Recently I read about the death of 89 year-old dementia sufferer Gordon Penfold who died whilst in the care of Charnwood Oaks Care Home. In the enquiry following his death the coroner criticised the home for failing to respond to his falling weight, making no real attempts to arrange for support from his GP or a dietitian. His family felt terribly let down as they had trusted the home to care for their father who couldn’t communicate himself. Although they had visited regularly, given that he was bed-ridden, I imagine his weight loss had become severe before they registered it. At that point they had insisted on a visit from a medical practitioner, but by then Gordon was too poorly to recover.
This was followed two days later by a programme on BBC Radio 4 about the impact on the Hyde surgery and its patients of GP Harold Shipman’s terrible series of murders. The current GP spoke with feeling about the loss of trust in the practice and the lengths he had gone to rebuild this trust. These two articles coming together made me ponder on the huge importance of the trust we place in those who care for us and for our loved ones.
Unless someone is still living at home with their carers it is likely that s/he will be left alone for quite lengthy periods. Medical staff may monitor them and family and friends will visit but we are very dependent on professional carers to maintain a proper standard of care. When I think of my fears about dying I find it can centre on how safe I will feel in the care of a nursing home who may have tens, if not hundreds of other residents many of whom may be in the same state as me. What if I’m not able to communicate with the staff or tell my visitors to speak up for me? I remember a friend’s mother visiting her husband every day at his care home because she knew that they would often just put his food in front of him or fail to realise he needed the commode. Suffering from severe dementia he often couldn’t feed himself and she couldn’t bear the thought of not being with him at mealtimes long after he no longer recognised her. In essence, she did not trust the nursing home to care for him.
It makes me sad to think of all the people who have no one to look out for them, to check they are not being neglected or even abused. The level of trust we need to place in those who look after the dying is pivotal to a good death but I wonder if we have enough checks and balances in place to ensure it is to the standard we want? Maybe the worry that this trust might be misplaced is what keeps elderly couples living in extreme difficulty caring for each other rather than “going into a home”. After all, if we can’t trust a GP who makes a home visit to an elderly person who can we trust?