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The Leveson Centre for the study of Ageing, Spirituality and Social Policy
 

The not-so-good life?

Living and learning alongside older people
James Woodward, Director of the Leveson Centre

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February 2005 saw the launch of Comic Relief's campaign to raise awareness of some of the challenges that face older people. To enable public awareness, especially around the sensitive subject of elder abuse, Comic Relief collaborated with the BBC and Tightrope pictures to produce a drama written by Lucy Gannon entitled Dad. [1]

Richard Briers, well known by the British public for his role in The Good Life, stars as Larry James, a cheery and independent grandfather in his eighties who has been caring single-handedly for his beloved wife Jeannie (Jean Heywood) who has Alzheimer's disease. The drama looks at what it is like from many perspectives to live alongside old age and its particular difficulties. Larry falls and breaks an ankle and precipitates a life-change which is abrupt and traumatic. His wife Jeannie is moved into a care home and Larry has to go and stay with his son Oliver (Kevin Whately), daughter-in-law Sandy (Sinead Cusack) and their teenage daughter Millie (Hanna Daniel).

As good drama can often manage to achieve, this work sheds light on old age with passion, understanding and humanity. There are some incredibly moving scenes as Larry makes daily visits to the care home and mourns the loss of the woman he loves so much. The interaction and communication between staff and residents and between staff and residents' families, illuminate the tragedy of our inability to connect sometimes with how people are feeling and experiencing old age. The drama also tackles the controversial subject of funding for old age care, with Larry set to sell his house in order to provide for his wife the single room and privacy he feels she so rightly deserves.

The core part of the story lies in the increased frustration of Larry's son and daughter-in-law as they cope with learning to live together all over again with such varied habits and needs now represented under their roof. The catastrophic changes and consequences of Jeannie's fall are revealed in close detail as Oliver, whose love for his father is self-evident, finds increasing difficulty in doing right by his father and handling deep feelings that surround the family's inability to cope with Jeannie's senility.

The drama shows that people don't set out to be abusers but demonstrates how easily abuse can happen. In a disturbing scene, a row breaks out in the hallway when Oliver, frustrated by having to take increasing amounts of time off work, and forgetting his promise to take his father for a hospital appointment, finally hits his father over the shoulder with his briefcase. The incident is over in seconds but it is a moment of madness that will affect Oliver's life for ever, and colour his memory of his Dad. It's hard to see how Oliver might have safeguarded himself against such a moment, but the moral of the story is clear - guard yourself against such moments, not just for the person who might be abused but also because of the love that you have for them. Do not end up with the horrible legacy.

The drama ends as Larry sells his house and buys a broken-down barge so he can reclaim the life he loved. Oliver searches out his father on the canal and another unpleasant row develops. Larry wants to 'Potter about a bit. Make a pot of tea. Bacon butty, read the paper.' 'Bloody bacon sandwiches! You'll kill yourself, you stupid old fart,' shouts his son, incandescent with irritation. As Oliver leaves the canal pathway the viewer is left to wonder, as a matter of chilling conjecture, what will kill Larry in the end. [2]

What can we learn from this play? First it contains a broad challenge to both church and society: how far are we prepared to go really to dig deeply into the depths of the experience of those who are growing older? Is it true that, for whatever reason, both individuals and groups marginalise and disempower older people by their lack of interest and imagination? How far do our own internal fears of ageing and diminishment produce unbridgeable gaps between this vulnerable group and the rest of society? [3]

In some senses this drama helps us to understand with more insight how good and ordinary lives can so easily be broken by both accident and circumstance. The writer of this drama leaves us with little room for doubt - we experience both the powerlessness of the father (Larry) and the intense frustration of his son (Oliver). The conclusions are obvious - we could easily become either the abuser or the abused.

The drama goes further. If any of us were fearful of the sheer frailty and dependency of old age, then we are enabled to enter into these personal, pastoral and social experiences with considerable intensity. The drama's attention to detail is a key part of the creativity of this work as it explores interaction between people and their frailties in old age and the carers' constant tensions between love and duty. [4]

Jeannie shows us the living terror of knowing how dementia has diminished her humanity. 'I know what I am, I'm mad, I've gone mad up here,' she says, pointing to her head. The awareness of what Alzheimer's disease is doing to her and others is set against a whole number of barriers and difficulties to our ability to enter into her world. Neighbours, the National Health Service, but most especially those providing residential care, are all exposed as people who lack the compassion and sensitivity to understand what is happening to Jeannie and how best to respond in a manner which is human, dignified and caring. There are some deeply disturbing pictures of institutional care in a residential setting - a range of lost individuals in a day room with staff who hardly engage with older people in their individuality and with their distinctive needs.

We are also given some understanding of how difficult it is for an older person (in this case Larry) with a Zimmer frame to negotiate the obstacles of an ordinary house. Moreover, the normal processes of washing and toileting within the confines of this space are sources of immense frustration. We enter with Larry into the many losses and diminishments of old age. He has lost not only the pleasure of living with his wife with its everyday routine, he has lost his home and his mobility and, in a sad cameo, he goes round to his friend's house, hoping for the companionship of a visit to a football match, only to find that his friend has died and no one thought to tell him. We can easily forget that those who live into older age suffer constant bereavements as they outlive their contemporaries and lose mobility, sight or hearing - or sometimes all three!

