Old People’s Home for 4-year-olds

“People are rarely happy on their own.  Which is why multi-generation houses are the model for the future: learning from one another, feeling needed, sharing joy. A real recipe for happiness!”

So said Dr Eckart von Hirschhausen, author and patron of a multi-generation house in Berlin’s Zehlendorf district.  I quoted Dr Eckart in one of my earliest blogs back in 2014, highlighting Germany’s pioneering intergenerational day care centres and houses that bring together everyone, from babies and toddlers to older people, with positive results.

Since then I’ve become ever more convinced of the power of mixing up generations – whether with projects such as Alive charity’s Paint Pals project in Bristol, where schoolchildren visit and befriend those with dementia in care homes, to my local Nightingale House in Clapham, which last year became the UK’s first care home to open a nursery for pre-school children in its grounds.  One 89-year-old Nightingale resident said that having the little ones with them was “like being reborn”.

So I couldn’t wait to catch up with the first of C4’s series, Old People’s Home for 4-Year-Olds.  In the longest experiment of its kind, ten young children joined ten of the 400 residents of Lark Hill retirement village in Nottingham.  Its sound track and occasional lingering camera shots of the village itself gave it the feel of a sort of anthropoligical-cum-social-care Great British Bake Off, but it was none the worse for that: I’m all for accessible documentaries with a heart.

Over three months, experts in both young children’s educational development and old age monitored the mood, memory and mobility of the older participants and the social interaction and language development of the youngsters to see whether being together for a sustained period could benefit one or both groups.  The proof of the pudding, as biogerontologist Dr James Brown of Aston university said, will be in the results, so for now we viewers can only wait.

That being said, the opening programme revealed, in the form of 97-year-old second world war veteran Victor, the bleak isolation and deep sense of loss with which older people are so often confronted, even when they are far from alone; it displayed in all its wide-eyed wonder, the unpredictability, honesty and vulnerability of four-year-olds.  And it hinted at the magic that can happen when the two age groups combine their formidable forces.

Clever little Phoenix, 4, struggles to adjust when he first enters Lark Hill.  Lavinia, a softly spoken retired librarian of 81 with Parkinson’s disease, notices this.  She picks up on his love of anything to do with transport and gives him a picture of a blue, old-fashioned lorry to take home.  He can hardly believe his luck. “I hope I’ve done something to make him more outgoing,” Lavinia reflects. “If he greets me when I come in tomorrow then I shall know”.

By day seven, Lavinia is Phoenix’s favourite.  She’s naughty too, for all her quiet exterior.  As a schoolgirl she broke windows playing rounders and persuaded a boy to write their names on the wall – they both got caught.   Lavinia.  The librarian rebel.  Who’d have thought it?

That’s the thing.  Old people are not an homogenous mass of nameless shapes; they are individuals with varied and unique pasts.  Victor remembers hearing the hiss of the shrapnel at the water’s edge on Dunkirk beach.  When he speaks of his late wife he’s no longer a curmudgeonly old so-and-so but the young romantic bereft of his love.  At 102, Sylvia’s been a widow for 40 years.  A lifetime of widowhood.   Her first child was born during the blitz, her midwife wore a helmet.  Now the strength of her grip is 6.5kg, which classifies her as frail – a fall or infection would hospitalise her and potentially lead to long-term care.  But she’s still Sylvia.

Dr Brown adds a note of caution.  “If we can get Sylvia eating and moving more and spending less time on her own, there’s a chance we can make her less frail – but for a 102-yer-old it really is a big ask”.

It’s worth trying.  Malcolm Johnson, Professor of Gerontology at Bath university says, “What we are doing is trying to restore to people what they appear to have lost.  Finding yourself from the past is truly pleasurable and life enhancing”.   Watching the first programme we saw this beginning to happen.

