t take Dad back soon, the place would have gone and I would have lost any future opportunity to have him placed in a nursing home. That seemed fine at face value, but obviously I know Dad won’t be as well as he is now in later life. His condition will only worsen.”

Ron was returned to the nursing home but, when he became aggressive because he wanted to go home, he was moved to a care unit for the elderly.

”There, they changed his medication, and all the aggression disappeared,” Jim says. ”He has been there for a month now and I have had to hire a solicitor to help me get him back. But basically, I am in despair.

”The local authority say he can’t have any day care – for which they would have to pay -and insist he must go to a nursing home. I feel so guilty, I feel I have let him down.

”They have usurped my role as his son. I just don’t understand why I can’t care for him in our own home. I know a time will come when his Alzheimer’s is so bad that he will need nursing home care. But that time hasn’t come yet. Why won’t social services listen?”