Regular readers may have noticed that when I am looking for a new topic for this space the news often throws me a bone. In this last week it has thrown me several. In my area there has been much asked and said about the quality of regional mental health care, the publicist Max Clifford has been found guilty of a series of sexual offences and the broadcaster Stuart Hall is returning to court for further hearings against him. All good sound topics on which I have things to say. But first I am going to return to the topic of care homes.

Recently there have been both newspaper articles and a TV documentary about the abuse meted out to residents of a specific care home in the UK, including upsetting footage of one resident being hit and another being repeatedly ignored as she called for help. This second chimes quite specifically with a rather contrary experience I had the other week. My wife and I were visited an elderly friend of ours in the care home where he currently resides. I've written before about what a nice place it is, but on this occasion there was a chap wandering around in the hall calling for help. Our friend was unconcerned but then he does have senile dementia, so I looked to my wife for guidance as to what to do. She had trained as a care assistant and spend some considerable time working in care homes before we were married. Knowing what I was thinking and seeing my anxiety, she gently but firmly shook her head. Should I get the chap some help? Apparently not. On the first occasion someone appeared and guided him gently back to his room, reminding him that he really ought to put trousers on. On the second he stood out there for a while and, in due course, fell over. When that happened people rushed to his side and a nurse popped in to ask our friend to press his emergency bell for help. All the residents have there, it's worth noting, both in their rooms and round their necks, so they are equipped to summon help and do get prompt attention. Later, when we left, I asked my wife why we were best to ignore the poor chap. She explained that some confused residents would call out quite arbitrarily for help and, when you arrived, would not be able to explain any actual problem because there wasn't one. You couldn't go dashing off to help the poor people every time they called out, because you had a building full to attend to, so it was one of the many essentially skills needed to realise when they actually needed help, and when they were best left to themselves.

None of this, of course, is an excuse for abuse in care homes, it's just to point out that care isn't always black and white. In the meantime, it's also important to consider the full impact of this abuse. I know nobody is pretending it's fine, but if we're going to be appalled by this behaviour, we really need to have some sense of why we're appalled. Anyone who is limited by age or disability will know better than I do how soul-destroying it is to surrender some measure of control over your own life because you can't do stuff for yourself anymore. I don't know whether it's worse to get help from someone you know, or a professional stranger, but to need help getting dressed, going to the toilet, eat your food from anyone at all must have a horrendous impact on your self-esteem. Many elderly people today suffer especially because they grew up in a much more self-reliant culture, with less support from other agencies and organisations than we are used to now. Either way, to surrender control, any, much less total, to a group of strangers needs sensitive handling if the person is to maintain their sense of self-worth. To fail in this respect is understandable, as it is no mean feat. But to compound this by leaving the person to rot or exploiting their captive trust and vulnerability is really akin to abusing a child. Other footage I saw was the daughter of one of the abused residents watching some of the footage. The poor woman was in tears with distress and also full of guilt at what she had inadvertently left her mother to face. To put a relative in a care home can be a very difficult choice to face, and it is essential for both parties that there is trust in the car system, then too many people are going to spend too long being cared for by people who really aren't up to the task any more, or caring for people when the process is putting a huge strain on them and their own lives. The impacts of this lack of trust are, in short, wide ranging and potentially catastrophic.

So what are we going to do about it then? Well one answer, I fear, is: money. You're not getting this service cheap, I'm afraid, it requires skill, knowledge, dedication and a lot of hours. But there is, I think, one thing we can do and, since I've rattled on for days now, I'll try to make this last bit quick. As yourself: what is the status of care workers, socially? Not in your mind, but in the minds of most people? Are they up there with military personnel and the emergency services? Because be in no doubt, they should be. With this sorted being a professional carer can at least be something that people aspire to be because it has the respect it deserves. Employers can be selective and choose only the very best people and standards of care can improve. So there you go, of you trot and do that.

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