The four-year-olds with their sense of adventure and fearless trust helped to mitigate the painful realities of later life.  Three youngsters accompany Pauline, Kathleen and Victor on a half hour tram trip.  It may not seem much (and other adults are on hand) but for some of the older ones this is the furthest they’ve ventured independently in years.  Until now Victor has, on average, been sedentary for 12 hours a day, often alone and, to quote him, “in the doldrums”.  On the tram trip he’s transformed into a different man – the man he was, perhaps?

“We’ve created a mode of old age which is to create risk free environment for old people but it is claustrophobic,” says Professor Johnson.  “Modest risk, even immodest risk, is very good for older people.  They realise that they can (do these things) and it makes their life richer and better”.

The other side of the coin is, to use a chilling, Orwellian phrase coined by Canadian journalist and author Dan Gardner, the “safest humans who have ever lived”.  The Danish existentialist philosopher Soren Kierkegaard, who had an electrifying way with words, expressed the phenomenon of over-zealous caution in even starker terms.  “To dare is to lose one’s footing momentarily.  Not to dare is to lose oneself”.

I’m looking forward to seeing how the experiment progresses, how much more we’ll discover about the 20 diverse characters and how much the older group regain those things they appear to have lost – whilst trying to forget one four-year-old’s definition of “very, very old” as 37.

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Pickering House – a tale of our times

Pickering House, Dorking, a small residential home for ex-journalists, has been forced to close

I’ve had a busy summer with much travelling (hence my woeful lack of blogs, for which apologies).  There have also been two weddings and two funerals, to misquote Richard Curtis; and both friends’ funerals were due to dementia.

The first of these very sad deaths was that of a distinguished ex-journalist.  His wonderful send-off was attended by many of his former colleagues, one of whom told me about the unhappy tale of Pickering House in my home town of Dorking.

Some of you may remember one of my early blogs in which, prompted by the saccharine but thought-provoking film Quartet (about a group of elderly residents living in a home for musicians), I mused on the benefits of residential homes for those with similar professional backgrounds.

I mentioned the Royal Hospital Chelsea, home of the scarlet-coated Chelsea Pensioners, whose then director of care, Laura Bale, said that she could see the advantages of her elderly residents sharing much in common.   I also wrote of Twickenham’s Brinsworth House (affectionately known as “The Old Pro’s Paradise) for retired actors and entertainers and, last but by no means least, of Pickering House, a residential home catering for the likes of me – that is, journos.

Today I’m sorry to report that Pickering House is no more.  Which, quite apart from my selfish reasons, is sad – and telling.  Because it says much about our current care home model and the way we as a society treat elderly people.

At our mutual friend’s funeral, broadcast and newspaper journalist Nicholas Jones told me the Pickering story.  Nick, who has written an excellent piece about its closure in the British Journalism Review, comes from a journalistic family.  His late father Clem Jones was former editor of the Wolverhampton Express and Star and his brother George was for many years political editor of the Daily Telegraph.

Clem spent his final days at Sandy Cross (the precursor to Pickering House) and Nick describes this time as a celebration of his father’s lifetime in journalism.  His favourite anecdote was when his dad sat down with an ex-Daily Mirror journalist; the two men had never met before but at the end of a week swapping press stories they totted up the names of 32 mutual acquaintances.

Clem’s days at Sandy Cross gave his life a satisfying circularity: he had been raising money for its financial backer – the Newspaper Press Fund (or Journalists’ Charity) – ever since the early ‘40s when he joined the Express and Star as a district reporter.  On Clem’s death in 2002, Nick (then the fund’s chair) knew that his father would want him to ensure that future generations of journalists could benefit as he had.

So when, in 2005, it seemed Sandy Cross would have to close because it had been condemned as inadequate (not least because bathrooms were some distance from bedrooms), Nick oversaw a £1.1 million appeal to build a replacement 20-bed, state-of-the-art home.  The trust’s confidence in the new project was boosted by its handsome investment portfolio and in 2009 Pickering House was opened by the Countess of Wessex.

The new home was innovative in its layout and construction, with an airy central lobby, a well-stocked library and, essential for us journalists, the Ray Tindle bar (named after the 91-year-old local newspaper legend who only stepped down as chairman of his 220 titles last year).

