Safe from Harm

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0:00:02 > 0:00:04This programme contains some strong language

0:00:04 > 0:00:06and some scenes which some viewers may find upsetting.

0:00:06 > 0:00:10- Catherine. You should have gone to bed when you was offered it.- Eh?

0:00:10 > 0:00:14You should have gone to bed when you was given the opportunity to get in

0:00:14 > 0:00:17- and the nurse to cover you up.- Yeah.

0:00:17 > 0:00:18And make you cosy.

0:00:18 > 0:00:22The best thing I could've done was go through the door and go home.

0:00:22 > 0:00:25You're not going anywhere. You're going into bed.

0:00:25 > 0:00:29- You'll just have to sit again on your own.- I don't care.

0:00:29 > 0:00:33- All right, don't care.- I don't care. - All right, you've said it.

0:00:33 > 0:00:37Now forget it and sit there and calm down.

0:00:37 > 0:00:40- Oh, I'm going to give in. - No, don't be silly.

0:00:40 > 0:00:42- I am.- Don't be silly.

0:00:42 > 0:00:46- Just leave it. - All right. OK. All right.

0:00:52 > 0:00:54- Hello.- Hello, sweet.

0:00:54 > 0:00:59There are more pensioners than children living in Britain today.

0:00:59 > 0:01:02As our population gets older,

0:01:02 > 0:01:05its health needs are becoming more complex.

0:01:05 > 0:01:09This is unfortunately a condition that does gradually get worse with time.

0:01:09 > 0:01:14Two-thirds of hospital patients are over 65.

0:01:14 > 0:01:17You are a bit black and blue, I'm afraid.

0:01:17 > 0:01:19We need more support at home,

0:01:19 > 0:01:22increasing pressure on carers and families.

0:01:22 > 0:01:24Do you think we're going to leave you just like Gladys?

0:01:24 > 0:01:29I just can't put up with this any more, I really can't.

0:01:29 > 0:01:32As we live longer, how will we care for older people

0:01:32 > 0:01:34and protect our own futures too?

0:01:34 > 0:01:39I wonder when you get to my age, what you're going to do?

0:01:40 > 0:01:45I wonder if someone is going to look after you like they're

0:01:45 > 0:01:47looking after me.

0:02:09 > 0:02:14We've been close for years, right from when I was first born.

0:02:14 > 0:02:18Sadly, when Uncle Sid passed away I sort of took over helping Auntie Bet -

0:02:18 > 0:02:23not looking after her, because she's fiercely independent.

0:02:23 > 0:02:28Rhonda Bibb is on her way to meet her aunt, Betty Williams.

0:02:28 > 0:02:30Like half a million older people each year,

0:02:30 > 0:02:33Betty is in hospital, following a fall.

0:02:33 > 0:02:36When I used to leave the house, I didn't know

0:02:36 > 0:02:39whether I'd see her alive again.

0:02:40 > 0:02:44And that's it, I mean she has to go upstairs for water

0:02:44 > 0:02:47because she hasn't got a sink in the kitchen.

0:02:47 > 0:02:51She sleeps in the kitchen on a stool, which you know, nobody should...

0:02:51 > 0:02:53You wouldn't let a dog

0:02:53 > 0:02:58or an animal live in conditions like that, you know, it's just not right.

0:02:59 > 0:03:06Rhonda found Betty after her fall and called the emergency services.

0:03:06 > 0:03:08She was on her own for 24 hours

0:03:08 > 0:03:10because she couldn't get to anybody for help.

0:03:10 > 0:03:13She just couldn't do it.

0:03:13 > 0:03:16We had to get in with the police.

0:03:16 > 0:03:19And I'd feared this, I really had, and so had she,

0:03:19 > 0:03:25I know she had because we'd spoken about it but you know, as I say,

0:03:25 > 0:03:27let's hope this is the wake-up call

0:03:27 > 0:03:32and it's the beginning of the next chapter of her life for her.

0:03:37 > 0:03:42Dr Peter Wallis is the lead elderly care consultant at Heartlands Hospital in Birmingham.

0:03:42 > 0:03:44- Hello.- It's OK. - Hello, Betty.

0:03:44 > 0:03:47He's been treating Betty since her admission.

0:03:47 > 0:03:51- You've had a busy morning, haven't you?- Yes, very.

0:03:51 > 0:03:53You've got this ulcer on your foot.

0:03:53 > 0:03:57- Yes.- You've been on antibiotics now for some days.

0:03:57 > 0:03:59- Yes, I have.- Um...

0:03:59 > 0:04:03Sister and I will need at some point, not now, to take the dressing down

0:04:03 > 0:04:05and see whether the ulcer is getting better.

0:04:05 > 0:04:08She's had a long period of having to look after her husband

0:04:08 > 0:04:13when he was very poorly and sadly, he died some years ago and I think

0:04:13 > 0:04:16she's never really sort of paid a lot of attention to her own needs.

0:04:16 > 0:04:19How's Betty getting on on the ward? Is she needing a lot of help?

0:04:19 > 0:04:21She's doing very well. She's quite independent.

0:04:21 > 0:04:23I mean, we was trying to help her today,

0:04:23 > 0:04:26but she's completely independent of her personal care.

0:04:26 > 0:04:31Now, our goal is obviously to get you well enough to leave hospital.

0:04:31 > 0:04:35With all due respect, I hear your house has got a bit cluttered.

0:04:35 > 0:04:39- Very cluttered.- Nobody wants to take away your independence, Betty.

0:04:39 > 0:04:41- No, I realise that. - And I respect that.

0:04:41 > 0:04:43But at the same time we want to make sure that you're managing.

0:04:43 > 0:04:46- That I'm safe and... - Yes, exactly. - I'm doing what I ought to.

0:04:48 > 0:04:51Do you want to go in, Rhonda, and take a seat?

0:04:51 > 0:04:54Helping patients plan for leaving hospital is

0:04:54 > 0:04:57the responsibility of Social Services.

0:04:57 > 0:05:01Student social worker Gemma is meeting Rhonda to discuss Betty's case.

0:05:01 > 0:05:05Things at home have gradually got worse.

0:05:05 > 0:05:06How bad are we talking?

0:05:06 > 0:05:08Well, I had a bit of a shock this morning

0:05:08 > 0:05:10because I had to go up the hall.

0:05:10 > 0:05:12The last time I went up the hall, I could walk up the hall.

0:05:12 > 0:05:14- I couldn't this morning. - Really?

0:05:14 > 0:05:17It's just, there's just stuff everywhere.

0:05:17 > 0:05:20- What about, have you been upstairs? - She won't let me upstairs, so...

0:05:20 > 0:05:24- OK. - I did go in the other morning and I cleared some away in the kitchen,

0:05:24 > 0:05:28but it's a small dent in a very, very big...

0:05:28 > 0:05:32So there isn't actually a kitchen, is there?

0:05:32 > 0:05:35The oven doesn't work. She's got two hotplates that she uses.

0:05:35 > 0:05:39She wears, like, a plastic apron

0:05:39 > 0:05:41and all that was melted on the front.

0:05:41 > 0:05:47That's when I really did have to say, "Look, you know, something has got to be done".

0:05:47 > 0:05:50Yeah, it has. I think, yeah... well, it has.

0:05:50 > 0:05:54She's not safe. I mean, I could just cry for her, I really could. Because she's...

0:05:54 > 0:05:57- She's very, very independent. - Oh, God, yeah.

0:05:57 > 0:06:00That's... I was saying it was a good thing.

0:06:00 > 0:06:02It's a good thing, because that's kept her going.

0:06:02 > 0:06:06- Yeah.- It really has kept her going, but there comes a time where...

0:06:06 > 0:06:09- You have to let people help. - Yeah. And this is the time now.

0:06:12 > 0:06:13Betty doesn't have children

0:06:13 > 0:06:16and Rhonda is her closest relative.

0:06:16 > 0:06:19But with her own family and mother to look after,

0:06:19 > 0:06:23Rhonda can't care for Betty full-time.

