A new report into the treatment of elderly people in hospitals and care homes has recommended that compassion should be as much of a recruitment criterion for nurses, doctors and care workers as their exam results.
The Dignity in Care report has said improving elderly care will need "fundamental changes to culture, leadership, management, staff development, clinical practice and service delivery".
Readers have been telling us their views on the report, based on personal experiences of working in this area or organising care for elderly relatives.
I work in a for-profit (very expensive) aged care home and as profits are always more important than people, the residents get the bare minimum of care due to the fact that management don't want staffing costs interfering with their greed for more money.
I take part in selecting students to enter medical school.
Medical schools already select on how empathic a student comes across. Most applicants who apply for oversubscribed places will get 3As or more at A-level so the next step in differentiating them is through interviews and what they have done so far in their short lives. Many will game the system and do a few weeks in a nursing home just to appear that they care, Who knows who the genuine ones are.
It is impossible to know what a 17 or 18 year old will turn out like when they are in their 30s and 40s and a practising doctor. Life events often shape people. I have known girls who were the most caring students turn out to be really hard nosed and brutal when faced with the realities of the career ladder as they fight to get to the top. When they got there, with the time pressures of family and career many feel they have no time for work.
Similar it is probably the same for nurses.
I have worked for 18 years as a live-in carer in the private sector, (in client's homes). I have tried various care homes but often found the level of compassion is appalling. Not abuse but a general lack of empathy. 'Do as you would be done by' is the ethos I try to live and work by. How will we be in old age? I imagine compassion can be assessed by aptitude tests but anyone can lie on a form. It will interesting to see how this works out. A step in the right direction at least.
I've been involved in "shaking up" care in two largish voluntary sector organisations and I have to admit the process was a miserable failure.
The majority of care given in homes is by people who at best have an NVQ. I think most assessors will probably agree that ultimately few people - if any - fail NVQs. When trying to fill posts many candidates will never have worked in care nor have any relevant qualifications.
Whatever people say at interview very few have a vocation to work in care. It is the labour market in any area that dictates the quality of care workers. Care homes compete for people who otherwise might be in bar work or cleaning jobs. Contrary to some postings there are many areas of the UK where there is no immigrant workforce.
Care and compassion isn't always easy - many workers expect people to kindly and gentle - to be patient - but the reality is that there are many incidents of agression directed at workers. Once this is understood there is often a decrease in motivation.
Given that the cost of care has to be passed on to the commissioner there is nowhere to go. Who would swallow increases in costs that are added to council or national taxes? People already say that the NHS has too much money. Just read the postings on other websites or the trolling against 'lefties' like me.
This is why I'm entirely against any private involvement in care delivery. There is no profit that should be made. When my mother was dying and lying in her own faeces there were four care workers supporting the entire wing of the large and expensive private sector home were she was placed. This met the standards. Even if the profits had only paid for one other worker that would have been an improvement.
I was once approached by a worker from the private sector who told me of his concerns about an elderly man with learning disabilites who had been resettled from a psychiatric hospital to a small care home. The man didn't have a pair of shoes that would keep water out.
Quite often the ma and pa end of the 'market' is looked on as others might see a small holding or a little farm. I've seen similar attitudes among families who have run 'fostering' farms of best part of a dozen children with learning disabilities.
Care at home (if you can call it that sometimes) is showing signs of being similarly blighted.
Care companies are employed by many GP practices to make home visits. Then, having ticked the care package box, they can show that they have done their bit.
Whether the elderly/sick patient is being "cared" for is rarely checked unless someone complains.
I speak from personal experience with an elderly, clinically depressed cancer sufferer. He gets a 45 minute (if he's lucky) visit by a young man who drops in, fills in his forms, and effectively checks that he's still alive!
This "carer" is not qualified to deal with the psychological problems he faces but the boxes are ticked so who cares?
My partner works with the elderly in the NHS and (admittedly, I would say this) is a very compassionate person. What I hear from her is that they are too understaffed to be able to spend time genuinely helping patients.
You could be Mother Theresa, but if you're responsible for single-handedly looking after the needs of a ward of dozens of vulnerable elderly patients, who would in the past have had several nurses caring for them, you're simply not going to be able to give all of them the attention and - yes - compassion that they need.
Instead it's all very targets focussed, about ticking boxes. They're told that they have to get those boxes ticked, and get them ticked fast so that they can get on to the next patient and tick their boxes too. She would love to be able to not just tick the boxes, but do so while listening to the patient talk about their needs and feelings, listen, and provide the compassionate care which attracted her to the job in the first place. But the emphasis that comes from above doesn't reward compassion, it penalises it.
My mum has twice-daily care which is provided via a private company because councils now use these organisations all the time. She has to pay £13/hour (it doubled from £7/hour 18 months ago). The staff who work for this private company are mixed in quality - it's clear there are those who are recruited because they need a job and, because they're paid a pittance, their heart is, unsurprisingly, not in the job - but most are really decent, caring people. However, as you say, their pay is around £6.50/hour, which is abysmal for what they have to do.
Worse, the company runs them around like headless chickens. They also cut the staff fuel allowance recently so now the carers spend even more of their meagre wages on driving between patients. The staff are very angry and disillusioned and several have left, heaping even more pressure on already stretched, remaining staff. This approach to running a service is appalling and it's all driven by the need to make a quick buck. The company does not give a shit about the people they care for, or their staff.
The county council does not care - they're happy to get the cheapest price for the service, so they won't listen to patients. The private companies compete to provide the cheapest costs to win the contract - no one seriously believe they compete on quality of service - and so the burden of providing cheap care is transferred to the staff in crap wages and unfair pressure and to the patients who face rising bills, like my mum.
I am a former nurse and hospital social worker. This isn't just just about the lack of front-line professional practice - its a national (and UK centric) issue about the deconstruction of health and social care values by political ideology. Target driven frameworks and inspection processes established over the last few decades fail to recognise and quantify the quality of relationships and the relationship time spent with patients and service users and fail to recognise it as a service or indeed core element to care.
The upshot is that an attitude that relationships, talking, counselling and emotional support doesn't matter has permeated through the whole hierarchy. The consequences are the the people that need the most compassion, dignity and caring relationships - i.e. frail and isolated older people and those with dementia. These people are not receiving it and they are left to the variances of unregulated free market home care and ever changing agency nurses. The politicians and tax payers of this country need to wake up to the fact that overwork and under staffing along with continued cuts will not help to turn things around.
Sourced from The Guardian, 1st March 2012.