4th January 2016 | By David Jolley
Media attention over this holiday period has been dominated by concerns about the weather, rain and floods, especially in the north of England. Whilst this has been part of a global phenomenon of unusual weather, worries have surfaced that failure to provide the best flood defences in vulnerable places has contributed to the devastation.
Attention has also been drawn to the murder of Rita King, an 81 year old resident of a care home in Essex by her 86 year old husband Ronald. There seems little doubt that Ronald was responsible for his wife’s death and had planned the act well ahead of the killing. She is said to have a diagnosis of dementia, her move into care was occasioned because he found he could no longer cope with her needs at home. He is himself disabled and had booked to stay at the care home over the holiday period, taking with him the gun which would be used. He is quoted as saying: ‘She had had enough’.
No doubt more details will emerge about the background and current factors but this is a personal tragedy for Rita and Ronald and their family and friends. It is an alarming happening for other residents and staff of the care home and everyone in the care industries.
www.theguardian.com/uk-news/2015/dec/30/essex-care-home-shooting-pensioner-ronald-king-charged
www.mirror.co.uk/news/uk-news/pensioner-shot-dead-husband-pictured-7091586
Death in a care home is usually a matter of routine. Sixty percent of people with dementia die in a care home. But death at the hands of another whilst in care is unusual.
In 2014 Ryan Guest - a 33 year old man killed his grandmother – smothering her on the instruction of voices which he believed to be God. He has paranoid schizophrenia and is now detained in Broadmoor. He had left another prisoner in a vegetative state after a previous attack
www.bbc.co.uk/news/uk-england-bristol-27936735
www.bbc.co.uk/news/uk-england-bristol-30374727
Similarities include kinship to the victim and altered health of the perpetrator, but there are likely to be many differences between these cases. It is a constant worry that when people are under stress and have responsibilities for vulnerable relatives, they may take action which they believe to be well motivated but are damaging or destructive.
Reducing circumstances which produce or compound stress, identifying trigger times and taking preventative action are things we will want to do and ought to do.
In contrast we are more used to reading of problems in care produced by neglect or orchestrated institutional abuse:
www.telegraph.co.uk/news/health/news/11442024/Police-investigate-neglect-claims-following-death-of-care-home-pensioner.html
Orchid View 2013
http://www.dailymail.co.uk/news/article-2465955/Five-elderly-residents-died-neglect-care-home-institutionalised-abuse.html
Such happenings are also identified as consequences of stress within a system where care to the most vulnerable is underfunded and low in priority and kudos. Crises receive dramatic, scandalised headlines for a few days but these are rarely followed up by shifts of funding, training and ongoing support which might reduce the likelihood of similar tragedies in the future.
Dr Claire Hilton is currently researching the work of Barbara Robb whose investigations and publication of ‘Sans Everything – a case to answer’ in 1967 gave impetus to the movement which generated Psychogeriatric Services (AKA Old Age Psychiatry) and other more positive approaches. Much has changed in the interim, but much remains unchanged and is challenged only at times of scandal. Blame is too often and too easily directed at immediate relatives or hands-on staff.
The current climate is reflected in some of the statistics gathered by Age UK:
Median time to death after admission to a care home: 462 days
Growth in population 65+ since 2001 – 11% - Growth of places in care homes – 0.3%
Estimate of older people abused per annum: 500,000 (150,000 being in care)
Day care places halved 2014 – 15
Spending on Social Care in England – reduced by £770m 2010 – 2015
Threshold for the provision of any care: ‘Substantial need’ in 85% of Authorities
900,000 people with care related needs receive no help from formal agencies
www.ageuk.org.uk/Documents/EN-GB/Factsheets/Later_Life_UK_factsheet.pdf?dtrk=true
This is a man-made microclimate which leads to man-made tragedies. It can be more directly modified than the phenomena which are causing recurrent problems to the Lake District and other parts of the world. It is a question of will.