I’ve been visiting a public nursing home very frequently, and I’ve been shaken by some of the things I’ve noticed and some of the things I’ve been told.
The clue is in the name.
Nursing home. That’s Home.
I can see nothing homely about the public nursing home I’ve come to know so well. What I’ve seen is an institution, a place where everybody — staff and residents — are institutionalised. But what’s tragic is that it wouldn’t have to be like that if only attitudes were different.
Ireland has a strong authoritarian streak, limited only by our membership of the EU that forced us to comply with certain basic norms, whether we liked it or not. One of those norms is this: people are entitled to their essential human dignity. This is not something in the gift of any other human being. It is not to to be offered or withheld at the whim of a ward manager, a cleaner, a nurse, a doctor, a kitchen assistant or a clerk.
And yet, from what I can determine, human dignity is withheld all the time in nursing homes under the control of the HSE, though in a more subtle way than the days when a staff member felt comfortable threatening a resident: take your pills or I’ll bust your jaw. Legislation and the fear of the HR department have changed that, but neither law nor HR administrators can change mindsets.
That”s why there’s no more overt bullying, or at least not when anyone is watching. Instead, it’s covert and insidious.
Let me give you a few examples. Would you, as a grown adult tolerate anyone addressing you as Good girl or Good boy?
Would you, if your mobility became reduced due to an injury, tolerate anyone berating you for dropping food on the floor?
How would you react if somebody constantly spoke to you in an exaggeratedly loud voice?
If you had diarrhoea and vomiting, how would you like being told you’ll have to wait?
How would you feel about a uniformed authority figure assuming you have some cognitive disability even though you know you are far better read than they are?
How would you, as a grown adult, like it if you had no defensible space, no privacy and no say in the decisions made about your living conditions?
How would you like it if you had nowhere to keep your personal possessions or the little luxuries that a grandchild might bring?
How would you feel if those little treats mysteriously disappeared in the middle of the night?
How would you feel if you had no entitlement to a key for a locker?
How would you like it if your clothes went to a common laundry and if they returned stretched, shrunk or not at all?
I know that a nursing home is not a hotel. I realise that all residents have health problems of one sort or another, but a nursing home is not a hospital. It’s a home. It’s the only home the residents have or will ever have, and yet, the regime in public nursing homes is all about authority, at the expense of the residents’ dignity.
Let me ask a few questions.
Why does a nursing home physically need to look like a hospital? Why is it painted in the soulless hospital cream?
Why can’t there be semi-private spaces that people can retreat to when they feel the need?
Why do staff need to wear uniforms?
Why can’t staff address residents in a normal conversational tone of voice as equals, unless they happen to know the resident is deaf?
Why can’t staff assume that a resident is compos mentis unless they have evidence to the contrary?
What would be wrong with basic courtesy towards another human being?
Why are staff given to understand that they have authority over residents when in fact they do not?
Why do some staff think they have a right to discipline residents verbally, as they might do to a child?
Here’s a revolutionary idea: what would be wrong with asking residents how they’d like their homes to be organised? How about consulting the people who live in public nursing homes, listening to them with respect, and doing what they request, as far as practicable?
It’s all about respect in the end.
It’s all about dignity, and most of it would cost the HSE nothing, since basic courtesy is free. In all likelihood, the staff would never think of treating their own family or friends the way they treat their vulnerable, powerless residents, unless they wanted a strong reaction. A very strong reaction indeed from those of us who aren’t impaired in one way or another.
There is nothing worse than being rendered powerless, but sadly, as with all Irish institutions, the only way this will change is through fear, and in that regard, we can only welcome the appointment of the Confidential Recipient, Leigh Gath.
I might just get in contact with this admirable woman. And I might just install a hidden video camera that operates even when I’m not there.
What do you think?
Failing that, I might get legal on their ass.