Nick describes the sense of optimism at the time, with the fund’s trustees confident that Pickering House would provide an unbeatable level of care in friendly surroundings where former journalists, friends and families could fraternise and reminisce.

But by the time it opened, the 2008 financial crash had made savage inroads into the value of the trust’s share portfolio and dividend income.  Added to which, Government policy was now to keep elderly people in their own homes for as long as possible, while the ageing population and rapidly rising levels of dementia made the expense of providing more specialised care a steady drain on the charity’s finances.

By 2014 the home’s financial deficit was £597,000, threatening the charity’s various other demands – each year it helps about 200 journalists and dependents with one-off payments and grants ranging from £30 to £50 a week at a total annual spend of £400,000.  Despite managing to halve its annual losses to £250,000, the home simply became unviable and earlier this year it closed.  The reasons for this make salutary reading.

First, it was in the wrong place.  Had it been in the town centre close to transport links, access would have been easier and staffing costs lower.  How often do those of us involved in elderly care bemoan the fact that residential homes are frequently positioned on the outskirts of town – out of sight, out of mind, as if the rest of us don’t want to know what goes on behind their walls? Friends of the Elderly are investigating how care homes might be transformed into community hubs using local resources and assets.  What a great idea.

Secondly, with only 20 beds, Pickering House was too small.  Jill Palmer, the Newspaper Fund’s chair, told me that while staff-to-resident ratios were double that of most homes, it didn’t have the economies of scale available to bigger organisations.  Yet in its 2016-17 state of health report the Care Quality Commission (CQC) found the trend was for smaller homes to be rated better than larger ones, with 92pc of small nursing homes and 89pc of small residential homes rated as good compared with just 63pc of large nursing homes and 72pc of residential homes.  (The CQC says this might be partly because many smaller homes are for people with learning disabilities but, given the importance of person-focussed care, the finding makes sense to me).

Thirdly, by the time the home closed, just 14 of its 20 rooms were occupied – because it could only offer them to ex-journalists – and of the 14 residents, 12 had dementia.  This increased costs, but the home didn’t raise residents’ fees.   Even as I write this blog, today’s media is full of reports and comment columns about the scandal of those with dementia being charged 40pc more than others for their care – typically facing costs of £100,000.  My mum was one of them.

On the up side, Pickering’s 14 residents have all found different homes (where necessary, the journalist’s charity subsidises up to 15pc of their new fees), while its staff have taken other care jobs.

And Ribblesdale, the development of 23 sheltered bungalows and flats in Dorking that the charity also maintains, remains full and viable.  So it seems that in years to come I could return to my old stomping ground to chew the fat with fellow hacks – but still, what a sorry tale of our times is that of Pickering House.

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Seniors Helping Seniors

 

Sally (far R) & Christian with some of their carers

The only advert that Christian and Sally Wilse ever used for their care service Seniors Helping Seniors appealed to those with “the heart of a volunteer”.  It was a clever idea that immediately weeded out anyone applying for the money.

“Applicants thought they were volunteering”, Sally explained to me when I visited her and her husband at their house in Canterbury. “It means you get those who really want to do it for what it is, not the salary”.

In fact “it” is a job that pays its carers £10.65 an hour.  Some 150 care providers on the roster have been fully checked and approved to work, with an average of 40 working each month.  Client and carer are carefully matched according to personalities, likes, dislikes, interests and chemistry, and clients pay £20.50 an hour.

Since that first advert five years ago, applicants for Seniors Helping Seniors have all come via local word of mouth (and the enterprise has a page on https://www.homecare.co.uk ).

Sixty-seven-year-old grandmother Pat Curtis of Herne Bay took redundancy from the Bank of America eight years ago.  When Sally appealed on Facebook for someone willing to devote a few hours a week to knitting with some of her clients, Pat was happy to oblige.

