Fans of Eighties TV will remember The Golden Girls, the hit US sitcom that was the first to put older people and their lives front and centre.
At its heart was the mother and daughter duo Sophia and Dorothy and the acid repartee between them over Shady Pines, the decidedly basic care facility where Dorothy had sent Sophia to live for a time.
The razor-tongued Sicilian widow would guilt her offspring with exaggerated descriptions of ‘that retirement home you stuck me in that resembled Sing Sing… my mistake, Sing Sing has a movie night’. Dorothy, in moments of frustration, would yell ‘Shady Pines, ma’ to scare the recalcitrant octogenarian into compliance.
Behind the laughs lay a nagging ambivalence about our use of care homes. In many instances, only a residential centre can provide the 24/7 care and support that an older person needs. There are 400,000 care home residents in the UK and 70 per cent of them have dementia or severe memory problems. Their families would struggle to cope and it could even be dangerous to try.
But the reason care homes make us uncomfortable is our suspicion that sometimes they might be more convenient for us than for our elderly parents or relatives. Spend any time visiting a care home and you will meet a lot of people who need to be there but also some who, with a little support from their loved ones, could live independently or in the family home.
Because this subject makes us so uneasy, we shunt it to the back of our minds. As a result, these institutions and their residents occupy a low position in our hierarchy of concerns. Nothing has exposed that fact quite like the horrific impact of Covid-19. In Scotland, care home residents account for one in every four deaths and the toll on staff will be traumatic.
Twenty residents of Berelands Care Home in Prestwick have died in the last two weeks. Thirteen people passed away at Burlington Court Care Home after a suspected Covid-19 outbreak at the Glasgow facility. Nine residents of Westacres Care Home in Newton Mearns have lost their lives.
Jack Ryan, chief executive of Westacres’ parent company Newark Care, is ‘extremely frustrated and highly disappointed’ with the Scottish Government’s response to Covid-19 and has called for a public inquiry once the virus has been brought under control. He has written to Nicola Sturgeon, who says all care home residents and workers showing symptoms should be tested, to complain that Westacres received no testing, even after reporting nine deaths.
Mr Ryan is witheringly candid about why his residents were not tested: priorities. ’It has taken them so long to realise care homes might be an issue,’ he told an interviewer. ‘We have known from the start the people most at risk are the older population, so why is it that four weeks in we are now looking at care homes as a priority?’
It is a grim thought but does anyone think he is wrong? Older people are so easily forgotten, especially when they live in residential facilities rather than independently or with their families. Over-75s may be the demographic under the greatest peril from Coronavirus but those in care homes were simply out of sight and out of mind. When pre-Covid strains on residential care staffing and financing are taken into account, this outbreak was a perfect storm but we ignored the clouds gathering overhead until it was too late.
As Professor Bruce Guthrie, a researcher in general practice at Edinburgh University, told a newspaper: ‘There is a historical context of societal stigma for this population. They are not a high priority, which means it is a heavily under-resourced sector and it is very fragile… That lack of attention means we seem to have a very large epidemic in care homes and possibly among care home staff.’
How many lives were needlessly lost? We will have to wait for a public inquiry to establish facts like these but the thought will haunt us all the same. So it should. The most vulnerable among us have been let down, their lives put at risk, and some condemned to die without the soothing embrace of a loved one. Yes, the thought should haunt us but it should also make us angry. No one deserves to be treated like this.
The First Minister and her Health Secretary have now given assurances on testing for symptomatic care home residents and personal protective equipment for staff. Those promises must be carried through without delay and the opposition parties must continue to apply pressure. This is not party politics. It’s what good oppositions do: make government better.
Governments at home and abroad have grappled with this pandemic and none have been without error. Given the nature of Covid-19, the toll on older people was always going to be lethally high but that is all the more reason why the residential sector merited more consideration. If we must speak in the cold, technical language of priorities, what could be a higher priority than care homes when fighting a virus that targets the elderly?
A new study suggests there could be almost 4,000 Coronavirus deaths in UK care homes that have not been registered as such because of reporting methodologies. This under-reporting could have influenced the decisions of both home staff and ministers to the detriment of residents. This is not only a scandal but a moment of profound national shame.
What has been done cannot be undone but it can be learned from. Care homes and governments alike will have to reflect on their actions but all of us will have to reflect on our attitudes towards senior citizens and especially those with care needs.
When Coronavirus first hit, there was a strange relief at being separated from parents and elderly relatives. It was dangerous for them to be with younger loved ones in case they caught the virus. Then came Mothering Sunday and a wave of regret. Yes, there were video chats and WhatsApp messages but an emoji is no substitute for a hug.
For all the talk about families being cooped up together, most families are not together. Granny and granddad, the backbone of many a family, are on their own, separated from their children and aching to see the grandchildren again. For those who live alone, the trials involved in getting a supermarket delivery or making it out to the nearest open shop have been exacting. That those in residential care have suffered the brunt of this virus does not mean that people who live independently have got off lightly.
But care homes and the service they provide are an indicator of the value we place on the elderly. The way we treat older people, the way we speak about them, can be callous, insulting and at times even hate-filled. If we behaved this way towards any other group, it would be called prejudice but contempt for the elderly is inevitable in a society so thoroughly turned on its head that children are venerated as wise and virtuous and their parents disdained for making the messy compromises adulthood requires.
This apocalyptic cult of youth tells each generation that its future has been destroyed by the generations that went before. In this cartoonish morality play, age becomes evidence of corruption and youth a symbol of purity. No wonder no one wants to grow up.
The culture we need to build in the wake of Coronavirus is one that values human life regardless of age or health or economic cost. Part of that involves rethinking how we care for the elderly and asking if we are too reliant on residential homes and whether families should be doing more to look after their loved ones.
Life is precious. We know that now more than ever. We must start acting like it.