Elderly suffer from neglect, cruelty and abuse.12th February 2007
The elderly are suffering from neglect, cruelty and abuse.
An investigation to be shown on TV tonight reveals the truth about treatment of the elderly in nursing homes. Its findings raise disturbing questions for us all
Agnes Moore is 68 years old, diabetic, a double amputee and, two years ago, lost her husband of 45 years to cancer.
But she's also a practising Roman Catholic, and every night, before she goes to bed, this former auxiliary nurse prays for those worse off than herself, and for one, easily forgotten group of people in particular.
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"I pray for those in nursing homes who are being ill-treated," she told me when I visited her in the comfortable sheltered accommodation where she lives in the West Yorkshire town of Halifax.
Agnes, you see, has first hand experience of the appalling cruelty and ill-treatment that is all too frequently meted out to residents in some care homes for the elderly in this country. Scandalously, this sort of abuse is rarely pursued by the police or Crown Prosecution Service, and neither Social Services nor the industry regulator have been given the powers to prevent it.
If the cruelty that is being inflicted on some of our most frail and vulnerable senior citizens was being done to children, there would be an immediate public outcry and the abusers would be frog-marched straight to prison.
But it isn't and they aren't, and so the abuse continues, as Agnes and many others told us as we researched for a Panorama programme being shown tonight.
In 2004, when her husband, Brian, was entering the last months of his life, Agnes was due to undergo her second amputation. Until then she had been helping to look after Brian at home, but when home help arrangements broke down, there was no alternative but for both of them to go into a local nursing home.
Brian unfortunately died soon after, but Agnes, grieving, exhausted and in pain, stayed at the Laurel Bank Nursing Home in Halifax for what was called respite care. But this was certainly no rest cure.
While she was there, she was badly and painfully lifted; a sore on her back that she arrived with was so poorly treated that she developed septicaemia; and, perhaps most shocking of all - although she did not tell her family at the time so as not to upset them - she was slapped across the face by a member of staff.
Agnes's mistreatment, we would discover during the course of making the programme, is by no means unusual. There's nothing special or unique about Halifax - its care homes for the elderly are not obviously worse than those in any other town or city in Britain, nor is its Social Services department scandalously negligent.
But that is exactly what makes what we discovered there so alarming.
Because the incidence and persistence of elderly abuse we found in this ordinary Yorkshire town suggests that a great many other elderly and vulnerable people in this country are enduring a painful, stressful and often very frightening old age.
Agnes eventually made a full recovery but only after she was transferred to hospital, where she finally received treatment for her septicaemia -she was so ill that doctors told her family she might not survive the next 24 hours. Others, however, were not so lucky, despite the diligence and dedication of some of their relatives.
John Hoyle is a management consultant, lecturer and magistrate, and until his 87-year-old mother, Irene, had a stroke in 2000, he had helped care for in her own home.
When a nursing home became the only option for his mother, he continued to visit her every day, confident that the care home staff were doing what they were supposed to do: caring for his mother.
Even he - an intelligent man and attentive son - couldn't spot what was going on, and because the stroke had left his mother unable to speak, she couldn't tell him.
He could see she was distressed and seriously unwell but the care home told him it was pneumonia and advised that nature be allowed to take its course.
But it wasn't pneumonia, it was septicaemia - blood poisoning - and if John had thought to lift off his mother's blankets and remove the dressings on her pressure sores, he would have discovered why. The flesh had rotted right down to the bone.
John only discovered this after his mother had died in a local hospital and a post-mortem test was carried out. He was so appalled by what the pathologist discovered that he asked a forensic photographer to take pictures of his mother's dreadful wounds.
"I'd no idea that I could have looked under the dressings to find the bones protruding," he told me. "Who would have thought that in that atmosphere of total trust, that is something that one ought to have done?' John is not the sort of man to let such neglect pass unchecked.
Despite meeting enormous indifference and resistance - one lawyer declined to take on the case because he couldn't see significant damages being awarded - he pursued the case and eventually the two former owners of the home, who were both nurses, were found guilty of professional misconduct.
