Tuesday, 5 January 2016

“My Own Four Walls”



At the beginning of November I fell down a flight of stone steps at work, as I was leaving a patient's home and rushing on to the next one. As I fell my left foot was twisted back under me and I landed full on it, my full weight landing on my ankle and smashing it into a stone step. In that moment I fractured and dislocated my ankle in three lands.

Apart from a lot of pain, I had to have my ankle operated on to repair the fracture, it was too mangled to heal on its own, which has left me was a lot of metalwork holding my bones back in the right place. The worst part is that I had to have my leg and ankle in cast and be non-weight bearing for eight weeks (This is now week seven).

Once home I could hobble around on crutches but I couldn't leave the house. I am not very stable on the crutches, I can only walk on flat surfaces (The pavements here are far too uneven to safely hobble along on my crutches), and I can only walk for short distances because hopping along on these crutches is so damn tiring. Ten metres and then I need a rest. For the last seven weeks I have been house bound.

Being house bound has not been fun; it has been very frustrating and isolating. I am here, in this house, twenty-four/seven. My world has reduced down the sofa in the sitting room, and occasionally the toilet when I hobble out to it. My human company has been Martin, my partner, and the television. Martin works long days and is tired when he gets home, then he gets quizzed by me about what has happened during his day. Just hearing about the world out there makes me feel I am still part of it. I watch a lot of television, far more than I ever used to. The television doesn't just pass the time, though it does and that can help, but it tells me what is happening out there, it is another thread I can keep in touch with the world by.

But I never realised how isolating staying at home all the time is. I've had days off work, even weeks off work, but I have never been so long without the usual variety of people in my life. When friends telephone me I cling onto those telephone calls for as long as I can. I want to hear about their lives, what is happening with them. My news is so limited, how many different ways can tell someone that daytime television is so crap, but they have stories to tell and they have lives they can share with me and I want to hear everything.

I can spend hours on social media, surfing through Facebook and Twitter and Tumblr, because they are filled with other people's lives. Stories of what they have been doing, what they plan to do or sharing stories from yet other people's lives. I can read those stories, past comments and for a brief moment share in those people's lives.

I don't want anyone to think that this is a pity blog. In just under a week the cast on my leg finally comes off and I start being much more mobile. With mobility will come back independence and contact with the outside world. I will be able to leave our home and will eventually be able to return to work and my old life. Not everyone who is house bound has the same release from it.

I work as a District Nurse and my job is to provide nursing care for people who are house bound. For so many of my patients the only people they see, from day to day, are us District Nurses and their carers. They can be so lonely and crave contact. I will only have a limited amount of time to provide their nursing care (Give them their insulin or other daily injection, help them to take their medication, change the dressing to their wound, etc...) and they emotionally cling onto me, making conversation, asking me question upon question. I'm never cold or brisk with my patients, if anything I talk too much with them, nursing someone you become involved with their lives, especially with the patients we care for on long term. I was always aware of how isolating being house bound is, I have seen it so many times in the patients I have nursed.

Being house bound myself, even only for seven weeks, has forcefully reminded me how isolating and frustrating it is. We as humans are social creatures and most of us need the company of other humans, so why do we allow people to become so socially isolated just because they are elderly or their health is failing. In the last five years, under Tory austerity, council budgets have been slashed, we've seen many day centres and luncheon clubs for elderly people closed. Others have had their resources cut and so have had to cut the number of days people can use them, isolating more people in their homes.

We now have developed an attitude that people should stay in their own homes above all else, and that entering a care home is somehow a failure to be avoided. I have nursed so many people in their own homes who are almost prisoners of their homes, who would be far happier in a care home. In a care home there would be company for them, other residents to talk and socialise with. Staff would be available to meet their needs at their pace, not be rushed into the time bands allowed to District Nurses and carers. Instead they are confined to their own homes, grabbing what company they can from the limited time professionals visit them.

But are there enough care homes out there to meet people's needs even if we changed our attitudes? Care homes are full, good care homes have long waiting lists for them. We are not building enough good new care homes because the private companies who run them can barely make viable profits from the ones them currently run, there are very few incentives for them to open new ones. Also, care homes are not valued as places to work in. In nursing, working in a care home is still seen as professional failure, “Oh, you only work in a nursing home.”

In a week my cast will come off and I will finally be able to leave my home under my own steam. When I finally return to work, though, I will go back to caring for patients who are house bound without any end in sight. When did care of our elderly population become such a low priority?

Drew Payne

1 comment:

Fiona Johnston said...

Beautifully written Drew. You're right, our culture not only doesn't value older people, it abandons them...we have become a society who value only youth. Youthful beauty (so called) and the lives and accomplishments of youth. Older people have so much to offer, their insights and their history and their memories of the past. Sadly I don't know how or even if, this can be turned around.