(Wednesday blog)
My apologies for not writing anything sensible for a few days. But a family situation has arisen which readers might find interesting.
My current wife works at a care home for residents with severe dementia and has been summoned to a disciplinary hearing which will probably result in her being fired. Here is what happened:
1. For some time this care home has been under pressure due mainly to staff shortages
2. This has necessitated the frequent use of agency staff
3. The company running the care home boast on their website about the high level of care provided by their well-trained staff and the care home is among the more expensive of its type
4. However, many of the agency staff have possibly received only 2 to 3 days training and therefore cannot be considered to be as well-trained as full-time staff. Moreover, agency staff often are less effective due to unfamiliarity with how the care group operates and may also have motivational problems.
5. Due to the pressure on staff to complete all their duties despite being constantly under pressure from under-staffing, a number of bad practices developed at the care home which led to complaints from several residents’ families and the eventual departure of the manager from a job that she repeatedly said she ‘loved’.
6. A new manager has now been sent in to sort out the issues at this care home and ensure the standard of care meets the care group’s claimed levels.
7. While carrying out care on a resident, two carers (my wife and a young man on his second day at work) were faced with a difficult situation. Half-way through being changed, the resident, who was well-known as having behavioural problems, started to get agitated. The two carers had to decide whether to stop changing the resident out of her soiled pad and clothes and thus leave her lying in her own excrement thus risking being accused of not providing proper care or to continue changing the resident out of her soiled pad to make her comfortable and avoid having her lie in her own excrement for several hours more. The two carers made the decision to continue changing the resident to make her comfortable. While my wife cleaned the resident, young man talked to the resident to calm her down and placed a towel over her hands to prevent her hitting and scratching the carers and from injuring herself. No harm was done to the resident, no ambulance was called, no doctors needed to attend and there was no bruising or any other signs of harm on the resident. Nevertheless, in the view of the care home management, the two carers made the wrong decision and should have left the resident lying in her own excrement. And now a disciplinary hearing has been organised against one of the carers my wife for supposedly wrongly using restraint on a vulnerable resident
8. Some of the accusations that are being leveled at my wife are totally untrue and may constitute slander/libel. For example, my wife is accused of placing a towel over the resident’s hands to prevent her harming the carers or herself. Yet the report of the incident makes it quite clear that it was the young man who placed a towel over the resident’s hands and that my wife did not do this. Yet my wife has been unjustly accused of this.
9. A tape-recorded interview was conducted with my wife by the new care home manager. In this interview, the care home manager claimed to my wife that the report of the incident stated that “we” (meaning my wife and the young man) placed a towel over the resident’s hands. This was not true. In fact the report clearly states that “I” (the young man) placed a towel over the resident’s hands. By either mistakenly or deliberately misrepresenting the contents of the report, the new manager led my wife (who is not a fluent English speaker) into admitting to mistakes she had not actually made due to her shock and confusion at the interview and her failure (because of not being a fluent English speaker) to understand exactly what was being said and what she was being led into agreeing to.
10. The false accusation that my wife placed a towel over the hands of the resident and the tape-recorded supposed ‘confession’ will now form part of the disciplinary hearing against my wife even though it is stunningly clear from the incident report that it was the young man and the young man alone who placed the restraining towel over the resident’s hands to prevent her harming either the carers or herself.
11. With ever more people getting dementia and needing care, this incident indicates a dilemma that faces carers who are often from abroad and on minimum pay. If a resident becomes agitated and strikes out as many severe dementia sufferers do, official guidance is that no restraint should ever be used. However, if carers can see an elderly dementia sufferer is uncomfortable from lying in his or her own excrement, their natural instinct is to want to change the person’s pad and clothes to make them comfortable. This is especially true if (as was the case with my wife) the carers are already half-way through changing the resident.
12. I expect that this week or next week my wife will be fired from her ‘sh*t’ job because (I believe) the new manager wants to demonstrate her authority and that things that happened in the past will no longer be tolerated. I, on the other hand, feel that my wife and the other carer made the right decision to carry on changing the resident out of her excrement-smeared clothing and pad even if they had to use just a little mild restraint – a towel placed over the resident’s hands.
I wonder what you would want if you had an elderly family member with severe dementia – them to be left lying in their own excrement or for the mildest form of restraint to be used to make them clean and comfortable?
Your wife has all my sympathy for the predicament in which she finds herself. At one point in my career as a health professional I came into daily contact with patients suffering from severely reduced mental capacity following stroke and I know how difficult it can be to treat or care adequately for people whose higher centres no longer function. Throughout health care, education, policing, the idiots are now running the asylum. If kind, well-intentioned, health carers, teachers and indeed police constables – all those “at the coal face” – risk unjustified persecution for no more than trying their best to do extremely demanding jobs, eventually there will be no one left willing to put him/herself in the firing line. I know I wouldn’t. I am mightily thankful that I was able to retire with honour about the time the culture of suing anyone for anything in health care was beginning to kick in. If your wife is “let go” for some falsely perceived dereliction of duty, I can only say I hope she speedily finds alternative employment, where she will be better appreciated. In my professional life in hospital, although it was not part of my “job description”, I not infrequently assisted overstretched nursing staff in removing soiled clothing or bedding from a mentally impaired patient, then cleaning and re-dressing them. My assistance was appreciated primarily because I was an extra pair of hands preventing the patient from fighting the nurses and smearing faeces over themselves and the nurses. What the young man assisting your wife was probably trying to prevent when he deployed a towel. This entire issue of unjustifiably alleging cruelty to residents in institutional care is yet another case of a sledge hammer to crack a nut. Of course there have been sadists caring for demented patients, just as there have been paedophiles teaching in boarding schools, murderers practising as doctors (remember Dr. Shipman?) and bullies working as serving policemen. When such are identified, the Law should prosecute and impose sentences of the utmost severity. But leave kind, caring, perpetually severely overstretched health care staff, teachers, doctors and police to get on with their demanding work without interference and to the best of their abilities. (Unrelated but supremely idiotic, the news story this a.m. of a comedian who has withdrawn from an arrangement to entertain students at some university because of the list of a dozen or so topics – readers can guess what they are – to which he must guarantee not to refer, since the auditorium must be a “safe space”!)
had the patient been left in excrement the next possibility would be the patient suffering skin damage and then ulceration which would cost the care home a great deal
Exactly! Apart from the pain for the patient/resident and the possibility of bacterial invasion of the ulcerated site, leading to sepsis and death!
Jacob Rees Mogg…a PM we need..
https://twitter.com/Jacob_Rees_Mogg
Jacob Rees-Mogg: “A taxi driver said to me he didn’t vote for deal or no-deal, he voted to leave, and that’s what he expects to happen…the world will carry on. Business will carry on.”
If there is “no room for renegotiation” then we leave without a deal and do not pay the EU £39 billion.
https://twitter.com/Jacob_Rees_Mogg/status/1072572709048070145