In This Issue...

• Introduction
• links
• forum
• Download of the Week
• Feedback from visitors

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Introduction

Welcome to the Nursing Home Forum,i set up this forum because i feel that putting a loved one into a nursing home is a very hard and lonely decision and one that isn't taken lightly,my Mother was admitted to a nursing home in 2004 with senile dementia and went downhill very quickly,when i visited her on the first day she sat in a locked room on her own with thousands of ants crawling all over her,with no sign of a care assistant.

I have heard of many nursing homes that have poor care and has highlighted on recent televison programmes doesn't seem to be localised,we have created forums and we would like your input on them,does your loved one deserve to be degraded by this poor service we have in this country,is it more about money than service ?,should we have to sell our houses to pay for our care ?,we have worked all our lives so that we can have a decent retirement ?,do we really have to stop earning to look after our loved ones ? ,have we been let down by our government ?

let the debate begin........

"being unwanted,unloved,uncared for,forgotten by everybody,i think that is a much greater hunger,a much greater poverty than the person who has nothing to eat"

quote by Mother Teresa

Tens of thousands of vulnerable old people are suffering appalling abuse in homes for the elderly, experts are warning.

The first ever audit of calls to England 's social care watchdog shows that more than 1,000 were made in just six months by people who suspected their relations or friends were being abused by care workers.

Social services chiefs estimate that a further 60,000 "alert calls" are made directly to local councils every year.

The Commission for Social Care Inspection (CSCI) has uncovered homes where residents were routinely tied to their beds and chairs, locked up or dragged around by their hair. Some were refused food to punish "bad behaviour", denied trips to the lavatory or stolen from by staff.The figures show that 1,043 calls were made to the CSCI in the six months ending in March, regarding 506 residential homes and agencies providing home helps. No national statistics are kept on the number of cases logged when relations contact councils to raise concerns.

The audit was disclosed by the CSCI as it prepared to publish, on Wednesday, its first guide to all 4,000 residential homes in England for the elderly and disabled, giving each a star rating so that relations can compare factors such as the use of sedatives, staff training, and social activities.

The inspectorate has already said 248 homes do not meet basic safety standards. Investigations have revealed a woman of 85 who had her fingernails ripped off by a care worker, a 78-year-old covered in cigarette burns, and a number of thefts of pensions by "home helps".

Charities are calling for new laws to oblige councils that are told about possible abuse to investigate, as is the case in child protection. They say the current voluntary system means social workers and police fail to step in even when relations identify risks.

Gary Fitzgerald, chief executive of the charity Action on Elder Abuse, said: "If you include abuse carried out by relatives and friends, studies suggest there could be 500,000 cases each year across Britain ."

New research commissioned by the Health Technology Assessment (HTA) programme, a programme of the National Institute for Health Research (NIHR), is assessing the effectiveness of a group exercise programme combined with staff training, for reducing depression in older people living in residential and nursing homes. Up to 40 percent of residents in these homes suffer from depression. Increasing both exercise and social interaction may help reduce the burden of depression, but this is yet to be fully researched.

Researchers based at the Warwick Medical School Clinical Trial Unit and Queen Mary University of London and will examine the effectiveness of a ‘whole home' intervention, which comprises twice weekly group exercise sessions delivered by a physiotherapist, combined with staff training in depression awareness. The 77 participating homes in central England and north east London will receive either the ‘whole home' intervention of exercise sessions and staff training in depression awareness or just staff training.

Researchers will determine whether exercise reduces the overall number of people with depression in a care home, after 12 months, and will also examine whether individual people who are already depressed respond to exercise. They will also examine the effect of the exercise programme on participants' physical fitness, mental agility, the amount of pain they have, number of fractures, hospital admissions, and the use of medication.

“Many older people living in residential and nursing homes suffer from depression. This can have a major impact on the quality of life of a very vulnerable group. It is often not recognised by their carers, and even when recognised treatment can be difficult,” says lead researcher Professor Martin Underwood of Warwick Medical School. “A group exercise programme that includes a social element is a promising approach to managing depression without the use of drugs. We hope that this research will help improve the delivery of future services in residential and nursing homes.”