0:06:23 > 0:06:26- You've got a cup of tea. - Yeah.- Do you want any...?

0:06:26 > 0:06:29No, I'm all right. I had a sandwich just before I came.

0:06:29 > 0:06:32Oh, because there's chocolate digestives, your favourite.

0:06:32 > 0:06:35They're now her favourites.

0:06:35 > 0:06:36As long as she's...

0:06:36 > 0:06:38- Going back.- Yes.

0:06:38 > 0:06:42You can't go home at the moment to how things are.

0:06:43 > 0:06:45Why, what have you done?

0:06:45 > 0:06:48I haven't done anything, I mean how they are.

0:06:48 > 0:06:51- You mean me and the necessary? - Yes.

0:06:51 > 0:06:53- OK.- Because if you do,

0:06:53 > 0:06:57you will end up back in here, Auntie Bet,

0:06:57 > 0:07:00and that's what I'm fright... what I'm afraid of.

0:07:00 > 0:07:01Yes, it's all right.

0:07:01 > 0:07:04We were afraid of what happened anyway, weren't we?

0:07:04 > 0:07:06I understand, yeah.

0:07:10 > 0:07:13In Betty's situation, you know, she is clearly very lucid

0:07:13 > 0:07:18and quite capable of understanding the risks.

0:07:18 > 0:07:22If somebody wishes to be at home and they want to run those risks

0:07:22 > 0:07:27then, you know, we have to be careful about how much we intervene.

0:07:27 > 0:07:28You know, on the one hand,

0:07:28 > 0:07:32one can be too over-protective and too concerned about the risk.

0:07:32 > 0:07:35Because if they are here long enough, they will lose those

0:07:35 > 0:07:39vital skills that are needed to maintain independence at home.

0:07:39 > 0:07:41Hospital-type complications will set in

0:07:41 > 0:07:45and then someone loses the opportunity totally of getting home.

0:07:45 > 0:07:47So one's got to try and strike a balance.

0:07:51 > 0:07:55Like Betty, 80-year-old Jim Page has had a fall.

0:07:55 > 0:07:58He's been in hospital for two months.

0:07:58 > 0:08:02Jim, you know what's happening now, where you're going?

0:08:02 > 0:08:03Home.

0:08:03 > 0:08:06Who's going to be there now waiting for you?

0:08:09 > 0:08:12- Daughter. - That's it, that's it.

0:08:13 > 0:08:15When the ambulance comes for you.

0:08:17 > 0:08:18We're going to miss you.

0:08:18 > 0:08:20- Oh, yeah?- Yes, we are.

0:08:23 > 0:08:27Getting Jim ready to go home is complicated by his dementia.

0:08:27 > 0:08:29But his doctors and social workers

0:08:29 > 0:08:32have decided it's in his best interest to leave.

0:08:35 > 0:08:40Jim's son Mick and daughter Pauline are getting his house ready.

0:08:40 > 0:08:43So what we're doing now is

0:08:43 > 0:08:44for when he comes home,

0:08:44 > 0:08:47we're bringing his bed down from his bedroom,

0:08:47 > 0:08:50bring it down and hopefully they'll bring in, like a commode

0:08:50 > 0:08:53and block off the staircase so he can't actually go upstairs.

0:08:53 > 0:08:55Cos he will try.

0:08:59 > 0:09:02Is that going to be too high for him?

0:09:02 > 0:09:04It's just to make it more easier, more comfortable for him.

0:09:04 > 0:09:07So that when we're not around,

0:09:07 > 0:09:10we can be sure that he'll be more safer.

0:09:13 > 0:09:17But I know he'd rather be at home in his own surroundings.

0:09:19 > 0:09:21OK, James - come on, mate.

0:09:24 > 0:09:29Jim's wife of 50 years died just before he went into hospital.

0:09:29 > 0:09:33She'd been his main carer, but now he'll be at home alone.

0:09:35 > 0:09:38It's just a bit raw at the moment.

0:09:38 > 0:09:39All of a sudden,

0:09:39 > 0:09:43within a couple of weeks everything has completely changed.

0:09:43 > 0:09:48I mean, we found a photo of my mum that was, erm, was just over 12 months ago.

0:09:48 > 0:09:52And the difference, you know, to looking at her

0:09:52 > 0:09:54a couple of weeks back.

0:09:56 > 0:09:58And then I look at my dad, the same thing.

0:09:58 > 0:10:00And you're looking at him thinking

0:10:00 > 0:10:02he can't change that much in 12 months.

0:10:02 > 0:10:06But it's in the pictures, you can see it.

0:10:06 > 0:10:08Want a cup of tea?

0:10:10 > 0:10:13- Would you like a cup of tea, Dad? - Eh?- Would you like a cup of tea?

0:10:17 > 0:10:18I know you don't have sugar.

0:10:20 > 0:10:22Yes, I know. Oop.

0:10:24 > 0:10:26I'll have a look.

0:10:27 > 0:10:30Because Jim's savings are below £14,500,

0:10:30 > 0:10:34he qualifies for full Social Services funding.

0:10:34 > 0:10:38He gets the maximum four visits a day by carers.

0:10:38 > 0:10:40Beyond that, it's down to Pauline and her brother

0:10:40 > 0:10:44to help their father during the 20 hours a day he's on his own.

0:10:44 > 0:10:48You're aware you're not allowed upstairs no more, don't ya? You can't go up the stairs no more.

0:10:48 > 0:10:49- Why?- They're blocked off.

0:10:49 > 0:10:53- What?- They're blocked off. Your toilet is there now.

0:10:53 > 0:10:54Where?

0:10:58 > 0:11:00Your toilet is there.

0:11:00 > 0:11:03And you've got your bed down here.

0:11:04 > 0:11:05Yeah. When?

0:11:06 > 0:11:08When?

0:11:08 > 0:11:11Now. You're home now.

0:11:12 > 0:11:15So you're going to bed here at night-time.

0:11:15 > 0:11:16And you go toilet there.

0:11:17 > 0:11:19This comes off.

0:11:21 > 0:11:23This is your home now.

0:11:23 > 0:11:25This is where you lived before you fell and went in hospital.

0:11:28 > 0:11:33I live too far to come over here and keep doing the everyday things.

0:11:33 > 0:11:36And my daughter being still at school,

0:11:36 > 0:11:38she's too young to leave on her own.

0:11:38 > 0:11:41So I don't have much choice.

0:11:41 > 0:11:46So somehow between me and my brother, we have to fit in what we can.

0:11:49 > 0:11:51But he wants to come home,

0:11:51 > 0:11:55so, better off in his own surroundings, I think.

0:12:02 > 0:12:05We used to go out and have parties in the garden, didn't we?

0:12:05 > 0:12:07- Uh-huh.- In the summer.

0:12:07 > 0:12:10Because their anniversary was in the summer, so it was always

0:12:10 > 0:12:15a great excuse to have a drink, do you know what I mean?

0:12:15 > 0:12:18Or everyone just come round for a chat.

0:12:21 > 0:12:24We'd put the music on and everyone would be dancing in the garden.

0:12:26 > 0:12:29Didn't care who was looking, who was watching, no-one bothered.

0:12:29 > 0:12:31- Barbecues, weren't it? - Yeah.

0:12:33 > 0:12:37We miss all them, miss them laughs, don't we?

0:12:40 > 0:12:43When we was younger and he was younger we used to go er,

0:12:43 > 0:12:45he used to take us swimming.

0:12:45 > 0:12:48Not just to our local pools.

0:12:48 > 0:12:51- The lido. - The lido, that's it.

0:12:51 > 0:12:53- Open pool.- Yeah.

0:12:53 > 0:12:56He used to take us to...

0:12:56 > 0:13:00In the summer, if he wasn't working, jump in the car, "C'mon, we'll go."

0:13:00 > 0:13:04Mum didn't swim, so Mum would sit there with the food

0:13:04 > 0:13:06and we'd all go on the diving boards and swimming pools

0:13:06 > 0:13:08and Dad would be with us, joining us.

0:13:08 > 0:13:12- We'd all have races, wouldn't we? - Yeah.

