Volunteering to care

Back with the possibilities for the “big society" once again, and I was intrigued to hear about a system operating in Japan whereby people can earn credits to pay for their own future care needs by caring duties they carry out now for elderly and disabled individuals on a voluntary basis.

The government is apparently giving consideration to whether it could work in Britain, and on the face of it, there seem to be some benefits. The current situation with regard to providing services – particularly for those individuals living in their own homes, rather than in residential care – is patchy to say the least, with care workers who are employed by private organisations complaining that they are often not properly trained for the duties they are expected to carry out, poorly paid and ill-equipped. Last week's tragic accident in which a tetraplegic client's ventilator was switched off by an agency nurse is just the current, visible face of a much more pervasive problem.

So the idea of recruiting an army of willing volunteers, who will surely be well-motivated to do a good job, if only to invite positive karma for the time when they are dependent on someone else's ministrations, sounds like a good solution. But however willing, these volunteers are also going to need an investment of time and resources if they are to be properly equipped and trained to care adequately for people. All the goodwill in the world won't teach you how to transfer someone safely from their bed to a commode, or even something as apparently simple as helping them to drink without choking. So volunteers will certainly save the cost of wages, which is no minor consideration at this time of universal austerity, but they are not a cost-free alternative to paid care staff.

And I also can't help wondering what about the people who would love to volunteer, but simply don't have the time? When they get to be infirm and dependent on care from others, will they be looked at with disapproval because they haven't notched up credits to prove that they “gave" to society? If people feel pressured to do voluntary work after a full day in a demanding job, is it really voluntary? Surely we would be moving away from the fundamental principle of giving without looking for any return. And it would be ironic if the husband who dedicated his middle years to looking after his disabled wife or the daughter who juggled bringing up children with looking after a dependent parent, thus saving the NHS and social services significant sums of money, were somehow penalised when it comes to their own care needs because they were too busy to volunteer.

What do you think? A great way of getting people to feel a sense of responsibility for other, needier members of society, or a divisive wedge which, however well-intentioned, will label our future selves as deserving or non-deserving according to our individual circumstances at an earlier stage in our lives?

The Risks that Carers Run

A number of unrelated events have come together in the last couple of days to get me thinking about the risks that carers run when trying to move the person they care for.

Anybody who works in a job where they are lifting heavy weights receives manual handling training; the risks associated with the lifting are carefully assessed, and equipment is specified to minimise the possibility of injury to the lifter. Even so, musculoskeletal damage is common. Chatting to a friend who supplies stairclimbers (devices to carry a wheelchair user up and down stairs), I heard about the experience of a particular NHS Ambulance Trust who introduced powered stairclimbers and saw the rate of absenteeism due to musculoskeletal injury decline from 48% of the total to 6%, in an 18 month period. And this is amongst people who have had all the training designed to prevent them hurting themselves when lifting.

Another conversation with a long-term correspondent based in the US, who sells a cleverly designed lifting vest which makes manual transfers safer and more dignified for both parties, revolved around the costs of manufacturing in the States and labyrinthine systems of distribution in the UK, both of which tend to push the price of his product to a level where he feared it would be out of reach of potential customers. He said "For the life of me I could not understand why people would not pay to prevent back injuries to themselves and injuries to their loved ones."

To which the answer is probably they would, if they could afford it, or perhaps they would, if they understood both the risks and the alternatives. Which brings me back round to where I started. Organisations that employ people who are at risk of injuring themselves in the course of their work have a real financial incentive and legal requirement to measure and minimise the risks. But when it comes to family carers, who are estimated to save the NHS and social services some £87 billion a year on services that would otherwise have to be provided to the people they care for, who assesses and minimises their risks? Very occasionally, I hear about a manual handling training event aimed at non-professionals, but they are rare and not well-publicised.

Am I right to suspect that nobody wants to "find out" about carers running the risk of injuring themselves because they would then need to do something about it, and that would cost money? Even though keeping those carers fit and healthy is actually cheaper than replacing them when they are unable to carry on.

The final part of my injury/cost jigsaw was the story of former miners taking their former solicitors to court for not getting them full compensation for their inability to do various jobs around the house following damage to their hands caused by vibrating machinery. If a carer could point to some statutory body and demand recognition of damage to their health caused by caring, the risk assessors, equipment providers and manual handling trainers would be on the case in the next five minutes.