Carer Pat Curtis has crafting in her DNA

One of six siblings, she has crafting in her DNA and is a member of a knitting group called the Herne Bay Cosy Crew. Since working for Seniors Helping Seniors (a profit for purpose company), Pat has sourced small knitting needles for arthritic hands and says she always arrives at her clients’ houses “casted on”, whether this be for crocheting or knitting.

I accompanied her to see 84-year-old Gladys, who has dementia, at her Faversham home.  Pat calls in twice a week for an hour, in between social services visits.  When we arrived the TV was blaring in the corner, the remote too far away for Gladys to reach.  Unlike usual carers, those from Seniors Helping Seniors don’t wash or dress their clients or dispense medication: their role is that of supportive friend.

When Gladys isn’t up to knitting she holds the wool for Pat, who always makes them both a cup of tea as they sit and reminisce, look through the WI magazine or pot up a few plants.  I saw the power of this simple, human interaction as, TV turned off, the two of them chatted about Gladys’ family; Pat skilfully drawing her neatly turned out, grey-haired friend into the conversation as Gladys’ eyes lit up.  After each visit Pat messages Gladys’ daughters to let them know how she is.

Watching Pat and Gladys reminded me of my dad’s final years when he lived alone in an apartment originally intended for him and mum.  Mum’s dementia was exacerbated when we had to sell the family home and, instead of moving into the new flat, she was admitted to hospital for six weeks before entering a nursing home.

Dad visited her every day as his own health steadily deteriorated.   I lived over an hour away by car and my daughter was only seven, so to keep an eye on dad and provide him with company, I set up a coterie of informal carers.

There was 25-year-old Marius, a Polish charity worker (who’d had criminal record checks) and part-time waiter in dad’s favourite local restaurant.   My second world war veteran, Europhile dad and this young Pole were a perfect fit: they spoke French together, discussed history and where they might go for their next jaunt in dad’s clapped out old Mercedes (which I insured for Marius to drive).

When I became worried about dad’s diet I enlisted the help of Rosemary, a former pub landlady, who produced delicious lunches in dad’s kitchen which the two of them sat down to eat together.  Dad loved nothing more than gossiping over a meal with a glass of red until a series of strokes robbed him of his ability to swallow.

Confined to bed and fed by a tube, dad required specialist help and we employed trained carers, but Marius and Rosemary continued to visit.  They had become dad’s friends – an informal equivalent of Seniors Helping Seniors – providing support and human connection for my father in the transitory period before his medical demands became too much.

What Sally and Christian – and their US predecessor – have created in Seniors Helping Seniors (as I did in my own way for dad) is a 21st century paid-for model to take the place of close-knit communities, friends, neighbours and families.

It all began six years ago when, after successful media careers, Christian, then aged 54, and Sally, then 50, were made redundant. The couple decided they wanted to do something worthwhile with the rest of their lives.

Sally saw an advert in an inflight magazine headlined, “Looking for a few ordinary people with extraordinary hearts”.  It was promoting Seniors Helping Seniors as a 20-year-old US franchise business.  Inspired by the advert, Christian went to meet its founder, an inspirational woman who had worked for Mother Theresa – and in 2012 the idea for a UK version of the original American concept was born.

Sally explained how they sold their house, her husband completed care courses and the couple bought a master licence for the UK from Seniors Helping Seniors in the US.

Their first challenge was to refocus the model for the UK, where people plan ahead for their care far less than in America, where they pay for all their medical provision.  The couple have now sold (for £10,000 each) two Seniors Helping Seniors franchises, run by like-minded people to them, in Harrow and Guildford.

Carer Eileen with Peggy, one of her clients

Retired boarding school matron Eileen Connell has been working for the Canterbury company for four years.  One of her clients, 84-year-old Joan, has dementia and lives alone in her home.  Eileen visits Joan daily for two and a half hours.  When, last year, Eileen noticed that phone calls from Marion, one of Joan’s old friends, had dwindled, Eileen arranged to drive Joan from Canterbury to visit Marion in Crawley.

