I have lost count of the number of rhetorical statements that come out of the Government about how health and social care must be more personalised. Despite this noble objective, there is one area where the system ignores personalisation completely and that is the area of married couples and partners who need different levels of support.
Last week, I heard a heartrending story of a couple who had been married for nearly 70 years, one of whom had dementia and the other had a debilitating stroke. The local authority had decided that they could not be kept together because of their differing needs and so after those years of marriage they were separated.
The last few months of their lives were spent miserably because they had not got the support that they had offered each other over those preceding years.
The care home where the lady lived was so concerned about her well-being that they took her on regular visits to see her husband. This was not commissioned or acknowledged by the system, it was something they did because they understood the importance of relationships.
The saddest thing about this story was that the husband-and-wife died within five days of one another, but they died alone rather than as they had lived, supporting each other.
This is an issue which has been too long ignored and we must in future find a mechanism to ensure that people stay together. If this system truly is built on well-being and wants to nurture relationships, it cannot be a system that denies couples the opportunity to be together to the end of their lives.
It is interesting to note that even though we have an equality and human rights act and there is endless discussion by the political and chattering classes about the importance of relationships and family life, yet this is an area they have completely ignored when it comes to the care and support system.
I hope that there will be some discussion of this issue in the forthcoming Green Paper because it is so vital to the quality of people’s lives and to the maintenance of their well-being. I think this is another area where the system exhibits its ageism. There are many examples of the connection between parent and child being upheld by the system, when they need care and support and this is seen as a human rights issue. It is my belief that the same must apply to older people who are in relationships and who need care and support.
The impact of not delivering a system that understands peoples’ relationships is that they will increasingly become more unable to cope because their support mechanisms have been taken from them.
It is not only when people go into residential care that this separation happens, we see a system that does not facilitate older and disabled people visiting loved ones in hospital, or other care services and because of the inability of the system to catch up with new and relatively cheap innovations such as UBER and other bespoke transport options, people are often left waiting for the statutory sector to deliver an option which is no longer fit for purpose and should like the dinosaur, have become extinct.
I sincerely hope that as we start to think about reconfiguring the system to focus on independence, outcomes and well-being we put the importance of relationships at the centre of our thinking and have a system that is flexible enough, not only to support the person who requires care, but also the network of important people that surround them.