0:13:12 > 0:13:14My dad and my brother used to pick my sister up and me

0:13:14 > 0:13:17and chuck us up in the air in the pool.

0:13:17 > 0:13:19Obviously you can't do that now!

0:13:25 > 0:13:29You don't expect it, though, do you, when they turn ill?

0:13:29 > 0:13:32And only recently they've been giving him medication.

0:13:36 > 0:13:38Cos you've got memory loss.

0:13:42 > 0:13:46- Doctors at the hospital.- Hah!

0:13:52 > 0:13:54Do you know why you can't walk on your leg?

0:13:58 > 0:14:00- No.- Yes, they did!

0:14:00 > 0:14:03Do you know how you hurt your leg before they put you in hospital?

0:14:03 > 0:14:04No.

0:14:04 > 0:14:06You wasn't walking, you was dragging your feet

0:14:06 > 0:14:08and all of a sudden you kept falling.

0:14:13 > 0:14:15I do find it difficult sometimes.

0:14:15 > 0:14:18You get on the bus and go home and then you sit there

0:14:18 > 0:14:21and think about it. And you get so upset.

0:14:21 > 0:14:24Takes a toll on you sometimes, especially

0:14:24 > 0:14:27when you're over here, if you come every day.

0:14:27 > 0:14:29That's why I've stopped coming every day.

0:14:35 > 0:14:40What do you fancy for your dinner? Hot dinner or a sandwich?

0:14:40 > 0:14:41I don't want one.

0:14:41 > 0:14:44- Will you have one tonight, then? - Yeah.

0:14:48 > 0:14:52Did you think I was going home now, is that what you thought?

0:14:52 > 0:14:56No, I didn't. I wasn't listening to you.

0:14:56 > 0:14:58Now, I don't want to appear rude.

0:15:01 > 0:15:03It's ten days since Betty

0:15:03 > 0:15:07was admitted to hospital following a fall.

0:15:07 > 0:15:10Her social worker Gemma is concerned about the cluttered

0:15:10 > 0:15:13state of the house Betty is planning to return to.

0:15:15 > 0:15:19Betty currently is not willing to allow anybody into her home.

0:15:19 > 0:15:25But I'm hoping that once some of its moved she'll allow us to help.

0:15:26 > 0:15:33I still am independent if I go home without having strangers

0:15:33 > 0:15:37more or less saying that ought to go there and this ought to go there.

0:15:37 > 0:15:39That's not what I want.

0:15:39 > 0:15:42And that's what I'm not going to have.

0:15:42 > 0:15:45I'm sorry, but it's my home

0:15:45 > 0:15:50and I'll have it and do it as I want to.

0:15:53 > 0:15:57'I think the fact that she's got her independence is absolutely

0:15:57 > 0:16:01'fantastic. Nobody wants to take that away from her, that's not what'

0:16:01 > 0:16:04this is about, and I don't think by decluttering her house that's

0:16:04 > 0:16:06going to take away her independence.

0:16:06 > 0:16:09It's going to, if anything, give her more independence.

0:16:09 > 0:16:13I just thought if we all sat down and talked together...

0:16:13 > 0:16:14Uh-huh.

0:16:14 > 0:16:18..because it's about what you want, your decisions...

0:16:18 > 0:16:22- But we'd like to help as much as you'll let us.- I know, I know.

0:16:22 > 0:16:27I don't think, honestly speaking,

0:16:27 > 0:16:32I don't want anyone to go in until I am there.

0:16:32 > 0:16:35It's my home.

0:16:35 > 0:16:41It might not be up to standard as it was 20 years ago, ten years ago.

0:16:41 > 0:16:46But the basis is still there for me.

0:16:46 > 0:16:50Even if we could just work on small goals of just clearing one

0:16:50 > 0:16:52space at a time.

0:16:52 > 0:16:55Rhonda, you've said you'll help, won't you?

0:16:55 > 0:16:57Course I will.

0:16:57 > 0:16:59But you've got to let us help you.

0:17:01 > 0:17:06Until I've been home at least for two weeks,

0:17:06 > 0:17:09I won't have settled into a routine.

0:17:10 > 0:17:16What would you think about a temporary placement? Still going,

0:17:16 > 0:17:19going home to sort out your home.

0:17:19 > 0:17:22What I've got to sort out, yes.

0:17:22 > 0:17:29Well, that sounds as though it needs looking into a bit further,

0:17:29 > 0:17:30and that sounds all right.

0:17:30 > 0:17:32So what do you want me to do now?

0:17:32 > 0:17:34I don't want you to do anything.

0:17:34 > 0:17:35Just think about it?

0:17:35 > 0:17:37Yeah, yeah, let it sink in.

0:17:37 > 0:17:41I'll get what information I can about a temporary placement

0:17:41 > 0:17:44and see what sheltered accommodation's around.

0:17:44 > 0:17:45Thank you very much indeed.

0:17:45 > 0:17:46No, that's fine.

0:17:46 > 0:17:49I do appreciate all the time you're giving me anyway.

0:17:49 > 0:17:52We're going this way, down this way.

0:17:52 > 0:17:53Oh, are we?

0:17:53 > 0:17:56For those well enough to leave hospital,

0:17:56 > 0:17:59Social Services has access to a limited

0:17:59 > 0:18:03number of places in care homes for short-term, respite care.

0:18:04 > 0:18:08Gemma's going away to see if there's anywhere that Auntie Bet

0:18:08 > 0:18:12could have a temporary placement, so she's got somewhere to be

0:18:12 > 0:18:16comfortable in and then go back to her house to try and get it sorted.

0:18:16 > 0:18:21The only worry I've got is that Auntie Bet has said she doesn't want

0:18:21 > 0:18:28any help for at least two to three weeks from any outside agencies.

0:18:28 > 0:18:35I'm just hoping she will accept the help after this two to three weeks.

0:18:35 > 0:18:41I've just got a feeling she might not, eventually,

0:18:41 > 0:18:43get round to accepting help from anybody else.

0:18:43 > 0:18:45That's my only concern.

0:18:55 > 0:18:58We have done some further tests on your back,

0:18:58 > 0:19:02and it does look like at some point when you fell you've injured one of

0:19:02 > 0:19:07the bones at the bottom of the spine and it has crumpled slightly...

0:19:07 > 0:19:09Henry Robinson is 82.

0:19:09 > 0:19:13He came to Heartlands two weeks ago after falling downstairs.

0:19:13 > 0:19:17You've got an infection on your lung, that does sometimes

0:19:17 > 0:19:22happen when you're in hospital and not very mobile.

0:19:22 > 0:19:24We'll get your chest better,

0:19:24 > 0:19:25painkillers for the back ache,

0:19:25 > 0:19:28and when your breathing is a little bit better in a day or so, we'll get

0:19:28 > 0:19:31the physiotherapist to get you up and start moving you around again.

0:19:31 > 0:19:32OK.

0:19:32 > 0:19:35And our goal, keeping focused on it, is to get you home.

0:19:35 > 0:19:38- OK.- Is that what you want?

0:19:38 > 0:19:40- Yeah.- Good, OK.

0:19:42 > 0:19:45Henry's daughter Pat has been helping him

0:19:45 > 0:19:47since the death of his wife three years ago.

0:19:47 > 0:19:49Hello, Dad.

0:19:50 > 0:19:52How have you been?

0:19:52 > 0:19:55- A bit better today. - Oh, well, that's good. That's good.

0:19:55 > 0:19:59Funny how just falling down the stairs gets you into a predicament.

0:19:59 > 0:20:02Yes, well, it can't be helped, can it?

0:20:03 > 0:20:08If you think positively, you'll be back home and normal again.

0:20:15 > 0:20:17Yeah, but you'll just have a bit more help and it will make

0:20:17 > 0:20:20life a lot easier than it...

0:20:20 > 0:20:23- It obviously wasn't easy before, was it?- Yeah.

0:20:24 > 0:20:28He's had a urine infection, he's had this chest infection,

0:20:28 > 0:20:30so he has been quite poorly.

