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Source: (consider it) Thread: 15 Minutes
Boogie

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# 13538

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Home carers are increasingly being given only 15 minutes per visit.

Fifteen minutes to get up, have a shower and breakfast - no way!

My son was a carer for disabled men in Germany until recently (he's now training as a nurse) and every one of his visits was an hour long, often more.

Why can't we do this?

Why can't we employ enough carers and pay them properly?

Link to newspaper article

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Sarkycow
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# 1012

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Because the money comes out of council budgets, and councils are increasingly being told to do more things with less money. Every service is squeezed.

Councils might have more money if we all paid more taxes. But then lots more people would need help cos they didn't have enough to live on.

It's also partly down to how we value different jobs - carers don't require many qualifications, so it's perceived as a basic, anyone-can-do-it job which isn't worth much. Until you require one. But when you require one you tend not to have much pull at decision-making levels any more.

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Baptist Trainfan
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# 15128

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Dare we also say, "Because caring services are contracted out to private companies, who have to make a profit for their shareholders"?
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leo
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Yes, we dare, because it is true. 'Caring' rarely exists is it has to be paid for. Those who go into such work because they care are also being short-changed by being exploited.
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Baptist Trainfan
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... With the consequence that the good carers leave their jobs in frustration, and standards of caring fall.

My late mother had wonderful carers provided by Norfolk County Council (presumably under contract); however, according to local news bulletins, NCC now has a new "care provider" and standards have declined catastrophically in recent months.

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Higgs Bosun
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There was a very moving interview with an older lady on the Today programme this morning on this very subject (at about 08.35). Her care workers are not allowed to do simple things like cut her toenails. She has not had a bath for 3 years. But what she really wants is for someone to come, to cook a hot meal, and sit down and have a chat while they both eat it.

Someone once said that the reason we have a welfare state is because we don't have a welfare society. This lack of real care for the isolated elderly is a symptom of this.

[ 07. October 2013, 08:43: Message edited by: Higgs Bosun ]

Posts: 313 | From: Near the Tidal Thames | Registered: Aug 2011  |  IP: Logged
EtymologicalEvangelical
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# 15091

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I could write so much about this subject, and perhaps I might, given that I am a domiciliary care worker at the moment (one with qualifications, no less!).

All I'll say at the moment is that, as with most news items, there is another side to the story. Many 15 minute calls actually only need to last about 5 minutes, but they are only 15 minutes because that is the legal minimum Social Services have to pay - at least that's the case here in East Sussex. Many people requiring care do not need personal care, because they do it themselves - and if they wish to do this themselves, that has to be respected - very important!. But they may just need help taking medication, which usually takes a matter of a few minutes if, as is usually the case, a dated blister pack is used. Some of them do not even want the carer to hang around "for a chat".

Adult Social Services has a responsibility to ensure that vulnerable people have taken their medication. In an extremely busy day - with many half hour, three quarter hour, hour and multi-hour calls (many of which involve large amounts of time just talking to lonely elderly people with dementia), it is physically impossible to increase the time of calls that actually only require a task that takes a few minutes.

Now I am sure that some local authorities are abusing the system, and using the 15 minute facility to squeeze in calls that should last much longer. If that is the case, then carers should alert CQC or Social Services and get something done about it. Some of us are don't mind shouting off about a lot of things. After all, we don't have a lot to lose financially!

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You can argue with a man who says, 'Rice is unwholesome': but you neither can nor need argue with a man who says, 'Rice is unwholesome, but I'm not saying this is true'. CS Lewis

Posts: 3625 | From: South Coast of England | Registered: Sep 2009  |  IP: Logged
Boogie

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# 13538

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When my son worked as a carer in Germany he also had all his transport costs paid - a ticket which covered tram, train, bus, the lot.

There are plenty of unemployed people in the UK who would make great carers if they could get around.

There may be cuts but we are not a poor country. Our priorities are simply upside down imo.

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EtymologicalEvangelical
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# 15091

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quote:
Originally posted by Higgs Bosun
Her care workers are not allowed to do simple things like cut her toenails. She has not had a bath for 3 years.

Because it is not actually a simple thing. Have you seen the feet of many elderly people? The risk of infection is high, and there is a particular risk if the person is on Warfarin, which prevents the blood from congealing. Any small cut becomes problematic.

