This blog is the second in a series responding to the RSA's work on Reimagining the care home.
The decision to commit a much loved one to a care home is not straightforward, not easy, not comfortable. For someone with advanced dementia the decision is final; there is no way back. Questions such as “Could I have done more to allow my wife to stay at home? Have I done the right thing? What now for both of us?” are inevitable. Personally I do not want to have to make this decision. I particularly do not want any of the words your report identifies as most associated by the public with care homes, ‘Boredom’, ‘loneliness’, ‘illness’, ‘isolation’ and ‘uncaring,’ to apply to anywhere I might select.
The decision to be taken has to be that incredibly difficult combination of holistic and individual. My wife enjoys gardening, loves our dogs, is an avid fan of live classical music, collects teddy bears, and as an ex-PE teacher thrives on fresh air. However good a rating any care home receives from the Care Quality Commission, it is highly unlikely that under the current system these life affirming activities can be easily catered for, especially in a high dependency, behind a locked door, unit. Of course things are different and we cannot expect life in institutional care to be the same as care at home. And yet the cost of care - while variable - is as a rule exceptionally high. Perhaps there could to be the opportunity for some tailored negotiation here?
From a personal perspective it is also where the work of RSA with the Airedale Social Health Movement could be so valuable. I just love the idea of the engagement of young people with those suffering from dementia. The natural enthusiasm of the young, their lack of fear and desire to both help and learn could deliver enormous benefits. As past memories diminish it is vital to replace them, no matter for how short a time, with new and interesting thoughts and ideas. Storytelling, arts activities, sharing photographs and beauty therapies feel to me as though they could provide this. I do not believe any one-size fits all approach to care would do anything other than destroy my wife’s soul & will to face the new day.
As the RSA blog makes clear, care can only be as good as premises, their ethos and staff expertise, professionalism and sensitivity will allow. Nevertheless care homes need not, and should not, be the end of the road for those struggling to cope. Intelligently managed & resourced they should have the capacity to offer a new lease of life for those for whom being at home has simply proved impractical. I do not want to let go, but I know I have no option and all I can do is ensure I make the right decision. I will most certainly be referencing guidelines provided in “Reimagining Care Homes” as I continue my search.
Read more about the RSA's work on Reimagining the Care Home in this blog by Research Assistant Becca Antink
Read more about the RSA's work on Health as a social movement
Follow the RSA on Twitter and stayed tuned for the next blog in the series