“Joan was delighted”, Eileen said.  “We all went out to lunch, where the two of them reminisced about shared holidays and adventures while looking at old photos”.  Joan’s feeling of wellbeing and happiness remained well after the visit.

Katherine Spencer, who at 53 is one of the younger helpers, has been in the caring profession since she was 16.  She joined the company last October because she was impressed by its ethos.  “At Seniors Helping Seniors its all about getting it right for the client.  It’s flexible work and I feel respected and nurtured as a carer”.

“It’s about trust,” Sally said.   “When choosing our carers we see the individual, the person behind the CV and match them with the right client.   Families want a fully managed care service where there is always a plan B and flexibility to deal with what life throws out.  Carers love that they can work guilt free, not rushing in and out of people’s homes or taking on too much”.

Seniors Helping Seniors wasn’t around for my dad.  However, I was lucky: Marius and Rosemary turned out to be honest, decent people.  But I won’t forget that heart-in-mouth moment when I entrusted the keys of dad’s apartment to a young Polish man I had interviewed once (albeit having studied his CV and background checks).

Sally and Christian Wilse spotted something good that was happening over the Pond, recognised its strengths, realised it fulfilled a growing need – as far-flung families, greater numbers of working women and increased life expectancy result in too many older people being left to fend for themselves – and decided to replicate it here.

What’s more, they put clients’ needs at the centre of their service and tailor it around them with carefully matched carers rather than creating a one-size-fits-all framework.  It’s neat, it’s simple, it works and – best of all – it can be replicated.  Let’s hope it is.

Christian & Sally Wilse wanted to do something worthwhile & founded Seniors Helping Seniors

 

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Thank you Barbara

Barbara Windsor in 2010, Wikimedia Commons

A few years ago as I wandered along a London street looking for a parking ticket machine, I saw an immaculately dressed, petite blonde I recognised.   “Hi,” I said.  “Hello,” she replied, giving me her trademark beaming smile.  It was only then that I realised the woman was Barbara Windsor – familiar, yes, but not known to me at all.  She could have ignored me (goodness knows how often this must have happened to her), but instead she graciously, kindly, considerately, put me at my ease.  Now it’s our turn to do this for her.

For the 80-year-old actress, famous for countless Carry On films and, latterly, EastEnders, has Alzheimer’s disease.   Four years after she was diagnosed and as her symptoms become more pronounced, her husband Scott Mitchell has decided to let the world know so that if, when she’s out and about, Barbara acts uncharacteristically, people will know why and “accept it for what it is”.

This is so, so important.  When entertainment royalty such as Dame Barbara Windsor go public about their dementia it makes headlines, generates discussion, raises awareness of a condition which, despite being the biggest killer of women in the UK, despite afflicting 850,000 people and despite costing the country £23bn a year, is still much misunderstood and shrouded in stigma.

In less than 48 hours Scott Mitchell’s announcement has projected the topic into everyone’s lives.  All the national newspapers carried the story, many with double-page spreads.  Yesterday evening Radio 4’s PM programme ran a lengthy interview with Formula 1 racing legend Sir Jackie Stewart, whose wife Helen has frontotemporal dementia.

He spoke informatively, fluently, personally and courageously about what Helen’s illness has meant for them in ways that will resonate with thousands of families up and down the country.  He described how, because of the wealth he’s accrued, he can afford specialist nurses for his wife whereas others, less affluent, less fortunate, cannot. Staggered to discover that there is no cure, Sir Jackie has launched a charity, Race Against Dementia, to fund research into the condition.

On the BBC Breakfast television show a panel including author Wendy Mitchell, who lives with Alzheimer’s, discussed Barbara Windsor’s diagnosis.  In just a few minutes several key points were beamed into households the length and breadth of the land.  The main, crucial, message being that with more knowledge of the condition, the public could better appreciate how it affects those who have it and show them more tolerance, more patience, more understanding.