What carers are supposed to do is inform their agency that toes need cutting, and a chiropodist is sent to do it.

The insinuation that the interviewee may be conveying (I didn't see the interview, but I am just basing my response on what you have written), that this ban on cutting toenails constitutes some kind of neglect or even abuse, is totally out of order. The same goes for bath arrangements. Some people have particular disabilities which prevent them from getting in the bath, unless they have the proper equipment, which they may not be able to afford - or, more likely, are not willing to pay for, because if they genuinely could not afford it, it would probably be provided for them. Do the general public have any idea just how difficult daily tasks are for most disabled or elderly people? We may think that it's just easy to plonk someone in the bath. The reality is rather different...

Furthermore, she could have a shower, using a shower seat. Did she mention that?

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You can argue with a man who says, 'Rice is unwholesome': but you neither can nor need argue with a man who says, 'Rice is unwholesome, but I'm not saying this is true'. CS Lewis

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Raptor Eye
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One of my relatives was taken off of the council's care and put on a private 'care package'. Her health soon deteriorated when different carers walked in on her, and got her up and put her to bed at ridiculous times. She found it distressing to have to wait to get up, be expected to use an incontinence pad rather than be taken to the lavatory, and have men who were complete strangers walk in and give her the most personal of care. Her next door neighbour did a lot for her that the carers didn't do. She wouldn't let me complain. 'You don't complain dear, they make you pay for it'. What used to be an intelligent, confident, professional lady was reduced to someone whose spirit was broken and who welcomed death with open arms when it came.

I don't know what the answer is. As others have said, carers who do care are usually exploited out of the profession in the end. Nobody wants to hear it if people speak out. I'm not convinced that families should look after their own. They might have the right heart, but they may not have the patience or skills to do the right thing. Relatives are often ready to put great pressure on them too, as if there's an expectation of 100% attention.

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Be still, and know that I am God! Psalm 46.10

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EtymologicalEvangelical
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quote:
Originally posted by Raptor Eye
One of my relatives was taken off of the council's care and put on a private 'care package'. Her health soon deteriorated when different carers walked in on her, and got her up and put her to bed at ridiculous times. She found it distressing to have to wait to get up, be expected to use an incontinence pad rather than be taken to the lavatory, and have men who were complete strangers walk in and give her the most personal of care. Her next door neighbour did a lot for her that the carers didn't do. She wouldn't let me complain. 'You don't complain dear, they make you pay for it'. What used to be an intelligent, confident, professional lady was reduced to someone whose spirit was broken and who welcomed death with open arms when it came.

I don't know what the answer is. As others have said, carers who do care are usually exploited out of the profession in the end. Nobody wants to hear it if people speak out. I'm not convinced that families should look after their own. They might have the right heart, but they may not have the patience or skills to do the right thing. Relatives are often ready to put great pressure on them too, as if there's an expectation of 100% attention.

I have every sympathy for what you say, and I agree that the Social Care system is broken. As a carer I have many complaints, particularly about private agencies.

However, I need to make the following points:

1. It is true that carers are sent at wildly differing times. This is very bad practice, but unfortunately there is a serious problem if every client wants to get up at the same time of the day, and there just simply are not enough carers to cover the calls. I encountered this situation just yesterday when, because of scheduling problems, I had to do my first call at 6:00 in the morning, rather than the usual start of 7:00. Thankfully it wasn't a problem getting a 93 year old up at that time, but there was literally no other time to do it, as the agency is understaffed and a key worker was off sick.

There are many care jobs available, but there is a serious recruitment problem, despite the fact that the job can be entered with no qualifications or experience at all.

2. Male carers should not get involved with female personal care. They may be present at a 'double-up' call (i.e. one requiring two carers) where the other carer is female, and the male just helps with any manual handling - i.e. hoisting, rolling the patient (or 'client') on the bed etc. It is very bad practice for an agency to allow male carers to do female personal care, and I certainly refuse to even consider it. It's stupid and it's wrong, and male carers only open themselves up to unwanted insinuations and accusations if they do this.