"Had a child been involved, I'm quite certain there would have been a trail lit to the very doors of Whitehall: it would have been in all the papers on the front page, but I think with old people it's something that's part of the package."
Mike Rourke, director of inspection regulation and review at the Commission for Social Care Inspection, the body that regulates care homes, rather surprisingly, takes a similar view.
"We think that the levels of awareness are increasing, we're certainly seeing more referrals of allegations (of abuse of the elderly) but there is definitely a gap in the legislative framework for adults and for children."
Halifax, it must be emphasised, is not a town that doesn't care for its
older citizens. Far from it. In 2004, the council, Calderdale Council, reviewed its past practices and declared: "Calderdale aspires to be the safest place in the UK for older people in care homes."
And yet the abuse continues, as even the council's new group director for health and social care, Jonathan Phillips admits: "There are too many examples of people in care homes suffering abuse or very poor care, there is no question of that."
His advice for anyone going through the traumatic process of placing a close relative in a care home: "Remain vigilant".
There can be few people more vigilant than Marilyn Hartley, a former magistrate, whose 82-
yearold mother, Lily Leatham, nearly died when she went into Laurel Bank in 2002.
While she was there, Lily developed grade four pressure sores - the flesh was rotting. "That smell never leaves you," says her daughter.
While she was at Laurel Bank, Lily became severely malnourished. The home later admitted
clinical negligence in a legal case brought by the family, but Marilyn believes relatives need more help. "There's no protection for elderly people."
But what do our elderly need protecting from? We spoke to a former care worker at Laurel Bank, a young women called Sarah Barrett, who went there untrained but keen to help.
By the time she left, she was deeply disillusioned and says relatives could never have known what the place was really like unless they worked there."They saw what they were supposed to see," she told us.
She witnessed residents being verbally and physically abused and one female especially humiliated: "towels, flannels - slapped on her bare arse. Water splattered in her face - to shut her up, to really give her something to scream about."
Laurel Bank is still open, and according to the latest inspection report from CSCI, the care home regulator, now very much improved. That is terrific but it's indicative of how CSCI likes to work - by encouraging homes to meet specific set targets and ensuring these targets are met through inspections.
This may prove effective in achieving medium to long-term improvement, but where care at a home has gone badly wrong, this softly, softly approach can leave residents and patients dangerously at risk. CSCI now admit it should
have required a much faster turnaround at Laurel Bank and allowed the home to be "tawdry, frankly, in addressing the issues".
The regulator has run into similar problems at another nearby care home, The Haven, where John and Dorothy Burton became so concerned about bruising on John's 87-year-old step-father, Arthur, that last month they moved him to another home.
CSCI admits "people were left at risk" at The Haven and want to close it down, but the owners have appealed and it's still open.
Clearly, CSCI cannot and does not operate as a sort of adult protection force. Their way of doing things is to get nursing homes to improve themselves. But what happens when care homes don't improve themselves and patients are left at risk?
Social Services are described as the lead agency for adult protection, but they lack statutory powers, particularly as a crucial part of the draft Mental Incapacity Bill proposed by the Law Commission in 1995 - which deals with the physical protection of the elderly and gave powers to rescue them from harm, similar to those that protect children - was never carried into law.
When approached, both nursing homes declined to comment. As for the police, what West Yorkshire Police told a Calderdale Council working group, when they were looking into the safety of older people in care homes, is certainly instructive.
"West Yorkshire Police reported that they do not keep specific data because it is not a huge concern." Not huge to whom? It certainly is of the greatest possible concern to those elderly patients being abused and to their anxious relatives.
The police say they recognise that this is a "sensitive issue" and "take any allegations very seriously and would gather evidence if necessary". But there's an obvious problem here. Old people, just like children, often make poor witnesses. They forget things. They get confused.
Not so long ago, the idea of children being abused and neglected seemed, to many, unthinkable. Perhaps it's time to begin thinking something similarly unthinkable - that old people in the trusting setting of a nursing home may be being abused - and start from there.
PANORAMA: Please Look After Mum is on BBC1 tonight at 8.30pm.