A debate is needed over the ethical dilemmas facing people caring for dementia patients, experts say.

The Nuffield Council on Bioethics wants to help advise carers and is launching a public consultation to gauge opinion on the tricky decisions made.

It has posed a series of questions about the appropriateness of denying freedoms and the use of deception.

The council said it was acting as the number of people with dementia was set to rise with the ageing population.

About 700,000 people in the UK have the condition, but that figure is expected to double in the next 40 years.

Dementia is a degenerative condition which results in memory problems, mood changes and communication problems.

Among the questions being posed during the 12-week consultation are:

•  Is it ever right to restrain a person to reduce the risks of wandering?

•  Is it ever right to deceive by disguising medication in food?

•  Should people with dementia be involved in research if they are no longer able to choose for themselves whether or not to participate?

The council also said that while it was normally taken for granted that patients should be told the truth and not forced into things, there may be something unique to dementia which overrides that.

Force

Dr Rhona Knight, a GP and member of the Nuffield working group which is carrying out the consultation, gave the example of a person who is forced against their wishes to go to a day centre because carers know that when they get there they always enjoyed it.

"It is not about making rules or saying what is wrong. It is about giving advice.

"There are a lot of grey areas when delivering care.

"As a GP, I know that people with dementia and the people caring for them are facing real-life ethical dilemmas on a day-to-day basis and often they don't feel equipped to deal with them."

The final guidance is not due out until 2009 and the council expects it to apply to carers and NHS staff.

Neil Hunt, chief executive of the Alzheimer's Society, said it was the right time to have a debate.

"Families, carers and professionals are often faced with a baffling array of ethical dilemmas when caring for a person with dementia.

"The use of restraint, the covert administration of medication and when to tell the truth are all issues carers and professionals face on a daily basis.

"They can often struggle to balance the rights of people they are caring for with the practical consequences of the decisions they make."

News this week

Ministers are warning that England 's social care system is heading towards a £6bn funding gap unless there is radical reform, the BBC has learned.

Health experts predict the ageing population means state funding for the care of the elderly and disabled will face a huge shortfall within 20 years.

The warnings come as ministers are about to begin a major consultation on how social care is funded.

Currently, most people in England have to pay for home help themselves.

'Unfair system'

State support is means-tested and most people have to pay for any home help, including washing, dressing, cooking, themselves.

Health ministers say they are aware of a widespread feeling that this system is unfair.

Also, rapidly growing demand means social care is already being heavily rationed and ministers predict that is set to worsen.

Within 20 years a quarter of the adult population will be over 65 and the numbers over 85 will have doubled.

It is expected over two million extra people will need care by the middle of the century.

But state funding for social care currently grows at a much slower rate than the population explosion among older people demands.

This means we are heading for a funding gap of £6bn within two decades unless the system is changed.

And that is what ministers have promised to do. They believe a new care system for the 21st century is needed and say they want a radical rethink.

On Monday, they will start a public consultation asking how the state, families and taxpayers should share the costs of this increasingly important service.

Share views

Care services minister Ivan Lewis insists there are no easy answers.

He told BBC News: "This is one of the greatest challenges facing not only government but families and society in general.

"Together we have to decide what quality and level of care services we have a right to expect in a civilised society.

"And what we need is to move towards a system which is fairer; where people feel it's fair in terms of what is expected of them and also in terms of what the government can pay and what is affordable."

Liberal Democrat health spokesman Norman Lamb said the cost of social care had to be shared between individuals and the state.

"We had previously argued for free personal care but any policy you come up with has to be sustainable," he said.

"We would inject an extra £2bn into care for elderly people and use that as a mechanism to increase the quality of care for people and to scrap this pernicious means-tested system."

The government consultation will last six months and include a number of so-called listening events around England where people interested in modernising the social care system can share their views.

Eventually the government will set out proposals for reform in a Green Paper.

One option certain to be ruled out is making social care free.

It happens in Scotland , but proved so costly there has been rationing.

Another option not on the table is the status quo - everyone seems clear, when it comes to caring for the elderly and disabled, things cannot go on as they are.

courtesy of bbc news