How to bring about changes

doi:10.1136/bmj.39212.705313.3A

BMJ 2007;334:1019-1020 (19 May), doi:10.1136/bmj.39212.705313.3A

Letters

Older people in care homes

How to bring about changes

The first 150 words of the full text of this article appear below.

McMurdo and Witham bring to mind the poor level of care thatso many elderly people have to tolerate when they find themselvesin residential care.¹ The question is how to alter the institutionalsystem that so often seems to work against the interests ofthe individual.

We underestimate just how stressful it is for nurses and careassistants to provide intimate, personal care non-stop, dayin day out, week after week. Unlike junior doctors, who alsohave this sort of stressful contact, these people are generallynot on an upward career track. Stress may be measured by howstrongly it is avoided, and staff turnover is an enormous problemin care of the elderly.

Amore subtle emotional avoidance also occurs when interactionsare carried out in a forced cheery manner, ensuring everythingis kept at a superficial level. Nurses simply are not providedwith sufficient resources to take on . . . [Full text of this article]

Paul Whitby, clinical psychologist

Green Lane Hospital, Devizes SN10 5DS

pwa@btinternet.com