Doctors, nurses and carers could face disciplinary action for addressing patients or care home residents as “dear” or “chuck” without permission in a drive to improve standards of dignity.
The recommendation comes in a wide-ranging report by a commission of senior NHS managers, charities and council chiefs designed to stamp out neglect and abuse in hospitals and in the care system. Discrimination towards the elderly is “rooted” in British society and older people are too often viewed as a “problem to be solved” rather than equals, the report finds.
The commission concludes that older people are suffering humiliation and degrading treatment on a daily basis while basic “respect for human rights” is too often ignored.
The report calls for an overhaul to give respect for human dignity the same importance as medical success rates or financial targets.
Over an eight-month period, the commission heard evidence from more than 40 organisations working with the elderly as well as doctors, nurses and carers. Examples included carers who insist on hand-feeding people who are perfectly capable of feeding themselves and patients who are denied a choice even in what clothes they wear.
An “unthinking disregard” for the needs and aspirations of older people permeates British life, from the transport system and housing to the NHS.
Many care homes are little more than “aimless places” with little aspiration beyond feeding, dressing and washing residents, the commission says.
Yet elderly people and their families too often fear they will be branded a “nuisance” or “troublemakers” if they complain. “Undignified care of older people does not happen in a vacuum – it is rooted in the discrimination and neglect evident towards older people in British society,” concludes the commission made up of Age UK, the NHS Confederation and the Local Government Association.
“Age discrimination is the most common form of discrimination in the UK.”
Instead of celebrating increased life expectancy as a major achievement, ageing is too often viewed as a “crisis” or a “population time bomb”, the commission says.
“The Government needs to take a lead by setting a positive tone for debate about our ageing society, celebrating the contribution that older people already make and seeking to build on this, rather than casting them as a problem to be solved.”
It continues: “Evidence to the Commission, particularly from carers, revealed how poor or neglectful care even for just a few days can have a devastating impact.
“Older people describe how their skills, self-help and self-confidence can deteriorate as a direct result of the way they are treated, such as being spoken to as if they are a child or having things done to them rather than with them.”
The report, published today, calls for a “major cultural shift” covering training and regulation of care workers and medical staff. Among 48 separate recommendations, it singles out the use of everyday language. “Language that denigrates older people has no place in a caring society – particularly in caring organisations – and should be as unacceptable as racist or sexist terms,” it says.
“Expressions such as 'bed blockers’ imply older people are a burden or a nuisance; referring to them by illness reduces them to a clinical condition rather than recognising them as a person; and using patronising language such as 'how are we today dear?’ belittles them.”
Dianne Jeffrey, chairman of Age UK, and one of the commissioners, said: “A person should be addressed how they wish to be addressed, if someone wishes to be addressed as love or chuck or dear – and they have made that clear – that’s all right but is one of the things that needs to be dealt with when they first come into the care system.”
Another of the commissioners, Prof Trish Morris-Thompson, the chief nurse, said speaking to older people in a patronising way amounted to a “failure of care” which should attract redress.
Among other recommendations is for universities and colleges to screen out candidates for medicine or nursing who show a lack of basic “warmth” and compassion as much as academic skills.
Meanwhile potential home care assistants should be observed working with older people before being considered for a job, the commissioners said.
The report calls for new standards to ensure all care staff have a good grasp of English, while hospital management structures should be changed to free ward sisters from a “command and control” culture to oversee care.
Hospitals and care homes should introduce new whistle-blowing procedures and managers should be forced to work outside a “nine to five culture” to be more readily available to staff on the ground at night.
The report also calls for family members to be directly involved in care and for homes to set up residents associations to give occupants a say in matters such as choosing menus or even the décor in the building.
Suggestions for hospitals include potted life stories for each patient which could be shared with their medical records to help staff understand them as individuals. Simple steps to improve quality of life in care homes include installing Skype to allow residents to talk to relatives far away face-to-face or inviting volunteers in to teach languages or musical instruments.
Dr Peter Carter, chief executive of the Royal College of Nursing, welcomed the recommendations to give ward sisters more freedom but said: “It is critical that hospitals and care homes employ safe numbers of nurses with the correct skill mix.”
Liz Kendall, the shadow minister for older people, said: “The commission is right to say that aspiring doctors and nurses need the right attitude, as well as academic qualifications and skills, to deliver the very best quality of care for older people.”
Paul Burstow, the care service minister, said: “Kindness and compassion, dignity and respect must be central to care, whoever provides it and wherever it is provided.”
Article from the Telegraph