'A dignified man facing an undignified death' - retired Norfolk teacher calls for rethink of our welfare state
PUBLISHED: 16:23 24 February 2016 | UPDATED: 07:41 25 February 2016
A Norfolk retired teacher, who asked to remain anonymous for the privacy of the individual involved, makes a poignant case for a major rethink of our welfare state.
It’s not sensational enough to make the news. No emaciated ribs, he wasn’t found face-down, drowned in the gutter. It’s just a story telling us something about the Britain we choose to live in. It’s a story of institutionalised neglect. About how someone, just like you or me, becomes a mere statistic.
A man of 96 – never been ill in his life.
Slim and temperate, until last summer, he was a regular walker. That’s why he was so fit. For years, he’d exercised his huskies in the forest twice daily.
But when the last one died, he decided it might be wise not to replace it.
He was getting less steady on his legs. So he walked alone in the forest, every day.
He was a man who had never been inside a hospital. Didn’t drink, smoke or gamble.
Since he retired at 60, he gave away half his monthly pension to various charities. No family. No close friends. Just a man living happily on his own in Britain.
Then he got an ulcerated leg.
It was difficult to get a doctor’s appointment and then it took some time for the doctor to organise nurses to come in and dress the ulcer twice a week: a pity, since the ulcer put an end to those healthy daily walks.
For three months, the ulcer just didn’t heal.
Perhaps the doctor should have called in to see how the man was, see if the nursing strategy might need modification? But doctors don’t do that sort of thing in Britain today.
Maybe the doctor, who has an enormous caseload because he works in Britain, not Germany or France, had forgotten that one of his patients who had always been fit was now spending all his days housebound, getting no exercise, with an ulcer that wasn’t healing?
But the man was cheerful and self-reliant. He got Budgens to deliver his shopping each Friday and did the washing and the ironing and the cooking still. Not bad for a man of 96. He wasn’t complaining.
Then he suffered a very minor stroke.
Was that anything to do with being stuck at home for weeks, not getting any exercise, losing his appetite and therefore eating less well? Who knows?
A neighbour noticed a slight distortion to the left of the Man’s face. The Man could still speak, but his memory was shaky. He was still himself, he could walk (slowly because of the ulcerated leg) but it seemed wise to call in the paramedics.
The doctor who knew him wasn’t available for home visits. The earliest appointment available at the surgery would have been a week later. Better safe than sorry, the neighbour thought.
The paramedics were prompt and caring. They decided it would be prudent, for they didn’t know the Man personally, to be taken into hospital overnight for observation.
The hospital reported back to the neighbour: they’d decided to keep the Man in, just for observation for a day or two as there was no transport available to take him home and he would need some social care.
It wasn’t something they could arrange quickly, even though, they admitted, very similar situations occurred every day.
No, they didn’t have that kind of capacity, to organise appropriate social care promptly, and no, the hospital didn’t have a social care unit.
It was fine, nothing to worry about: the neighbour could go on holiday as planned. The Man was in a specialist stroke unit, there were several similar men in there though two of them didn’t need to be in hospital either.
When the neighbour got back from holiday three weeks later, he had become A Different Man. Whether this was because he had suffered more minor strokes or because he’d fallen over a few times, (nobody seemed to know whether it was once or three times he’d fallen over, nurses have so many forms to fill in these days, are so busy at their screens, they can’t be expected to watch the whole time) or because he’d been spending every day in a room without windows, without a radio or any kind of stimulation, without any intervention from the dementia team and fed a poor hospital diet, nobody could say.
The Man certainly was dramatically worse: he’d lost a lot of weight, over 20pc and he was always slim – so much worse that, obviously, he couldn’t go home because he’d deteriorated beyond that stage.
“Sadly, we missed that window,” the doctor said. The Man needed a place in a nursing home.
Here’s a blameless man of 96 who was an air gunner in the war, who for the last 20 years has given half his money to charity, who shouldn’t be in hospital at all but has been there for two months, who’s become institutionalised, a mere statistic, a bed blocker.
The neighbour was advised to find the Man a bed in a nursing home. One catering for people with dementia. The neighbour was puzzled. How did you go about finding a nursing home? The neighbour knew nothing about nursing homes. How many people know anything about nursing homes?
Eventually the neighbour was able to talk to a social worker who gave a list of homes. He’d been too busy to visit any himself and, sadly, none of them were where the Man wanted to live, in his own town. And, of course, even if he had visited them, the social worker wasn’t allowed to tell the neighbour which homes were good, which were dreadful. It seemed a very odd situation.
Surely, the neighbour reasoned, the state has nursing homes for people who are 96 and have suffered a minor stroke?
Surely the hospital which has lots of men and women like this man every year to deal with has units in the community, near a person’s home, where people can go and be cared for well when it becomes necessary? Surely it’s not left to money-making companies to provide care for the vulnerable, to see nursing care as a profit-making opportunity? Imagine the kinds of nursing homes you’d get if that were the case!
Would they be well staffed by qualified nurses who had time to sit and talk to their patients?
Would the accommodation be welcoming, homely, a dignified place in which to spend one’s final years rather than some dreadful place resembling a seedy boarding house where the television blared out all day to a ring of old folk with their zimmer frames because if you dumped them all in front of daytime television all day long, you needed only one nurse on duty?
A very British euthanasia: a slow and undignified death.
Surely places run for profit would be dedicated to doing everything on the cheap?
Well, it depends what you mean by cheap. The places available to the Man charged about £1,000 a week so his house would have to be sold because his assets were worth more than £20,000. The neighbour visited a few homes and decided that if that was what awaited him when if was 96, he’d better book a trip to Switzerland now. It wasn’t a question of choosing the best, just of trying to decide which of the available handful was the least awful.
They were mostly dingy, smelly, scruffy, furnished with melamine chipboard cupboards with wonky drawers.
That’s what many of Britain’s nursing homes are like: not places you or I want to end up in.
The Man is still in hospital, lonely and waiting to die. You can visit him: he’s one of thousands.
Britain is, we are told, one of the richest countries in the world. We have an ageing population, a large population of the very old. Contrary to appearances, old people think and feel very much the way they did when they weren’t old people. White hair and being brain dead, insensitive, ignorant, useless and uncomplaining do not go together.
When we say Britain is a very rich country do we simply mean that if you are very rich you will be OK? Because if you consider the life experiences that most people can look forward to when they retire, the way most people will spend at least 20 years of their lives, especially the last two or three years, it does not look like a very rich country – more like a third world horror show.
We need, urgently, a national debate. Either we live in a country which believes in the Welfare State, in looking after people well when they need to be looked after – by taking money from that tiny percentage of the very rich and investing it for the benefit of the vast majority who cannot possibly afford private education, private health care and comfortable nursing homes – or we do not.
We could create an integrated health and social care system that would be the envy of the world if we raised income tax a little and remorselessly pursued all those individuals and companies presently evading taxes. Simply make it a criminal offence with stiff penalties to attempt deliberately to avoid paying tax.
All Cameron’s government wants to do is cut the Welfare State so rich people pay less tax and multinational companies can continue to pay very little tax at all.
Why aren’t more people concerned about what will happen to themselves? Because everyone will be old sooner than they expect. The circle of zimmer frames in the television lounge, with the hideous floral carpet and the plastic daffodils reeking of air freshener, has a space waiting for every one of us.
Does this poignant tale resonate with you? Do you know someone in the same worrying and sad situation? Write to EDP Letters, Prospect House, Rouen Road, Norwich NR1 1RE or email EDPLetters@archant.co.uk