• The Yanks are coming 12 February 2017 | View comments

  • The saga of Roger Curry has gripped the nation this week.

    Featured by Panorama http://www.bbc.co.uk/news/magazine-38769685 and taken up by the Guardian https://www.theguardian.com/uk-news/2017/jan/30/wife-son-dumped-roger-curry-dementia-uk-car-park, this is the story of a 76 year old man who was discovered, confused and lost in Hereford in November 2015. He was made safe by paramedics and found accommodation in a Care Home. As far as I understand it, he was physically well and well-nourished but had a dense memory impairment and a diagnosis of dementia was made. He gave his name but could not say where he came from. He has an American accent.

    The care staff took to him and he accepted his new life with no distress. The authorities, including the police explored all the usual channels in attempts to determine who he was and where he came from and who might be responsible for his care. There were no descriptions of missing persons to match him in the UK, nor in the USA of Canada.

    His identity was eventually discovered through links which started with the police but required a local television company and then the use of social media before contact was made by someone who had known Earl Roger Curry at school in the USA. They still had a year class photograph of a teenager who had that name and looked like the older man now in care in England. The details of the story revealed by the persistence of Darragh MacIntyre are extraordinary but give clues of progressive breakdown within a family which had rifts over many years and fell into crisis at Roger and his wife became elderly and infirm.

    How that could lead to a decision to resolve their problems by exporting him to England and abandoning him to the care of strangers in another country is baffling.

    The news reports declare that ‘granny dumping’ is a well-known phenomenon in the USA. This is a dreadful term which shows no respect for the individuals who present to services in this way and the complexity of differing considerations which may lead to a common pathway. Articles from the USA in the 1990s estimated that thousands of older people were being delivered to hospitals by families or other carers who just could not cope with their needs.

    A news item in the BMJ 1992 vol 34. 333 to 334 discussed the situation in the USA and drew attention to a study by The Academy of Emergency Care Physicians which identified older people left in emergency rooms. They blamed unaffordable costs of care.

    Judy Jones, writing in the BMJ in June 1993, could see similar tensions in the UK.

    Doctors fear that the virtual disappearance of NHS elderly care beds over the past decade combined with a gradual tightening of social security rules has pitched many frail elderly people and their relatives into a middle-class poverty trap.

    Strict limits on the amount of state support for care in private residential or nursing homes has led to the widespread 'bed-blocking' by elderly patients on acute NHS wards. Increasingly, hospitals are unable to discharge such patients because there is nowhere else for them to go. Relatives insist they can neither care for them at home nor meet the bills for private nursing home care.

    Such words are often repeated today as the cost of care has risen and the availability of care via social services has become more and more severely rationed.

    But these are desperate straits within an economy. The Roger Curry scenario is of an order beyond this for it sees an individual ejected from his own country to become the anonymous recipient of care in another country and culture.

    We encountered a similar situation in South Manchester in the early 1980s. Asked to see an elderly man at his sister’s flat in Whalley Range we were surprised to find that he spoke with a marked Southern drawl and believed himself to be living in Shenandoah. Not really so surprising because he had lived for over 70 years in the USA and had run a grocery in Shenandoah into his seventies.

    He and his half-sister had lived in Newcastle upon Tyne but were separated as youngsters, Douglas moving to America with their father, Ellen staying at home with their mother. Ellen moved to Manchester with her mother and worked here in a department store. They kept contact with Douglas by Christmas cards and occasional letters but never met. When her mother died, Ellen continued this tradition but latterly had received nothing in response. Soon after Christmas 1982 Ellen received an airmail message from people she did not know but who explained they were nieces of Douglas. They were arranging for Douglas to fly to Manchester and asked Ellen to meet him. The details of the flight and arrival time were given and they included a recent photograph so that he could be identified.

    Ellen was puzzled and a little alarmed. She had never been to the airport, did not have transport and herself was already old and frail and barely coping. Never the less she kept the appointment, travelling to the airport by taxi. Douglas was charming but entirely muddled. He had been attended by staff through the flight but really had no idea what was happening nor where he was going. He probably did not recognise Ellen but she knew him from the photograph and he was content to be welcomed by her and to go along with her.

    Her phrasing, oft repeated was

    ‘Under the circumstances, I felt there was nothing to be done but to look after him’.

    So there she was with her long lost, muddled half-brother in her small, cramped rented flat. Another mouth to feed and in need of a considerable amount of care. She found him to be incontinent of urine, needing help to dress, undress and shave. A night he would get up and wander the flat, taking off his clothes and urinating in corners. He was sometimes resistive when she came to wash him and give him clean dry clothes.

    For a while she cared for him at home with thrice weekly attendance at our Day Hospital. Care was arranged at home too and there was sensitive support from our Social Worker and Community Nurses but Ellen became very tired. Douglas became a resident of our long stay ward, a place which knew him from his Day Hospital attendances, where he had a sense of familiarity and where Ellen knew and trusted us, and all our staff knew her and respected her. There was no question of his being returned to America.

    There was no one to look after him. It was not an issue of money so much as lack of anyone who was close enough to him to offer the sort of attention and affection which came from Ellen, albeit lately as a visitor rather than direct carer. Ellen and our Social Worker researched finances and Douglas’ pension became available but could not contribute directly to payment for his care. He lived out his life in this situation.

    So Roger Curry’s story is unique but we have seen something similar in the past and no doubt others can give their versions of these unusual last days.

    It seemed to us that Douglas’ best interests were met by accepting him in this country right through to the end. Darragh MacIntyre reflected that he was not sure the rediscovery of Roger Curry’s identity and subsequent return to USA for care worked out well for him.

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