A comfortable chair, a hand to hold

I came across this quote from the renowned psychiatrist RD Laing in the manual handling bible affectionately known as the HOP 6. I thought it very apt for these times: ‘The range of what we think and do is limited by what we fail to notice. And because we fail to notice that we fail to notice, there is little we can do to change unless we notice how failing to notice shapes our thoughts and deeds.’

After 10 years in the care sector I feel the cracks in the system are now crevasses that elderly frail people are falling through on a daily basis. 

Working across nursing homes I have clients, many diagnosed with dementia, referred to me because they are falling, sometimes several times a day. When asked, my professional advice is to have someone sit with them, hold their hand, reassure them. We follow best practice, comply with statutory duties and complete appropriate assessments and referrals. That is all we can do. One-to-one care packages are too expensive, and our commissioners have removed ‘falls’ from its eligibility criteria.

So my clients fall, over and over again, while we say we have done everything we can to keep them safe. While ‘we’ as a small cog have fulfilled our duties, our health and social care systems are leaving these vulnerable people to repeatedly fall, banging their heads or breaking their hips, until their injuries confine them to bed, and they die. 

And nobody is outraged by this? If this were children, the newspapers would be screaming, and people would be marching in protest. But nobody seems concerned and grieving relatives are not best placed to challenge the authorities when death may be seen as a blessed relief. 

If I could change just one thing, I would wish every client a comfortable chair. I guarantee that carers would notice an immediate drop in stress levels, a de-escalation of challenging behaviours, improved health and perhaps even better function. 

However, I have no authority or power. I am just one small cog. I am involved with projects looking at how technology can reduce care costs where ‘money is not an issue’. I can trial little humanoid robotic carers and all sorts of applications of Alexa and Echo and there are ‘pots of money’ I can access to use the new technologies. But none of this is going to help Jim, 94, who has had seven falls this week. Jim just needs a comfortable chair, a hand to hold and a friendly face. Simple enough, but apparently beyond us.

• Pat O’Brien is a physiotherapist in the nursing home sector in the South West.