0:20:32 > 0:20:33Erm...

0:20:33 > 0:20:38But hopefully, we're on the turn now and things will get better.

0:20:39 > 0:20:42How are you feeling, though, in yourself?

0:20:42 > 0:20:43Better than I was yesterday.

0:20:43 > 0:20:46A bit better? You look better than I thought you would.

0:20:46 > 0:20:47- Yep. - Yeah.

0:20:47 > 0:20:51Are you seeing the doctor about getting some fish? Cod.

0:20:51 > 0:20:53- He wants...- Did you say cod?

0:20:53 > 0:20:55He wants you to get some scampi and chips.

0:20:55 > 0:20:56THEY LAUGH

0:20:56 > 0:20:59All right. We'll have a look, but I'm not sure.

0:20:59 > 0:21:02'Well, I'd like to think that Social Services would be able to

0:21:02 > 0:21:05'give him help at home.'

0:21:05 > 0:21:07I mean, I go over there about three times a week anyway,

0:21:07 > 0:21:10and I do his shopping and I clean the house.

0:21:10 > 0:21:13Erm. I'm sure he'll be happier.

0:21:13 > 0:21:19And it's his home, he's been there, ooh, lots and lots and lots of years.

0:21:19 > 0:21:23So I wouldn't like to see him in a nursing home...

0:21:34 > 0:21:39I saw my mum in a nursing home and I don't want to see my dad in one.

0:21:43 > 0:21:49So hopefully he'll get a lot better and I'll keep more of an eye on him.

0:22:08 > 0:22:12Social worker Gemma is also managing Henry's case.

0:22:12 > 0:22:16She's called a meeting with his medical team.

0:22:16 > 0:22:19We've started him on the appropriate antibiotics

0:22:19 > 0:22:21and he is making some improvements.

0:22:21 > 0:22:24That's what we're here for, is basically getting an appropriate

0:22:24 > 0:22:28discharge destination and essentially a safe discharge,

0:22:28 > 0:22:31so we are not going to rush him to be moved out of hospital

0:22:31 > 0:22:34until he's ready, that's the main thing.

0:22:34 > 0:22:36So it will be one step at a time.

0:22:36 > 0:22:39How long is he likely to be in?

0:22:39 > 0:22:40Not too long from now.

0:22:40 > 0:22:43- Yeah.- He's off the antibiotics through the drip,

0:22:43 > 0:22:47- so he's back on tablet antibiotics now.- Right.

0:22:47 > 0:22:52And he's showing much more improved from the chest infection point of view.

0:22:52 > 0:22:56We're looking at, upon discharge, a full package of care,

0:22:56 > 0:23:00so it'll be morning, lunch, afternoon and then evening, service.

0:23:00 > 0:23:02Very good. That sounds great.

0:23:02 > 0:23:04- So we're not there yet. - No, but we're getting there.

0:23:04 > 0:23:06- But we've got a plan.- Yeah.

0:23:09 > 0:23:12Eat your sandwich nicely, please.

0:23:14 > 0:23:16Sit down, Cath, please.

0:23:26 > 0:23:30No, you eat that. It'll do you good.

0:23:30 > 0:23:32- I don't want it. - No, I don't want it.

0:23:32 > 0:23:35After you've had your sandwich...

0:23:35 > 0:23:37- Yeah, I'll have that. - You have that.- Right.

0:23:46 > 0:23:48- That one. - That one there.

0:23:50 > 0:23:53BETTY: How, in all this world, have I

0:23:53 > 0:24:01got my home into such a state of a mess?

0:24:04 > 0:24:09Sid and I started our life together more or less, in that home

0:24:09 > 0:24:12and we were perfectly happy.

0:24:15 > 0:24:19I had hoped after my husband retired,

0:24:19 > 0:24:22we could find somewhere smaller to live

0:24:22 > 0:24:26and enjoy the rest of our lives together,

0:24:26 > 0:24:30doing what we both enjoyed doing -

0:24:30 > 0:24:33caravanning, going in the country.

0:24:33 > 0:24:37We've always been cyclists in our young days.

0:24:41 > 0:24:44I often speak to the good Lord,

0:24:44 > 0:24:48although I may not visit church too often...

0:24:49 > 0:24:55..and I do say, "Hope you don't mind,

0:24:55 > 0:24:57"I'm not ready to go yet."

0:25:00 > 0:25:03And with my little chats to my husband as well...

0:25:03 > 0:25:09because to me, he's always there with me.

0:25:17 > 0:25:23But as far as being ready, he's got to be patient for a little longer.

0:25:34 > 0:25:37I never expected to age so quickly.

0:25:37 > 0:25:41And I didn't feel that I'd aged so quickly.

0:25:41 > 0:25:46It just got on top of me,

0:25:46 > 0:25:51and I never thought that I would get into the state

0:25:51 > 0:25:53that I've been living in.

0:25:53 > 0:25:59I don't like even talking about now, I must be very honest.

0:26:05 > 0:26:08I can't, Rob.

0:26:10 > 0:26:13I'm so ashamed.

0:26:20 > 0:26:23OK, see you soon, bye.

0:26:24 > 0:26:28OK, she's 20 minutes away, so we'll just tell Dr Wallis.

0:26:28 > 0:26:31Erm, Henry Robinson has deteriorated, he's quite unwell

0:26:31 > 0:26:35at the moment, so we've actually rang the daughter to come in.

0:26:35 > 0:26:39She's actually on her way and will be here in about 20 minutes.

0:26:39 > 0:26:42It's ten days since the meeting to make plans for Henry to leave

0:26:42 > 0:26:43hospital.

0:27:00 > 0:27:04His daughter Pat is here with her best friend Sue.

0:27:05 > 0:27:08- Excuse me.- Dr Wallis is on his way.

0:27:23 > 0:27:27I'm just finding it a bit difficult.

0:27:29 > 0:27:31'He appears to have an infection on his lungs

0:27:31 > 0:27:34'and possibly an infection in the urine as well.'

0:27:34 > 0:27:37Um, we'd like to go to the bedside

0:27:37 > 0:27:41and have another little look at him now and see how he's getting along.

0:27:41 > 0:27:43You're welcome to come with us, would you like that?

0:27:43 > 0:27:45Yes, but I just want to compose myself.

0:27:45 > 0:27:47I don't want him to see me upset.

0:27:47 > 0:27:51No, I understand, I understand that, I quite understand.

0:27:51 > 0:27:55Are there any questions you want to ask us?

0:27:55 > 0:27:58There's not going to be a lot you can do, is there?

0:27:58 > 0:28:03Well, he's on the sort of maximum treatment that we can really

0:28:03 > 0:28:05safely give on the ward here.

0:28:05 > 0:28:09It's quite possible that he will pick up.

0:28:09 > 0:28:12But hospital infections do tend to be quite virulent infections,

0:28:12 > 0:28:14unfortunately.

0:28:14 > 0:28:16Obviously if the treatments don't work

0:28:16 > 0:28:21and he becomes more poorly, then, um, you know, he may well die.

0:28:21 > 0:28:22And it...

0:28:22 > 0:28:29it would be helpful to know from you, what sort of level,

0:28:29 > 0:28:34what level of care you think Henry would want us to deploy.

0:28:34 > 0:28:38Because the next step would probably mean moving up to an intensive

0:28:38 > 0:28:39care unit.

0:28:39 > 0:28:43But that would bring with it another lot of treatments that Henry

0:28:43 > 0:28:46might find, er, quite burdensome.

0:28:46 > 0:28:47I mean, if he...

0:28:49 > 0:28:51If he's got a chance in intensive care then

0:28:51 > 0:28:52I would go for that.

0:28:52 > 0:28:56- Yeah, yeah. - He's not the type of man to give up.

0:28:56 > 0:29:00No, well that's exactly what I wanted to know from you.

0:29:10 > 0:29:15'This is often a situation with older and frailer patients that

0:29:15 > 0:29:18'when an infection supervenes, there isn't a lot of reserve -

0:29:18 > 0:29:20'there's not a lot of physiological reserve

0:29:20 > 0:29:25'and so patients can quickly become very unwell very quickly.'