3. I'm flabbergasted that the lady felt she could not complain. I constantly tell people to complain if they are unhappy, and many of them do. Many vulnerable people worry that they will be victimised if they complain or that "I will get the carers into trouble". Good caring means encouraging a culture of honesty, which includes encouraging a proper complaints procedure. I often complain to the agency on behalf of clients!

The answer is a better regulatory system. CQC (Care Quality Commission) is not doing a robust enough job. There need to be better inspections of private agencies. Better still, scrap the system of contracting out to private agencies and go back to direct council delivery of care.

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You can argue with a man who says, 'Rice is unwholesome': but you neither can nor need argue with a man who says, 'Rice is unwholesome, but I'm not saying this is true'. CS Lewis

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Angloid
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# 159

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quote:
Originally posted by Boogie:
When my son worked as a carer in Germany he also had all his transport costs paid - a ticket which covered tram, train, bus, the lot.

I was shocked to hear on the radio report that carers in the UK do not get paid for the time they spend travelling between appointments. That could take a considerable part of their day: in rural areas because of distance and in urban ones because of congestion.
I assume, and hope, they get travel expenses.

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Brian: You're all individuals!
Crowd: We're all individuals!
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Posts: 12927 | From: The Pool of Life | Registered: May 2001  |  IP: Logged
no prophet's flag is set so...

Proceed to see sea
# 15560

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They call it Home Care here. Typically there is a subsidized user-pay rate of $10-20 per visit. These are typically 20 minutes. Baths are once per week. Typical is someone coming in the morning between about 6:30 and 10 a.m., getting the person up and parking them in the kitchen or watching TV with something to eat, setting out something for lunch and then returning between 5 and 7:30 and putting the person to bed. Pretty grim. The person won;t get the residential long term care facility until someone deems this unsafe.

When an elderly person falls down at home, they typically call emergency services who attend, and because the ambulance ride will cost a flat rate in the city of nearly $400, these are often refused by the individual and family, and they are taking taxicabs or being transported by family to hospital. The ambulance rides used to be covered publically.

A story in the local newspaper today concerned that families are hiring privately both to come into the home and into government run car facilities and having private staff look after their loved one. This has come up because of the progressive cuts to long term care. I think it is a political problem and an economic policy problem, and I've been blaming the right wing tilt to these policies per the right wing ≠ Christian thread. I think there's something to it. Been through this with 3 parents of 4 thus far, and I believe the "system" as it's constituted was a direct factor in the deaths of 2 of them.

The workers get about $15/hour. Minimum wage is $10 here. It is a crap job. They get mileage paid at per km rate.

[ 07. October 2013, 15:21: Message edited by: no prophet ]

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Matt Black

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# 2210

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quote:
Originally posted by Angloid:
quote:
Originally posted by Boogie:
When my son worked as a carer in Germany he also had all his transport costs paid - a ticket which covered tram, train, bus, the lot.

I was shocked to hear on the radio report that carers in the UK do not get paid for the time they spend travelling between appointments. That could take a considerable part of their day: in rural areas because of distance and in urban ones because of congestion.
I assume, and hope, they get travel expenses.

IIRC, you can't charge or be paid for travel time as this is now deemed to be disability discrimination; you can I believe claim travel expenses though.

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"Protestant and Reformed, according to the Tradition of the ancient Catholic Church" - + John Cosin (1594-1672)

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Boogie

Boogie on down!
# 13538

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My husband is a carer for a severely disabled man who is on a ventilator at night and a pacer during the day. He needs two people there 24/7. He is 26 years old.

When my husband started the job four years ago there always a nurse and a carer on duty. Now it's just carers, nurses only visit if he's ill.

Bearing in mind that he's on has to be 'bagged' as they move from ventilator to pacer I reckon a nurse should be present. But cuts in funding don't allow it.

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EtymologicalEvangelical
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# 15091

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quote:
Originally posted by no prophet
It is a crap job.

I assume you are referring here merely to the pay and conditions?

The job of caring for vulnerable people is certainly not 'crap'!

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You can argue with a man who says, 'Rice is unwholesome': but you neither can nor need argue with a man who says, 'Rice is unwholesome, but I'm not saying this is true'. CS Lewis

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no prophet's flag is set so...

