The Moral Challenge of Caring for Care Home Residents

An essay by Tom Penn

During my first year volunteering at Mother Teresa’s Home For Sick and Dying Destitutes in Kolkata, I was wide-eyed and pliant. During the second, I had evolved into a hyper-focused ‘long-termer’. And during the third I saw nothing more than a broken system of abusive neglect, the justification for which lay in a fanatical adherence to replicating Mother’s intensely austere frugality. One couldn’t bare witness to God’s infinite love, as it shone forth from the maggot and lice-ridden bodies of the poorest of the poor – as she once did – if one invested too many rupees in their care, it seemed.

Nevertheless, it was an immense emotional challenge trying to step away from the institution. In fact it took several attempts, so attached and yet simultaneously revolted that I was. My heart was spent, and my skull fractured from banging it incessantly against a philosophy of care that seemed to practically encourage suffering in an effort to slake religious thirst. But eventually I returned home to England, and despite feeling somewhat bitter, was intent on continuing the work of helping the vulnerable of society in some capacity.
I took up a Care Assistant position at a local, private nursing home, naive in the assumption that the quality of service in Britain must surely be quite exceptional – as wealthy and civilised as I thought my country, for the most part, was. What ignorance.

I shadowed a number of other assistants during that first week, quietly shell-shocked at their malpractice; vowing never to adopt such devious and manipulative habits myself. Yet within the space of six months I had caved-in; morphing into the paragon of an overworked, underappreciated, stressed, and patronised carer.

Turns out you can’t offer high quality healthcare when racing against the clock, and I mastered all the tricks of the corner-cutting trade as I fought to ‘finish’ my allotted corridor of social-lepers before lunch was served. For example, occasionally dissuading against a weekly bath (too lengthy a process, a quick flannel-wipe is quicker), or suggesting a ‘service-user’ take a day in their room at the merest whiff of any resistance to venturing downstairs (too many convoluted transfers with a lifting hoist, alone: bed to commode to wheelchair to armchair), or craftily placing personal-assistance call-buttons out of reach of the more trigger-happy residents, so as not to have my rotten rhythm disturbed by their selfish desire to defecate into a toilet, and not their already amply-filled night-pads.

I wasn’t always so fiendish; I genuinely cared about my job. Yet at the same time, due to severe external pressures, I was more than capable of folding ethically. I was young; my morals hadn’t yet calcified, and my ethical compass had not long since taken a jolting wallop.

But one episode stands out in my memory-bank of malefic acts above all others, and concerned a particularly stubborn, cognitively wayward old gentleman who didn’t wish to be put into bed at 4.30pm, as he said he was quite content sat looking out of his window, at the birds feeding. Not wishing to be so inefficient as to become the dolt responsible for precipitating a blitzkrieg of abuse from the night-duty to the day-staff – as they wrangled with the additional burden themselves, of an extra cadaver to tuck-in-tight that evening – behind Granddad’s back I simply put his clock forward an hour, exited, and then re-entered several minutes later. Then, pointing out that it was now 5.30pm, he reluctantly agreed to his bed. I had stolen an hour of his life.

I know incontrovertibly, that such derelictions of duty as I have described persist to this day – commonplace at best in residences of elevated repute; virtually the norm in the crumbiest. The misconduct I have referred to personally, was executed inside the floral wallpapered cash-machine of a hellish rabbit-warren of a home; with an official rating of ‘excellent’ from the inspectors. And proud of my acts I most certainly am not.

‘Protect the elderly and vulnerable’, has been the official line pulverised into our collective consciousness: ‘Shield’ them from harm – and your own murderous breath. The hypocrisy would be hilarious if it wasn’t so demonic.

For 16 months now Government have been tampering with our clocks. They’ve set them back an age, and tossed us back into the dungeon of near-total subservience. Only once we have been sufficiently tortured in what has become Care Home Britain, will we be granted temporary release – to pick up where we left off: reinforcing it’s crooked ramparts, whilst sitting in the sodden armchairs of our spiritual incontinence.

Maybe all this talk of new and old normal is redundant, and that the barbarous principles that governed our society pre-covid are in fact, and perhaps unsurprisingly, simply getting sadistically slicker. We weren’t exactly on an enlightened trajectory of compassion before this hostile, technocratic, medical take-over of our remaining empathy, and it’s those at the opposing ends of the age-scale that continue to pay the heaviest price.

It’s par for the course to brainwash our toddlers and teens alike, into obliterating their psychophysical wellbeing in pursuit of hollow, egocentric creeds. And their soft, malleable minds can do little to counteract the post-authenticity opium of the digital era. Mum and dad seem to thrive off it after all.

And likewise do the elders of the tribe bare the brunt of our pathetic sprint to nowhere – global reconfigurations of power or not. For quite some time now they’ve been the cast-offs – the wrinkled, gobbledygook-muttering, internally displaced people who exist it seems, only that their bank accounts may be given one last rinsing by the rotund pig-devil Lords and Ladies who run the Retirement Holiday-Asylums of Empire.

Left to rot in the utilitarian cells of over-lit, under-staffed processing plants for pointless pensioners – for whom all of a sudden the whole world must inexplicably now come to a standstill – our once-human seniors stare either out of the window, at the walls, or at the television, as it beams out it’s kaleidoscopic death-rays of fear and asinine garbage at terminal velocity. Down into the pitch-black catacombs of dementia they inevitably descend, as we slowly lose our patience, and grow increasingly irritated at their senseless drivel; whilst all the while scratching our heads as to why Nan has lost her marbles.

And betwixt the putty of the young and the biscuit crumbs of the old, lie the majority – the mystifying cast of multi-classed perpetrators: we, the legion should-know-betters but motivation-less shoulder-shruggers.
Who exactly are the vulnerable in this bedpan of ethics we currently find ourselves gasping for air in? Are they the Grandma Bettys of the world – their ilk subject to the rolling lockdowns of their care-packages, as has been the case for decades already? Are they our children who psychologically defenceless, have little choice but to mimic the ways of the grown-ups who patrol their behavioural borders?

Or are they these very shoulder-shrugging sentries, who without a moment’s hesitation would rather masturbate to their digital avatars than steer us all off the Elite’s roadmap to insanity; with an effortless check of the mirrors and a simple turn of the wheel.

The victim of my own time-crime would have remembered the opening of the Preston by-pass in 1958. Never in his darkest nightmares could he have imagined that it would eventually be superseded by the successive generations’ 100-lane, pseudo-scientific motorway of spiritual slaughter – which would plough without permission through the blinkered minds of all; the devil banging the pots and pans of his Heads of State together in glee, as the unswerving media road-trains rumbled ceaselessly on.

I don’t know about anyone else, but it seems to me that those with the psychological freedom to choose between right and wrong, truth and farce, and reason and lunacy, and who still want nothing more than to usher in the demise of our humanity – it’s they who are the most vulnerable.
Everyone else is just looking on, utterly powerless.

Tom Penn is author of the short story The Palinopsia of National Resilience