0:29:25 > 0:29:29Obviously the family are quite upset, that's understandable because

0:29:29 > 0:29:34we've swung from discussions about going home to discussions about

0:29:34 > 0:29:38whether he can survive and that's a lot for them to take on board.

0:29:58 > 0:30:01Grandad, it's Hannah, can you hear me?

0:30:07 > 0:30:09Can you hear me, Grandad?

0:30:14 > 0:30:16Dad?

0:30:19 > 0:30:22- Dad?- Laura, can you come here a minute?

0:30:22 > 0:30:25Laura! Can you come here a minute?

0:30:25 > 0:30:27Laura! Excuse us for a second.

0:30:27 > 0:30:31Check his thing is seven. The resus.

0:30:31 > 0:30:35- No...- Just excuse us for a bit.

0:30:35 > 0:30:38ALARM BEEPS

0:30:38 > 0:30:40SHOUTING

0:30:40 > 0:30:46- Lucy!- We've got someone helping out with chest compressions, please?

0:30:46 > 0:30:48ALL TALK AT ONCE

0:30:48 > 0:30:50Lucy, make sure the family are sitting...

0:30:50 > 0:30:52- Keep going.- OK.

0:30:52 > 0:30:55Ready to jump in on the next one, yeah?

0:30:55 > 0:30:58OK. Pulse is 32, can I just check the air entry?

0:30:58 > 0:31:01- Wait a second, guys.- Breathe!

0:31:01 > 0:31:04- Breathe! Yeah, we got some air entry...- OK.

0:31:04 > 0:31:06Keep going then, lovely.

0:31:06 > 0:31:08Who's giving drugs...?

0:31:08 > 0:31:12'In this sort of setting patients are incredibly vulnerable and coming

0:31:12 > 0:31:18'into hospital is swapping one set of risks for another set of risks.

0:31:18 > 0:31:22'At home, there's a risk of him being on his own and falling, etc.'

0:31:22 > 0:31:25In hospital there is another set of risks,

0:31:25 > 0:31:28and those are obviously hospital-acquired infections.

0:31:28 > 0:31:32So again, one's always trading one thing off against another.

0:31:40 > 0:31:42Henry was resuscitated.

0:31:42 > 0:31:47But three days later, he died with his family at his bedside.

0:31:54 > 0:31:58'Stability in a frail older patient is really quite capricious.

0:31:58 > 0:32:01'It's difficult to know how long it's going to last

0:32:01 > 0:32:04'and how it's going to become de-stabilised.

0:32:06 > 0:32:10'The trick is, I suppose, if one can call it that, is to get

0:32:10 > 0:32:12'somebody back on their feet quickly,

0:32:12 > 0:32:13'get everything organised and

0:32:13 > 0:32:18'get them moved to the next, safest care setting as quickly as possible.

0:32:22 > 0:32:25'Because the longer one delays in an environment where

0:32:25 > 0:32:30'there are hazards, the more likely you are to fall victim to them.

0:32:33 > 0:32:38'However, you know, if you manage to get somebody home quickly,

0:32:38 > 0:32:41'there might have been another set of problems there.'

0:32:42 > 0:32:43OK. Here you are, James.

0:32:48 > 0:32:52'It's difficult to know, this is not an easy territory to predict

0:32:52 > 0:32:53'and to chart.

0:32:55 > 0:32:57'I think, you know, getting moved through

0:32:57 > 0:33:00'the system as quickly as possible is the best way to try

0:33:00 > 0:33:02'and avoid these sorts of problems happening.'

0:33:08 > 0:33:10OK then, James, I'm going now. The calls.

0:33:10 > 0:33:11OK, mate. Thanks for coming round.

0:33:11 > 0:33:15There'll be somebody along for your next call at five o'clock for your tea call.

0:33:15 > 0:33:17- OK, mate.- Have a good day, see you soon. Bye.

0:33:24 > 0:33:27TV COMMENTARY OF RUGBY

0:33:37 > 0:33:40So, have you got any expectations, Betty,

0:33:40 > 0:33:43of what it's going to be like?

0:33:44 > 0:33:46Erm. I think it's going to be large,

0:33:46 > 0:33:48spacious, friendly.

0:33:50 > 0:33:53I should have maybe put that first!

0:33:54 > 0:33:59When I walk in that door I shall know whether it's me, or it's not.

0:34:01 > 0:34:03A month after her fall, Betty is taking

0:34:03 > 0:34:07a look at one of several nursing homes suggested by Gemma.

0:34:07 > 0:34:11It's the one closest to her niece Rhonda.

0:34:11 > 0:34:13And you've got to remember it's not permanent.

0:34:13 > 0:34:15No, that's right, that's what it isn't.

0:34:15 > 0:34:17It's got to be better than the hospital ward.

0:34:17 > 0:34:18You're right.

0:34:18 > 0:34:20- OK, go in here and turn left. - That's lovely.

0:34:20 > 0:34:23- OK? - Yes, fine.

0:34:23 > 0:34:24If Betty likes it here,

0:34:24 > 0:34:28her local authority will fund a place for a month.

0:34:29 > 0:34:32It's nice and warm in here as well.

0:34:32 > 0:34:33This is nice, Betty.

0:34:33 > 0:34:35Yes, it is nice.

0:34:35 > 0:34:38- Much better than the wards. - What do you think?

0:34:38 > 0:34:41- Is this going to be my room? - This will be your room, yes.

0:34:41 > 0:34:42Ooh, it's beautiful.

0:34:42 > 0:34:44- There you go. - Oh, that's lovely.

0:34:44 > 0:34:46All right, can you see all right?

0:34:46 > 0:34:49Oh, yes, and the big tree, the large tree,

0:34:49 > 0:34:53they're huge aren't they? Oh, many years of growth on those.

0:34:53 > 0:34:55What do you think Betty?

0:34:55 > 0:34:57- Oh, it's lovely. - Do you like the room?

0:34:57 > 0:34:58- Oh, yes, I do. - That's good then.

0:34:58 > 0:35:00Thank you very much indeed.

0:35:00 > 0:35:02I'm a happy lady at the moment.

0:35:02 > 0:35:03I can see that.

0:35:03 > 0:35:06I'm a happy lady, thank you.

0:35:08 > 0:35:13'I'm really positive about Betty. I think it went really, really well.

0:35:13 > 0:35:15'It's a hospital-to-home bed.

0:35:15 > 0:35:17'So it's always with a view of going home.

0:35:17 > 0:35:19'It's never, ever to be long-term.'

0:35:19 > 0:35:21Cos that is the aim, for her to go home

0:35:21 > 0:35:25and to have her independence back, so that is what we want.

0:35:25 > 0:35:28And the house has got to be de-cluttered either way,

0:35:28 > 0:35:31so I'd rather Betty be part of that.

0:35:31 > 0:35:32Let me have a look at the bathroom.

0:35:32 > 0:35:37Social Services pay a reduced rate of £525 per week

0:35:37 > 0:35:39for Betty's temporary place.

0:35:39 > 0:35:43Long-term residents who don't qualify for council funds

0:35:43 > 0:35:44can pay twice that.

0:35:47 > 0:35:49- It's been nice to get out. - Mm, it has.

0:35:49 > 0:35:52I bet you're looking forward to going back to have a cup of tea.

0:35:52 > 0:35:54That's what I would like now, a nice cup of tea.

0:35:54 > 0:35:55A nice cup of tea.

0:36:09 > 0:36:12No, you haven't, Dad. You've not even been here an hour.

0:36:12 > 0:36:15- Who ain't?- You ain't!- I have! - No, you haven't.

0:36:18 > 0:36:19Slippers.

0:36:19 > 0:36:22Four weeks after returning home,

0:36:22 > 0:36:27Jim Page is back at Heartlands A&E, following another suspected fall.

0:36:27 > 0:36:28It doesn't seem five minutes

0:36:28 > 0:36:31since he was in here and back out again, does it?