So, we see that there is endless scope for both society and church to look again at what prevents us from having a deeper appreciation of old age, its limitations and possibilities. Can we uncover and rediscover our pastoral heart? Do we have the resolve to build relationships within which there can be respect and dignity? [5]

As part of my responsibility within the Foundation of Lady Katherine Leveson I oversee a medium-sized residential care home. We have worked very hard to develop a model of care which respects older people with all their complex and diverse needs. So I had some sympathy with the Head of Care and General Manager in the care home portrayed in this drama. It is very difficult to create a 'home from home' and to support staff to both care for and about older people. This is an undervalued part of social care which means that it is difficult to recruit staff to work in this area. Furthermore, the regulatory system, which quite properly monitors and directs much of what we are allowed to do, poses particular problems in the operational and strategic management of care. Care homes have been expected to abide by a whole new framework of quality standards and outcomes which have posed particular pressures and strains, and whose rationale is not always clear. [6]

It is appropriate, therefore, to ask fundamental questions about how as a society we best organise for the care and support of older people. Some of this, though not all, comes down to finance. The refusal of the Government to fund personal care in full (despite the recommendation of the Royal Commission on Long Term Care) means a failure to offer the resource to enable those working across the social and health care divide to provide sensitively for older people. Old age care is simply not seen as a financial priority. [7] Residential care continues to bear a great deal of prejudice and negativity and we're left with a whole section of the care sector which is both under-financed and under-valued.

This debate is picked up by the drama. Oliver's finances are stretched to the limit by the need to pay top-up fees for his Mum, whilst Larry feels forced to sell his house in order to fund a single room for his wife. While there is some admission on the part of all the family that she would be better cared for at home, it is clear that this aspiration is simply not practical. Her needs demand intensive and specialist care and support. Larry is neither empowered nor given choice - he is portrayed as an embattled customer who is up against a system that cannot hear his needs and concerns. His financial issues and challenges, and the related culture of care both in the Health Service and through statutory and voluntary social care organisations, make up a key policy issue that needs further research, dialogue and examination. Larry's frustration expressed in the words, 'I don't know what to say. I don't know what to do,' is related to both the systems and cultures of care and our resourcing of them.

Finally, it would be an imbalance of perspective to give the impression that life in old age should only be characterised as the 'Not-so-good life' that we should all fear. In this drama, as in life, old age brings with it a range of possibilities and opportunities. There is a wisdom about Larry and his reflections that is passionate and heart-warming. As Larry and Jeannie walk through the autumn leaves in the grounds of the care home, there is a deep sense of completion and satisfaction in a life well lived which can appreciate the colour and smell of autumn. Time taken at a slower pace and given to build up friendships and support are also opportunities of these last years of life. And uniquely it is the small things of life that are celebrated and attended to here - a wave at a neighbour in the care home, a memory of a piece of music recalled, the combing of hair, the compassion and depth of a kiss and a pint of beer with an older neighbour are all small and seemingly inconsequential details which add up to a rich and good life lived well and within love. [8]

There are many things that are left unspoken which remind us that it is not possible to comprehend all that is set before us. In a very moving scene Larry's granddaughter, Millie, gives him a massage. In this encounter, which significantly misses a generation of tension and conflict, the connection and understanding between two human beings are enabled through touch and smell. Millie expresses her solidarity with her grandfather by offering him a pastoring which transcends the limitations of words. This human solidarity and shared laughter express a freedom and understanding which are transformative. [9] But sadly even Milllie expresses a reluctance to visit her grandmother in the home - a common experience in many families, and yet visits from relatives can be transforming in the lives of people living with dementia.

Above all, the relationship between Larry and Jeannie, though traumatised by circumstance, remains undiminished. There is a power of love and human connection which moves throughout the unfolding drama. The bond and strength of their affection holds much of the surrounding conflict and their difficulty. It is against this backcloth that we need to examine the place and role of older people in both church and society and work together to raise the profile of older people and elder abuse in order that we may all become less isolated and better cared for.

James Woodward, Director of the Leveson Centre

1 This programme was first broadcast on Thursday 24 February 2005. A clip from the programme can be seen at: www.bbc.co.uk/rednoseday/tvradio.shtml

2 For further information about elder abuse see www.elderabuse.org.uk

3 See Health, Well-Being and Older People by Jan Reed, David Stanely and Charlotte Clarke, Policy Press, 2004; A Survival Guide to Later Life by Marion Shoard, Robinson, 2004.

4 See Wholeness in Later Life by Ruth Bright, Jessica Kingsley Publishers, 1997.

5 See Ageing, Spirituality and Well-Being edited by Albert Jewell, Jessica Kingsley Publishers, 2004.

6 For further information about the Commission for Social Care Inspection see their web page: www.csci.org.uk

7 See Reviewing Care Management for Older People edited by Judith Philips and Bridget Penhale, Jessica Kingsley Publishers, 1996; Inclusive Housing in an Ageing Society: Innovative Approaches edited by Sheila Peace and Caroline Holland, Policy Press, 2001.

8 See Take me Home: Families living with Alzheimer's by Amanda Hampson, Rezolv in Print Australia, 2000.

9 See Images of Aging edited by Mike Featherstone and Andrew Wernick, Routledge, 1995.

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