Lauren Booth: My heartbreak as Grandad slipped into modern Bedlam of a care home

Last updated at 21:58 02 February 2008

My grandfather Sid Riley died last week. I wasn't able to grant his final wish that he be allowed to spend his last months in his own home - Grandad had become too forgetful and confused to care for himself.

The local social services said they were unable to provide even the twice-daily visits that meant he could have stayed in his cottage in rural North Wales.

He was forced to leave his house and move (against my express wishes) into a care home.

Fron Yw is a handsome old manor house set in ornate grounds in Denbighshire, where as many as 23 vulnerable elderly people live. When I last visited him there one Saturday in late November, most of the OAPs in the living room were slumped silently in armchairs, even though it was just 11.30am.

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It took me a while to recognise Grandad, a man who just weeks before the move had been vivid and lively, drinking wine with me in France.

His skin was now sallow, his eyes focused on the middle distance. His hair had been cut shockingly short. He was bereft, for the first time in living memory, of his trademark quiff.

"What a LOVELY surprise," he said, trying but failing to get to his feet, ever the gentleman. "Have you come to take me home?"

For me, it was a heartbreaking moment.

Like thousands of other families across Britain, my mother Suzie, sister Emma and I struggled with the painful decision about what to do with our increasingly frail 89-year-old relative.

We knew full well he wanted to stay at his home. Failing that, he told me time and again he wanted to come and live with me and my family in France.

It was what I dearly wanted, too. But it was impossible by then.

Grandad was suffering from early-stage dementia. He also had lung cancer.

Glossy brochures and charming websites may maintain the pretence that families have a "choice" in this most important matter.

Except that when our time came, we had less time to ponder where Grandad would live out his days than I have spent looking for a new car.

In his area there were only a handful of residential homes that met his nursing needs.

One wouldn't take him because he smoked. Another was full. On paper, two others seemed to fit the bill. A close friend near Rhyl, who knew them both, warned us off.

That left one suitable care home. Would you choose your next new car on the basis that "it's the only one we've got that meets your criteria"?

But that was my grandfather's fate. And, I suspect, the fate for many thousands of other elderly people.

You can feel very alone when you are struggling to get the best care available for your loved ones, but the postcode lottery in social care means that thousands like my grandfather are denied the help that will allow them to stay in their own home.

A new report last week from the Commission for Social Care Inspection estimated that 281,000 frail pensioners needed help with washing, eating and other life-sustaining tasks, yet received no support from local authorities, charities or commercial-care providers.

A further 6,000 elderly people with "high-support needs" - meaning they could not bathe or eat unaided - received no informal care or services whatsoever.

A separate report from the Alzheimer's Society recently alleged that care homes routinely starved dementia patients of attention and time to talk.

The Government has been too slow to react to this scandalous neglect.

Our elderly are being treated with less respect than animals. Too often sedated for the comfort of others or, as is so clear from the CSCI report, ignored and left in filth and hunger.

Over the past four years, Grandad's loneliness was eased by long visits from my mother and by visits to my home in the South of France.

Each stay with us was between six weeks and three months and was as much fun for myself, my husband Craig, daughters Holly, four, and Alexandra, seven, as it was hard work.

I looked into the entitlement to benefits for full-time family carers. For this costly, monumental and stressful task, the Department of Work and Pensions offers an "attendance allowance" to family carers of just £95 per week.

And to care for a relative of 89, like my grandad, would mean either my husband or I more or less giving up work.

The payment is provided only to households with a weekly income of less than £150. Otherwise, family members taking in an elderly, infirm relative get nothing.

In September, Grandad was taken to Glan Clwyd hospital in Conwy, where he was (eventually) diagnosed with lung cancer.

The hospital staff treated him exceptionally well - until his results came back. Suddenly, he turned from a valued healthcare "customer" into an unhelpful 'bed-blocker'.

The social worker told me as gently as possible that because his cancer was not treatable, the NHS "providers" wanted him off their ward.

They didn't seem to care where he went, so long as he didn't go home.

They told us that if he wasn't moved to an appropriate care facility within 48 hours he would be put - because of his symptoms of dementia - on a psychiatric ward indefinitely. These are the modern versions of Bedlam.

I asked his social worker about his options and, in particular, the chances of palliative care in his own home. It was at this point that we got lost in the madness of the NHS free market.

I was told that Grandad "didn't meet the criteria" for home care.

When I probed deeper, I was told that residential care services had been put out to tender but that no company had bothered to supply a bid for Grandad's area.

"He's too rural," I was told. "It's not worth anyone's while to call in at his house."

His home was just 15 minutes from the nearest town.

Luckily, Fron Yw received a glowing report from the Welsh inspectorate. It is clean, quiet and the staff are respectful and involved with the residents, most of whom have some form of dementia.

Yet, by my second visit, Grandad's demeanour had changed.

He was so drowsy he could barely talk. I'd never seen him so incapable of keeping his eyes open. I was shocked.

Perhaps the cancer drugs were making him drowsy, I suggested.

Sue, the matron, looked at his medication chart. "No, he's being given one aspirin a day, two paracetamol. That's it."

And his drowsiness? "It's hot in here," I was told. "We can medicate patients if they are agitated... but he hasn't been behaving like that."

Fron Yw is one of the better care homes. But what about all those who are sedated, ignored or abandoned to live alone in squalor and confusion?

They are our loved ones. They are us in a few years.

Our efforts to secure Grandad's care were fraught with fury, resentment, disappointment and guilt.

Perhaps my family's experience should serve as a warning to all with elderly relatives: Don't leave the decision as to where a loved one ends their days until that decision is effectively taken from you.

And don't expect automatic home care from the State. It no longer exists.

Sidney Seymour Riley, 1918-2007; D-Day veteran and bon viveur; Age Concern's Welsh regional finalist in the 2008 Grandparent of the Year contest.

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