0:36:35 > 0:36:37The carer that come this morning to dress you.

0:36:49 > 0:36:53He's all right when someone's there, but they can't be there 24/7.

0:36:56 > 0:36:59I assumed he was safe, being as it's been a while now.

0:37:01 > 0:37:02But obviously not.

0:37:08 > 0:37:12The A&E team and consultant Dr Sally Jones have to weigh up

0:37:12 > 0:37:15the risk of sending Jim home.

0:37:15 > 0:37:19Mr Page, you may or may not remember me.

0:37:19 > 0:37:22My name's Dr Jones and I saw you before Christmas

0:37:22 > 0:37:25when you were on ward 21.

0:37:25 > 0:37:28Have you been managing OK or has it been a struggle?

0:37:28 > 0:37:30- No, it's been all right.- OK.

0:37:32 > 0:37:35OK. Can you stand up for me now? Give it a try.

0:37:35 > 0:37:38I want to see how difficult it is for you.

0:37:38 > 0:37:44Oh, no, if I stand up my leg will hurt. I can't.

0:37:44 > 0:37:49Give it a try. I want to see. I need to see how difficult it is

0:37:49 > 0:37:51so we know what sort of help you need.

0:37:51 > 0:37:52Argh. It's this leg.

0:37:54 > 0:37:58OK. Try not to lean on that cos it's on wheels, all right?

0:37:58 > 0:38:01If you stand up straight, how does that feel?

0:38:01 > 0:38:03Oh, well, achy.

0:38:03 > 0:38:05Achy. All right. You sit back down again.

0:38:05 > 0:38:07OK.

0:38:07 > 0:38:11- Oh, no.- OK.- Argh!- OK.

0:38:11 > 0:38:15'At some point, you know, we can't stop him falling completely,'

0:38:15 > 0:38:19and I think he is always going to be at risk of falls.

0:38:19 > 0:38:22If he was to go to a care home he would still be at risk of falls,

0:38:22 > 0:38:25'but he'd be unhappy cos where he wants to be is home.'

0:38:25 > 0:38:28We'll get our therapy team to come and see you

0:38:28 > 0:38:30once you've had some more painkillers.

0:38:30 > 0:38:33See if we can get you on your feet.

0:38:34 > 0:38:37And, if you're well enough, we'll try and get you home.

0:38:37 > 0:38:39- Is that what you would like? - Yeah.

0:38:39 > 0:38:42OK. We'll see what we can do to help you. OK?

0:38:42 > 0:38:45- OK, love.- All right.

0:38:45 > 0:38:48'You know, this is the first blip we've had

0:38:48 > 0:38:50'since all these extra things have been put in place.'

0:38:50 > 0:38:53So I think it's worth another go. If it keeps happening,

0:38:53 > 0:38:56we're just going to have to see where we go from here.

0:39:01 > 0:39:03INDISTINCT

0:39:04 > 0:39:06Oh! Sorry!

0:39:06 > 0:39:08You know I'm tender!

0:39:08 > 0:39:09I know you're tender.

0:39:09 > 0:39:12It's also Betty's last day at Heartlands

0:39:12 > 0:39:14and it's a special one.

0:39:15 > 0:39:18'I've reached another year of my life.'

0:39:18 > 0:39:20I believe in telling the truth.

0:39:20 > 0:39:22'I wondered where I'd be,'

0:39:22 > 0:39:26what I might be doing, anything wonderful or not.

0:39:26 > 0:39:30Well, I think it's got to come under the heading of "not"!

0:39:33 > 0:39:36Is this bag done, Betty? The next bag?

0:39:36 > 0:39:38You can probably get a little bit more in that

0:39:38 > 0:39:41cos it's got a stronger handle.

0:39:41 > 0:39:42'It is still a big day

0:39:42 > 0:39:49'because I am going to Arden Lea for approximately four weeks.'

0:39:49 > 0:39:53I'll leave your bags with smelly stuff in there. That's all you need.

0:39:53 > 0:39:58As I said to the manageress, "You never, never know. You might

0:39:58 > 0:40:01"have to put up with me for longer than you think."

0:40:01 > 0:40:04Be good. Mind what you're up to.

0:40:04 > 0:40:07And it's been lovely meeting you.

0:40:07 > 0:40:09And I'll give you a...

0:40:10 > 0:40:13Oh, dear, I can't get at you! Your nose is in the way!

0:40:14 > 0:40:18Oh, dear, I can't get at you. I can't bend down.

0:40:18 > 0:40:23Never mind, here. That's done it, hasn't it?

0:40:23 > 0:40:24Look, sit down for five minutes.

0:40:24 > 0:40:28Now, I'm going to pull those curtains back and you'll see me.

0:40:28 > 0:40:31All right? Take care.

0:40:31 > 0:40:33- Bye.- You mind how you go.- I will.

0:40:36 > 0:40:39The arm, I can't get it round.

0:40:39 > 0:40:41There you go. Do you want it doing up?

0:40:41 > 0:40:44No, no, I might have it.

0:40:44 > 0:40:49- Bye!- It's been lovely knowing you! Bye, Catherine! Bye. Bye, Catherine.

0:41:01 > 0:41:04Jim is going straight home from A&E with the same care

0:41:04 > 0:41:09package as before - four visits a day, paid for by the council.

0:41:18 > 0:41:20I've been spoilt.

0:41:20 > 0:41:22We have to spoil you, don't we?

0:41:22 > 0:41:25- And it's your birthday today. - And it's your birthday.

0:41:25 > 0:41:29Beautiful. It's just how I like it.

0:41:29 > 0:41:31Just how I like it.

0:41:31 > 0:41:34- This is the menu for today. We've got beef casserole.- Yes.

0:41:34 > 0:41:36Cabbage, peas.

0:41:36 > 0:41:38I won't see you tomorrow.

0:41:38 > 0:41:40Oh, you're not on my programme to come tomorrow,

0:41:40 > 0:41:42so I'll see you when I can.

0:41:42 > 0:41:45- Is that Tuesday? - I probably might see you Tuesday.

0:41:45 > 0:41:48- Oh, yeah?- Yeah. - Are you done now?- Yeah.

0:41:48 > 0:41:50ALL: # Happy birthday, dear Betty

0:41:50 > 0:41:53# Happy birthday to you. #

0:41:53 > 0:41:56Oh, that's beautiful, Thank you so much.

0:42:15 > 0:42:19Now we're directed to keep people independent at home.

0:42:19 > 0:42:21He's by himself in that house now.

0:42:21 > 0:42:26So we have to make sure that he's as safe as he feasibly can be.

0:42:27 > 0:42:32With Jim back at home, community social worker Dave Sharp

0:42:32 > 0:42:35picks up the case from his colleagues at the hospital.

0:42:35 > 0:42:36How you doing?

0:42:37 > 0:42:40- The leg.- The leg? - Yeah. Playing up.

0:42:40 > 0:42:44- Playing up? Your knee or your leg.- My knee.

0:42:44 > 0:42:46And how's your mood? Are you in a good mood?

0:42:46 > 0:42:48Are you chipper or are you feeling a bit low?

0:42:48 > 0:42:51How are you feeling?

0:42:51 > 0:42:54- Half and half. - Half and half?- Yeah.

0:42:54 > 0:42:56- So up and down?- Yeah.

0:42:58 > 0:43:01OK. Do you ever feel lonely during the day, James?

0:43:01 > 0:43:04Yeah, nobody sees me.

0:43:04 > 0:43:06Nobody comes round and sees me.

0:43:06 > 0:43:09So the carers occasionally come in and make you a drink and some food.

0:43:09 > 0:43:12- That's it, yeah. - Your daughter comes occasionally?

0:43:12 > 0:43:13Now and again.

0:43:14 > 0:43:21Are you invested in the process of keeping James here? Health pending.

0:43:21 > 0:43:26- As far as we can. As far as we can, yeah.- As much as you can. OK.

0:43:26 > 0:43:29There's something called telecare when you can actually monitor

0:43:29 > 0:43:33James' movements during the day, for a temporary period of time,

0:43:33 > 0:43:37just to see if...what risk he's at.