Proceed to see sea
# 15560

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quote:
Originally posted by EtymologicalEvangelical:
quote:
Originally posted by no prophet
It is a crap job.

I assume you are referring here merely to the pay and conditions?

The job of caring for vulnerable people is certainly not 'crap'!

I was thinking of it as you state: pay and conditions. However, now that I rethink, and recall when I worked in a care home in the late 1970s, I did do a fair of of "crap work" (and also pee). ((I should be sorry for posting that, but am instead giggling at my own joke, bad man that I have become.))

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Mudfrog
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# 8116

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quote:
Originally posted by Higgs Bosun:
There was a very moving interview with an older lady on the Today programme this morning on this very subject (at about 08.35). Her care workers are not allowed to do simple things like cut her toenails. She has not had a bath for 3 years. But what she really wants is for someone to come, to cook a hot meal, and sit down and have a chat while they both eat it.

Someone once said that the reason we have a welfare state is because we don't have a welfare society. This lack of real care for the isolated elderly is a symptom of this.

This is exactly what Mrs Thatcher meant when she said ""I think we've been through a period where too many people have been given to understand that if they have a problem, it's the government's job to cope with it. 'I have a problem, I'll get a grant.' 'I'm homeless, the government must house me.' They're casting their problem on society. And, you know, there is no such thing as society. There are individual men and women, and there are families. And no government can do anything except through people, and people must look to themselves first. It's our duty to look after ourselves and then, also to look after our neighbour."

I was a chaplain in a Salvation Army elderly care home and I can tell you that many residents had loving, attentive families who would visit them regularly; but there were some residents whose sons or daughters lived locally but who never visited; it was our job to care for their mothers so they wouldn't have to!

Now I know that 'society' isn't what it once was - where we all worked where we grew up and lived round the corner from parents, etc. But is there not something to be said for families helping to look after their own?

Why should we put all the burden of caring for our loved ones on 'society'? We should be reminding people that, like it or not, we should be caring for people in families, in communities, in churches, in the local community centres.

Yes, there are people who need care that we cannot give; there are people who have no family or close community to help them - and it is these people who are the priority.

I will say one last thing. Not all visits are 15 minutes long. And some of those 15 minutes vists are all that's needed - to give medication, for example. What the lady in the interview seems to need is a friend. And no amount of tax payers money will buy that.

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JoannaP
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Which is why it is so important that Pope Francis has said that "the loneliness of the old" is one of the most serious evils afflicting the world today. It is also something that most congregations should be able to do something about.

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HughWillRidmee
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# 15614

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quote:
Originally posted by Mudfrog:
I was a chaplain in a Salvation Army elderly care home and I can tell you that many residents had loving, attentive families who would visit them regularly; but there were some residents whose sons or daughters lived locally but who never visited; it was our job to care for their mothers so they wouldn't have to!

Now I know that 'society' isn't what it once was - where we all worked where we grew up and lived round the corner from parents, etc. But is there not something to be said for families helping to look after their own?

Not wishing to disagree with much of what has been posted - but specifically ^.

Being a parent/grandparent/great-grandparent is a biological function. Many of us are fortunate to have a loving/caring relationship with our older family members, but many is by no means all. Should working parents extract time from their family life to be belittled, denigrated etc. by fully compos mentis, unpleasant, older people who just happen to be blood relatives? Much of the wickedness of abuse takes place within families doesn't it? Unless one knows the history of a family it is surely dangerous to make judgements about the relationships within it. Sometimes people deserve what they get - whether the state (society at large) should pick up the pieces is a different discussion (but, at least to a minimum standard of human decency, it should).

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The danger to society is not merely that it should believe wrong things.. but that it should become credulous, and lose the habit of testing things and inquiring into them...
W. K. Clifford, "The Ethics of Belief" (1877)

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Coa Coa
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# 15535

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My Father has PSW's (personal care workers) come they are supposed to stay one hour but are told to cram as many people into one hour as possible. Their company charges the gov't one full hour per person on the list of clients(or more) As family we have to advocate constantly for dad and his needs BUT Veterans affairs have been incredibly generous and we feel for the PSW's who only make 15.00/hour and drive one end of the county to the other (11?2 hours sometime one way)
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Coa Coa
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oops sorry that one and one half hours one way
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