As I walked into my aunt’s care home recently, I noticed the ‘A Team’ were on duty. Fab, I thought, it’s her birthday and this will be a glorious day.
There she was, in her wheelchair, in the lounge, looking lovely, dressed in her favourite skirt with everything matching, her hair nicely arranged. I knew that my aunt would approve.
Everything was right that day. My aunt drank tea from a china cup and elderflower (her favourite tipple) from a glass. She ate a little of the afternoon tea independently. She used a napkin.
My visit two weeks previously was different. My aunt had looked a little dishevelled, in an uncoordinated outfit, her hair was a mess.
As we sat in the dining room on that occasion, one of her carers came across and popped a plastic apron over my aunt’s head, her bib. Lunch arrived in a bowl. The contents were as always, orange, green, white and brown – who knows what it was? No one said. Her drink was delivered in a plastic spouted beaker, with a straw inserted for good measure.
Service was with a smile. I cannot say that any of my aunt’s carers are unkind. They are not. So why were the two visits so different? The ‘A team’ visits leave me happy that my aunt’s life, such as it is, is enriched. Other visits make me sad, because the boxes for “get her up,feed and hydrate” are ticked, but probably not much more.
This is a very familiar pattern for me, but why is the difference so stark? The staff quotas are always the same. The residents are largely unchanged, so the workload is fairly predictable.
The difference is in the mindset. It is about our own personal standards, and the personal care we individually strive to give.
The ‘A Team’ are always able to deliver all the tick box requirements of my aunt’s care, they just add thought to the mix. Her food doesn’t need to be almost liquid. My aunt won’t eat it. Her drinks don’t need to be in a spouted plastic beaker with straw. This is alien to her. She has spent her life drinking from a cup and saucer, or a glass.
My aunt’s mental capacity may have deteriorated, but her intuitive judgement is alive and kicking. Her swallow reflex is compromised, but all speech and language therapists worth their salt will tell you that these spouted beakers are a “no no”. Straws are a “no no no”.
“Plastic spouted beakers, plastic bbs or aprons, and incontinence pads compromise dignity”
What I am looking for, quite simply, is dignified care. Plastic spouted beakers, plastic bibs or aprons, and incontinence pads compromise dignity and the values that the 6 Cs teach. It is perhaps important to add that I have observed a lack of dignified care, as well as heart-warming dignified care, in all healthcare arenas. This is not just about my aunt’s care home. This is not a case of “this doesn’t apply to us”.
My aunt was never a nurse, but she cared for her own mother until she died aged 106. She understood dignity. The principles of the 6 Cs were instinctive. A spouted beaker would not have been entertained. Tea was served in her Minton china and cold drinks were served in a glass.
If my grandmother required a little help, then it was given. She lived a dignified life to the end. My aunt, even in her confused state, through the devastation that a massive haemorrhagic stroke has caused, will still talk about how she loved and cared for her mother.
I am a former nurse, my sister is still an intensive therapy unit nurse. I understand what it feels like to be up against the clock. However, I hope that my story illustrates that dignified care of an individual is about mindset, and that you can still win the race against time.
If the ‘A Team’ can manage to deliver personalised, dignified care then I think we all can.
Let us try to #Endplasticspoutedbeakers please.
Elizabeth Meatyard is a former nurse and founder of Dining Companions at Kingston Hospital