More and more of us have an elderly relative in residential care. Currently more than 400,000 people in the UK live in care homes, a figure which is bound to rise further, given the ageing population (there are currently 3 million people aged over 80 in the UK, and that figure is predicted to almost double by 2030. Currently one-in-six of the UK population is aged over 65; by 2050 it will be one-in-four).
NICE the (National Institute for Health and Care Excellence) has issued new guidance on improving the mental wellbeing of older people in residential care, via a quality standard which stresses the importance of meaningful activities.
It might sound blindingly obvious that with so much time to fill (as much as eleven hours a day) once the basics of eating, sleeping, dressing and personal hygiene are dealt with, many people in care homes get lonely, bored and depressed. Research by the Alzheimer's Society showed that, shockingly, the typical person in a home spent as little as two minutes interacting with staff during a six-hour period.
My father was in nursing homes for three months a couple of years ago while he was waiting for, and recovering from, orthopaedic surgery. Day-time entertainment was limited to sitting in the lounge watching TV. He detested being "put through" the Jeremy Kyle show day after day and came to prefer staying in his room, alone, watching the telly we took in for him. Our visits were a welcome distraction from the monotony. Staff were well-meaning, but too busy to stop and chat.
If you have a relative in a care home, what questions should you ask?
Some care homes already pride themselves on the personalised care and range of activities they provide, but charge a premium for it. Given that it's often relatives who are choosing the home, and arranging payment, asking the right questions and having high expectations could help change the current culture (identified by NICE) of providing the bare minimum.
If you have a relative in a care home, what should you look for, beyond the basics, and what questions should you ask?
Has the home taken the time to find out something about your relative's background – not just their health, but their interests and experience? This can make a huge difference to their self-esteem, and it can be particularly important for people with memory issues, who find it harder to recall past events without a prompt.
Are a range of activities available?
Is your relative encouraged to take an active role in choosing activities that are meaningful to them? (Not everyone will want to join in with the same thing)
If they are very frail, can they still access activities (perhaps via one-to-one or small-group sessions)?
Are you, or other members of your family, encouraged to join in activities with your relative sometimes?
Supporting charities that focus on older people can also have an impact, allowing them to conduct valuable research and spread their influence. In a recent interview in The Guardian, actress Carey Mulligan spoke of how she's chosen to champion the Alzheimer's Society, because she wants to change the public's perception of dementia, following her grandmother's diagnosis: "The way people treat it, as if it's funny, really pisses me off."
I'm a trustee of Independent Arts, an Isle of Wight charity that provides therapeutic arts in the community – including in care homes – and I've seen the transformative effect singing, reminiscence, music, art and movement can have on people. In one reminiscence session, we arranged to take a vintage car to a nursing home. A lady with dementia, who'd been in a wheelchair for weeks, was suddenly animated. She stood up and walked to the car and got in, recognising it as the same model she and her husband had owned in their youth. The care home staff were astonished by the change in her.We'll all be old one day – hopefully – so let's address how people in residential care are treated. The guidance from NICE is a good start.