Dementia

Healthcare Bishop argues for more loving attitude to people with dementia in care homes

 

In an article published in The Tablet online, the Lead Bishop for Health and Social Care, Bishop Paul Mason stresses that we must look at those living with dementia in care homes through the lens of love.

+++

Dame Barbara Windsor’s husband, Scott Mitchell, recently spoke out about the pain he felt at leaving his wife in a care home due to her worsening condition with Alzheimer’s.

Speaking to the BBC, he said:

“I feel I’m on an emotional rollercoaster. I walk around, trying to keep busy, then burst into tears. It feels like a bereavement.”

This feeling of bereavement has been accentuated during the COVID-19 pandemic for thousands of people who have partners, family members and friends with dementia living in care homes.

As COVID-19 restrictions gradually ease, more vulnerable members of society have been able to regain some of the crucial human connections which felt so distant at the height of the lockdown. If we are a country that is serious about preventing a mental health crisis in the aftermath of COVID-19, now is the time for us to start talking honestly and openly about the care sector and how we treat residents with dementia. They cannot be left behind.

Equal dignity and value

As Catholics our starting point is that we are all made equally in the image of God. Human value is not a measure of our mental or physical capacity, our societal function, our age, our health or of any other qualitative assessment.

God made each of us and in so doing gave us all equal dignity and value. It is the love of God and the love of those around us which ensure that this dignity is not lost at any point, especially during sickness and dying.

People suffering with dementia are some of the most vulnerable in our society and deserving of all the love and care we can muster. Yet, their care needs can be neglected, and assumptions made about what is best for them and their relatives who wish to visit them.

An impaired ability to understand new situations or recall memories may seem inconsistent with the great depth of feeling which people with dementia can retain throughout their illness. However, it has been shown that when someone is living with dementia, meaningful human interactions can make a real difference to the rate of progression of this disease.

According to Julia Jones and Nicci Gerrard of John’s Campaign, more than 70 per cent of the 440,000 people living in care homes are living with dementia and the majority are in the last years of their lives. While the average length of a stay in residential care is approaching two and a half years, in nursing care the average is 13 months. To have lost five months of such precious time is painful in the extreme, especially when there is no firm hope of reconnection until the loved one is dying, when a visit will finally be allowed.

Committed staff

One cannot deny the commitment which staff in care homes have shown their residents. Many carers became resident themselves, with some leaving their own families for weeks or even months, to look after those in their care. We recognise that these are great sacrifices, for which I thank every single member of staff in care homes. We continue to pray for the souls of those who, in their selfless acts of care, also tragically lost their lives as a result of COVID-19.

Though care home staff have taken on so much more over the last five months, we simply cannot expect them to be able to fill every role involved in caring for a resident. For many, more pressured and intensive schedules simply do not allow carers the time to sit with a resident for long periods, talk or read to them, play them music, hold their hand. This was the care typically provided by loving relatives, often on a daily basis. If relatives are not allowed to visit their loved ones in care homes for prolonged periods, we risk hastening the deterioration and, at worst, the death of people who could have had months of meaningful and loving care through to the natural end of their life.

Love – a crucial part of caring

The care provider Methodist Homes for the Aged has been one of the first to recognise this in recent times, and have formulated a new policy, More Than Just a Visitor, which aims to implement these learnings. The policy defines an essential family carer as “a resident’s family member or friend whose care for the resident is an essential element of maintaining their mental or physical health. Without this input a resident is likely to suffer significant distress or continued distress.”

Acknowledging that the care of relatives cannot be replaced demonstrates that love is a crucial part of care. The social doctrine of the Church explains that “in order to make society more human, more worthy of the human person, love in social life – political, economic and cultural – must be given renewed value, becoming the constant and highest norm for all activity.”

The Government, local authorities and the care sector undoubtedly recognise that there is a fine balance to be struck between protecting vulnerable lives on the one hand, and on the other maintaining a sense of dignity and purpose for those living with a long term illness like dementia. Perhaps now is the time to ask if this line is currently in the right place?

Mental health and wellbeing

Greater encouragement for care homes to follow the lead of the MHA and facilitate family visits, for example, would be a first step towards a more loving attitude towards people with dementia.

Throughout the lockdown, the risks of a possible global mental health crisis have been cited by the World Health Organisation, leading mental health charities and other organisations.

Jones and Gerrard observe:

“Disconnection from the love of the essential relative, is effectively a disconnection from the inner self.” This profound truth applies to both care home residents and their relatives on the outside. The mental health and wellbeing of a person with dementia is crucial to their experience of life with this disease. Dr Donald Macaskill, CEO of Scottish Care, has written of experiences of people with dementia in care homes dying of a broken heart due to a lack of contact with their loved ones.

The love which forms the bonds in a relationship goes both ways, and the continued separation of people from their relatives in care homes does not resonate with our national and global focus on improving mental health. We fail in our most basic duty of love and care when we begin to treat those who are sick and dying as dispensable, or worth less than those who are healthy.

There is a line between the legitimate protection of others on the one hand and, on the other, what the purpose of being alive is in the first place. As time goes by that line inevitably takes in more of the latter.

When the choice is dying of a long-term degenerative disease or a broken heart, we must look at those living with dementia in care homes through the lens of love.

Right Reverend Paul Mason
Bishop of the Forces
Lead Bishop for Health and Social Care