0:43:37 > 0:43:39Anything to keep him safe.

0:43:39 > 0:43:43- Then if I can't get over then I know it's OK.- Yes.- Or at night-time.

0:43:43 > 0:43:44That's what I'm suggesting.

0:43:44 > 0:43:48I mean, you can be contacted in an emergency,

0:43:48 > 0:43:50but it means that he retains some level of autonomy.

0:43:50 > 0:43:52Independence. Stays here.

0:43:52 > 0:43:55For as long as we can manage that and it's safe,

0:43:55 > 0:43:58which is what he seems to want.

0:43:58 > 0:44:00- All right. Thank you for your time. - Yeah.

0:44:08 > 0:44:11He's existing at this point, he's not really living.

0:44:16 > 0:44:20But that's an enduring problem for older adult social work, really,

0:44:20 > 0:44:21in the community.

0:44:26 > 0:44:27Oh, dear.

0:44:30 > 0:44:36In terms of your quality of life when you're isolated, it's possibly

0:44:36 > 0:44:41limited when we're pushing down that road of keeping someone at home.

0:44:42 > 0:44:46There should be more to life than just being safe.

0:44:47 > 0:44:49ICE CREAM VAN JINGLE PLAYS

0:44:53 > 0:44:57Would you like to push me back in? Oh, that looks nice.

0:44:57 > 0:44:59"Thanking you, sir," she said.

0:45:01 > 0:45:04Betty's month of convalescence at the nursing home

0:45:04 > 0:45:05is coming to an end.

0:45:07 > 0:45:10Social Services has been paying for her stay,

0:45:10 > 0:45:13to give her time to make her house safe to return to.

0:45:13 > 0:45:18- Hello, Betty, how are you?- Better than I was when I first came here.

0:45:18 > 0:45:20Yeah.

0:45:20 > 0:45:22Gemma and her manager, David,

0:45:22 > 0:45:24are here to discuss her plans for leaving.

0:45:24 > 0:45:26You're looking so well.

0:45:26 > 0:45:30The difference, seeing you today, is quite shocking.

0:45:30 > 0:45:32Oh, I'm sorry if... You ought to have asked me.

0:45:32 > 0:45:35I didn't know it was you. I nearly knocked on the door next door.

0:45:35 > 0:45:37- Her eyes are brighter as well. - Yes, very.

0:45:37 > 0:45:39Do you feel better in yourself?

0:45:39 > 0:45:45Yes, yeah. I'll be truthful - I don't feel I'm quite ready to go home.

0:45:46 > 0:45:51I dread putting the key in and opening it first time.

0:45:51 > 0:45:53So you haven't been home at all?

0:45:53 > 0:45:56- Pardon?- You haven't been home? - No.- No.

0:45:56 > 0:45:59To be honest, I never felt well enough to...

0:45:59 > 0:46:01SHE COUGHS Excuse me. ..go out.

0:46:01 > 0:46:05Do you think you'd not go back? Who would sort out...?

0:46:05 > 0:46:08I haven't even thought about it, Gemma.

0:46:08 > 0:46:11Because obviously we were funding the placement for the four weeks.

0:46:11 > 0:46:14- Yes.- We're coming up to the end of the four weeks.

0:46:14 > 0:46:15It's coming up to the end.

0:46:15 > 0:46:17Not that it's rush, you've got to go.

0:46:17 > 0:46:19Oh, yes.

0:46:19 > 0:46:21But we do need to make plans.

0:46:21 > 0:46:23That's fine.

0:46:23 > 0:46:27I think what we're saying is that you need a bit more time,

0:46:27 > 0:46:31and I think we're all agreed here that the best place for you

0:46:31 > 0:46:35to stay at the moment is the place that you've improved

0:46:35 > 0:46:40fantastically over the past, sort of, four weeks.

0:46:40 > 0:46:42- I see.- Enjoy your lunch.

0:46:42 > 0:46:47Rather than risking her safety by letting her return home,

0:46:47 > 0:46:50Social Services extends its funding by another month to give

0:46:50 > 0:46:54Betty more time to declutter her house.

0:46:54 > 0:46:56Auntie Bet is a very determined lady.

0:46:56 > 0:47:03But I think because she's comfortable at Arden Lea, that pressure to get it

0:47:03 > 0:47:08done has gone away because she's got a bit of respite from it.

0:47:08 > 0:47:13I think that's what it is. I'm hoping that's what it is.

0:47:13 > 0:47:16And facing up to going home will be even harder for Betty.

0:47:16 > 0:47:19Gemma's student placement is coming to an end

0:47:19 > 0:47:23and she'll have a new social worker.

0:47:23 > 0:47:26If Betty had been more settled, I think it would

0:47:26 > 0:47:28have been easier to leave.

0:47:28 > 0:47:32It's difficult cos obviously I'm going to have to pass...

0:47:32 > 0:47:34Somebody else will take over,

0:47:34 > 0:47:38and Betty will have to build up that rapport again.

0:47:50 > 0:47:55For the third time in five months, Jim Page is back in hospital.

0:47:55 > 0:47:58When did you fall? A long time ago before the carer come?

0:48:06 > 0:48:10- Just stay there and rest.- Eh? - Just lay there and rest.

0:48:13 > 0:48:16He must have lain on the floor for a long time this time cos he's

0:48:16 > 0:48:19got signs in his blood that he's been on the floor for quite a while.

0:48:19 > 0:48:23That's probably contributing to him being quite poorly this time.

0:48:25 > 0:48:28Mr Page. Are you having a snooze?

0:48:30 > 0:48:32You're usually a little bit brighter than this.

0:48:32 > 0:48:34Can we have a bit of a chat?

0:48:34 > 0:48:35How are you feeling, anyway?

0:48:37 > 0:48:40Half and half.

0:48:40 > 0:48:42Yeah.

0:48:42 > 0:48:45'I just wonder whether he's somebody that would actually do quite well'

0:48:45 > 0:48:49in a residential home, in terms of not being quite so lonely,

0:48:49 > 0:48:53having somebody to chat to, somebody to keep an eye on him, such that

0:48:53 > 0:48:56if he was to fall he's not going to lie on the floor for many

0:48:56 > 0:49:00hours undiscovered, which is what's happened this time.

0:49:00 > 0:49:02I just wonder if we're approaching that point,

0:49:02 > 0:49:04but it's a very difficult decision to make.

0:49:04 > 0:49:07You know, even telling somebody that they've got cancer, in one

0:49:07 > 0:49:12sense, is much easier than potentially making a decision

0:49:12 > 0:49:16that somebody doesn't want that's really going to change their life.

0:49:19 > 0:49:22Have you got somewhere we can have a private conversation, with a family?

0:49:22 > 0:49:26Yes, let me just check... just check the room.

0:49:26 > 0:49:30Hospital social worker Dolores has taken over Jim's case

0:49:30 > 0:49:33from her community colleagues.

0:49:37 > 0:49:41I mean, what we're getting at the moment is approximately

0:49:41 > 0:49:44a maximum package of care. OK?

0:49:44 > 0:49:46So what we would be looking at now is

0:49:46 > 0:49:51whether or not that is going to continue to meet his needs

0:49:51 > 0:49:56when he goes home or do we need to look at something else for him?

0:49:56 > 0:50:00Would you consider him going into a placement?

0:50:00 > 0:50:02- At a very last resort.- Yeah.

0:50:02 > 0:50:08If he was to go into a placement, chances are it'd probably be

0:50:08 > 0:50:11a nursing home, based on where he is now.

0:50:11 > 0:50:14They would be able to provide him with all the care

0:50:14 > 0:50:18and support he needs, 24 hours a day.

0:50:18 > 0:50:22You could sort of breathe easy, when you know you can't be with him,

0:50:22 > 0:50:26that you know he's being looked after properly.

0:50:26 > 0:50:31So it might be something you would like to consider.

0:50:31 > 0:50:32I know it's difficult.

0:50:32 > 0:50:36It's always difficult for families to make this decision.