Presenters Charlie Stayt and Naga Munchetty were well-informed about dementia and its broad-reaching impact on, not just the individual involved, but his or her family – no doubt aided by their previous encounter with Wendy Mitchell, who appeared on the show earlier this year talking about her book, Somebody I Used To Know.  They knew the right questions to ask – and they had the right people providing the answers.

Wendy Mitchell with her daughters Gemma & Sarah

I don’t know if she’s fully aware of it, but Wendy Mitchell is a journalist’s dream.  She speaks in near perfect (and unusually sensible) soundbites.  I say this – I hasten to add – in a spirit of awe and appreciation.  It is one of those things that seems so easy yet is very, very hard to achieve, particularly on live television in front of 1.5m viewers.

“Dementia is like a cruel game,” she said.  “Some days it throws a curved ball at you but because I’m such an optimistic person  I say that tomorrow might be better.  If you dwell on the sadness of bad days, it is a day lost of happiness”.   A day lost of happiness.  Her inversion of the words merely adds to the power of the sentiment.

Wendy’s fellow panellist Simon McDermott sprang to the nation’s attention two years ago when he uploaded YouTube videos of his father Ted (who has Alzheimer’s) singing in the car.  The films soon went viral and the Songaminute Man was born; Simon’s Just Giving page has to date raised over £130,000 for the Alzheimer’s Society.

Picking up on Scott Mitchell’s desire to let others know about Barbara’s condition so that they can understand her behaviour, Simon spoke of strangers’ kindness, of how they became more considerate and mindful of his father’s behaviour once they understood the reason for it.

Kathryn Smith of the Alzheimer’s Society added that if people understand about dementia they can look out for each other so that communities become dementia friendly.  “A little bit of kindness doesn’t hurt anybody”.

“It’s being people friendly”, added Wendy, accurately, succinctly – before, just for good measure, charming us all with one of her most endearing smiles.

On Radio 5 Live’s Breakfast Show Charmaine Hardy, wife of 69-year-old George who was diagnosed with a rare form of dementia called Primary Progressive Aphasia a decade ago, spoke eloquently about how it had affected both their lives.  She stressed that George’s memory was still perfect, which may come as a surprise to anyone who thinks that dementia is all about forgetfulness.  But her husband cannot speak or understand what is said to him.  He has lost his sequencing and problem solving skills, so cannot clean his teeth, feed, wash or dress himself and were he to come across a gate, he wouldn’t know what to do.

George, she told listeners (2.2m tune into the Breakfast Show each week), had been a top scientist.  Now Charmaine cannot turn her back on him for a minute for fear of what might happen.  When presenter Nicky Campbell asked her how it was for her, she paused and we could hear her intake of breath.  “It’s not easy, but I do my best for him”.  How much emotion was contained in those few words.  And, importantly, how much knowledge of this rare, less spoken of dementia, did this thoughtful, caring woman impart to the rest of us.

In an echo of the devastating condition itself – whereby a single diagnosis has an overwhelming impact, on not just one individual but an entire family – when a celebrity and his or her loved ones decide to go public with a dementia diagnosis, the benefits ripple outwards, causing a cumulative, positive effect.

It is all part of the soft power of culture.  Slowly but surely as more and more of those in the spotlight choose to speak out – think of author Terry Pratchett, actress Prunella Scales (who, together with her husband Timothy West, has featured in seven television series about the couple’s canal boat trips following her diagnosis), Sir Jackie Stewart and his wife Helen – the public’s knowledge and awareness of dementia grows, silence gives way to understanding, fear subsides, stigma fades.

The famous have a platform and unrivalled power to use their well-trained voices.  But dementia – as anyone who has it or whose loved ones have it, knows only too well – is also very personal, involving complex, competing emotions.  It takes a brave spirit to talk out.

Fifty-five-year-old Scott Mitchell expressed this in the Times when he explained that, though his wife was aware that he was making her diagnosis public, Barbara may forget she gave him her blessing to do so.  In which case, he said, “I’ll just have to deal with that”.  Along with everything else – the frustration, grief, anger, bewilderment, exhaustion and guilt – which, you and I know only too well, he is going through right now.

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