0:50:46 > 0:50:48At the nursing home,

0:50:48 > 0:50:53Betty's period of funded respite care is once again nearing its end.

0:50:53 > 0:50:56But she still hasn't been home to declutter her house.

0:50:59 > 0:51:03After several meetings with Social Services managers, the pressure

0:51:03 > 0:51:07is on Betty, and her new social worker Trish, to find a solution.

0:51:09 > 0:51:14'We have very limited resources we have available to us.

0:51:14 > 0:51:20'So normally a person can remain there for a period of four weeks,'

0:51:20 > 0:51:23so I have to have that discussion with

0:51:23 > 0:51:27Betty now that we need to be making a decision.

0:51:28 > 0:51:32As Betty owns her own home and has some savings,

0:51:32 > 0:51:35from now on she'll have to pay for her temporary place.

0:51:35 > 0:51:40To stay here permanently, Betty may have to sell her house.

0:51:40 > 0:51:44- Are you comfy and ready? - Yes, I'm comfy.- OK, OK.

0:51:44 > 0:51:45Go on, then, Trish.

0:51:46 > 0:51:51Really, the bed, it won't be funded much more than from Monday onwards.

0:51:54 > 0:51:57I don't think that you've been home yet, have you?

0:51:57 > 0:51:59No, I haven't.

0:51:59 > 0:52:01Have you made a decision?

0:52:01 > 0:52:05Oh, yes, I am going to go home.

0:52:05 > 0:52:06- OK. Well, we've tried. - Yes, you have.

0:52:06 > 0:52:09- And you've made your decision.- Mm.

0:52:09 > 0:52:11You know the risks of going home.

0:52:11 > 0:52:13I know every risk that's going.

0:52:13 > 0:52:15OK.

0:52:15 > 0:52:19What I will need to explain now,

0:52:19 > 0:52:24I'll need to get in touch with the environmental health people.

0:52:24 > 0:52:25What for?

0:52:25 > 0:52:30In terms of... My understanding is you've gathered a lot of things.

0:52:30 > 0:52:32Yes, yes.

0:52:32 > 0:52:35Well, they would really like to come in just to

0:52:35 > 0:52:38assess in terms of fire, risks to neighbours.

0:52:38 > 0:52:42- I think you have to be there when they attend...- Shall I tell you?

0:52:42 > 0:52:44- It's not something that... - I shall be there.

0:52:44 > 0:52:47No-one goes in that house other than Rhonda and myself.

0:52:47 > 0:52:50Yeah, absolutely. They're aware of that.

0:52:50 > 0:52:56What possessions I have saved for my own pleasure at home,

0:52:56 > 0:53:00it's nothing at all to do with anyone.

0:53:00 > 0:53:03I needn't have told you anything about those possessions.

0:53:05 > 0:53:07It was just my story.

0:53:08 > 0:53:14Look. You're going to upset me, Trish, and I'm not having it.

0:53:14 > 0:53:20So I suggest you either go or you don't talk to me

0:53:20 > 0:53:23any more about home.

0:53:23 > 0:53:25Betty, I had to be open and honest.

0:53:25 > 0:53:28It's not for them to go in and poke around your possessions.

0:53:28 > 0:53:32I'm not saying anything more, and that's final.

0:53:32 > 0:53:35Now, do you mind? I've had enough already today.

0:53:35 > 0:53:37I'll leave you to it. I do appreciate that.

0:53:37 > 0:53:39I'm just not well.

0:53:39 > 0:53:44I don't want to hear the words Social Services ever again in my life.

0:53:50 > 0:53:53She won't let us in.

0:53:53 > 0:53:57If she was to give a little bit,

0:53:57 > 0:53:59we could have helped her a bit more, I think.

0:54:02 > 0:54:06But that's it. She's made her decision and I think it will be

0:54:06 > 0:54:10back to Rhonda now to be picking up the pieces.

0:54:10 > 0:54:13And I think, for us, we'll just have to wait to see

0:54:13 > 0:54:20if Betty does reach a point where she does feel she

0:54:20 > 0:54:22would work with us.

0:54:22 > 0:54:24I don't know if that will ever happen.

0:54:43 > 0:54:44HE COUGHS

0:54:46 > 0:54:49Hiya, Dad. Hiya.

0:54:50 > 0:54:51Hiya.

0:54:53 > 0:54:56- Are you all right? - Yeah.- Yeah?- Yeah.

0:55:00 > 0:55:03You're moving to another place.

0:55:03 > 0:55:06They're going to move you into another place soon.

0:55:06 > 0:55:08Why?

0:55:08 > 0:55:10Well, there's nurses there.

0:55:10 > 0:55:13You'll be looked after again, still the same.

0:55:13 > 0:55:14It's just another building.

0:55:15 > 0:55:19Like a nursing building, nursing home

0:55:19 > 0:55:21and they can keep an eye on you better.

0:55:21 > 0:55:24I'm not saying these are not keeping an eye on you,

0:55:24 > 0:55:26but they've more time for you.

0:55:46 > 0:55:50'I just wish my dad would respond to me telling him

0:55:50 > 0:55:53'he's got to go into a nursing home how he did last time he responded,'

0:55:53 > 0:55:55by telling us all to do one.

0:55:56 > 0:55:58Screaming, shouting.

0:55:59 > 0:56:04That would be my dad and I'd prefer that.

0:56:04 > 0:56:07At least he can talk to me then, he's got something to say to me.

0:56:07 > 0:56:09Whereas now he just don't say anything.

0:56:16 > 0:56:19All right then. See you tomorrow sometime.

0:56:19 > 0:56:21Bye. All the kids send their love to you, OK?

0:56:24 > 0:56:25Bye.

0:56:25 > 0:56:28- HE COUGHS - Ta-ra.- Bye.

0:56:44 > 0:56:46'It was wonderful at Arden Lea.

0:56:47 > 0:56:49'I was happy.

0:56:51 > 0:56:58'But I will not go into a home just to get out of doing

0:56:58 > 0:57:01'what needs to be done at my home.'

0:57:08 > 0:57:11- Hello.- Oh, hello. Oh, food, food, food.

0:57:11 > 0:57:12Yes. Are you hungry?

0:57:12 > 0:57:15What we having nice for pudding? You don't know?

0:57:15 > 0:57:21Listen. It's like lemon jelly, full fat yoghurt, light yoghurt.

0:57:21 > 0:57:24- No ricey pudding? - No rice pudding today.

0:57:24 > 0:57:27- I can ask for ice cream. - Ice cream, yes, please.

0:57:27 > 0:57:30- Would you like some ice cream? - Yes, I would today, thank you.

0:57:30 > 0:57:35- Thank you.- Thank you, my dear. Mind how you go. Don't you fall!

0:57:35 > 0:57:38God, we've got everybody falling round here.

0:57:38 > 0:57:43- I'm going to do some work. - OK, all right.

0:57:43 > 0:57:46'It's still a draw to go home, even now.

0:57:46 > 0:57:47'It always will be.

0:57:47 > 0:57:54'Because Sid and I started our life together in that home.

0:57:55 > 0:58:01'And even though I'm on my own now, it still draws me

0:58:01 > 0:58:02'because it's part of me.'

0:58:04 > 0:58:09It's peace, perfect peace in this dark world of sin.

0:58:09 > 0:58:13Why don't you open the door and let me come in?

0:58:16 > 0:58:19I don't want to go into a care home.

0:58:20 > 0:58:22I've got my home here.

0:58:24 > 0:58:27I think, at some point, you're going to have to make the decision,

0:58:27 > 0:58:30with our help, that it's not possible any more

0:58:30 > 0:58:33and that maybe we look at an alternative.

0:58:33 > 0:58:35We want to remain together.

0:58:40 > 0:58:44What judgments do we make about people older than us?

0:58:44 > 0:58:46Should we be challenging ageism?

0:58:46 > 0:58:49Join the Open University debate around ageing by going to

0:58:49 > 0:58:53bbc.co.uk/protecting our parents

0:58:53 > 0:58:56and follow the links to The Open University.