Home helps under pressure to fill the missing minutes

The words were still ringing in her ears as she hurried on to her next call. “Please stay for five more minutes,” the elderly woman had pleaded. But Una, her home help, had already been there for an hour (twice what she will be paid for) and had more calls to do. Guiltily, she raced out the door.

The woman who had begged her to stay just a little longer is well into her 90s and used to have home help for an hour every day but that has been cut to half an hour.

One day a week she still gets a full hour so that she can have a shower. The woman is incontinent and has thrush. She uses a walking aid. Her shower is upstairs and, according to Una, it takes half an hour to get her into the shower.

“I could not leave the poor thing for a week because she would be sore,” says Una who, like all the Co Sligo-based home helps interviewed here, won’t give her real name, having been instructed by text message not to talk to the media. Recently this client had a “turn” in the shower and Una had to practically carry her downstairs.

Una’s hours have been cut from 39 a week to 14 and a half in the past few months. The last time she got paid, the mother of four young children burst into tears when she saw how little she was getting.

Una feels guilty rushing elderly clients as she gets them up and dressed, empties commodes, makes beds, prepares breakfast and – in half an hour – tries to leave a dinner, maybe just a few fish fingers, which can be reheated later in the microwave.

She regularly does shopping for people with no transport. At the weekend if her husband cooks a bit of bacon and cabbage, she brings a plate to the woman in her 90s.

“I meet a lot of the girls on the road with plates at the weekend,” said Una who says she is not the only home help who puts a bit extra in the pot for a client who is too frail to cook. One of her female clients has been known to get dinner at 5am from a family member with a drink problem.

In need

At a recent demonstration against cuts, home helps from Sligo passed the time canvassing each other for items like secondhand microwaves and old clothes for clients in need. “Clients who are incontinent need lots of clothes,” Una explains.

She says she has no doubt that the cuts would be reversed if she and her colleagues walked out the door once the allotted time was up, precipitating a crisis for the health authorities – but also for the clients. “We could walk out the door and ring the office and say X is sitting on the toilet and won’t be able to get back to her chair without help but they know we won’t do that because our clients are like family,” says Una.

One of her colleagues was recently traumatised when she used her key to get into a client’s home and found that the elderly lady had fallen down the stairs and suffered serious injuries. The lady was blind and used to count her way down the steps. She worried about intruders and her home help always called out her name to reassure her, as she opened the door.

No one is sure how long she was lying in a distressed state and in agony in the hall, one leg awkwardly pinned behind her. This woman used to get three calls daily from a home help but this was recently cut to two. Now she is in a nursing home.

Home helps know that they can’t blame cuts for someone falling, but say vulnerable people who have lost either a lunchtime or an evening visit could, as a result, have to wait much longer for help if a crisis arises.

Bridie sometimes brings her own hoover to a client’s house if there is none there. She has done washing in her own home for someone with no washing machine or who needs sheets washed in a hurry.

Colostomy bags

Like many of her colleagues she regularly breaks the rules by changing colostomy bags for clients. “We are not supposed to but you could not leave someone with that seeping into bed sores,” says Bridie. She explains that the bond between home help and client becomes so close that the most intimate personal care can be looked after without embarrassment on either side.

“I have found a woman lying in bed, her incontinence pad on the floor and the bed destroyed. The poor thing can’t help it. I change everything. But it is hard to change a bed, bathe and dress someone, and get a bit of breakfast for them in half an hour.”

Bridie regularly washes and dresses leg ulcers to make one client more comfortable. “I have found her trying to wipe the seeping blood with a Jeyes cloth. The poor wee thing was so grateful when I helped her.”

Dealing with leg ulcers, bed sores, thrush and leaking colostomy bags are all in a day’s work for home helps. One recalled being confronted with a bandage leaking maggots where a client was being treated for gangrene.

Very attached

“We have great fun with our clients and get very attached to them and when they get used to you coming to their home, they don’t want anyone else,” says Una.

Bridie is worried about an elderly couple both in their 80s whose hours have been reduced from 45 minutes five days a week, to twice a week. The woman is unable to carry anything heavy following surgery. Her husband has dementia and heart problems. She does not want to be identified, believing that they could endure further cuts if they kick up a row.

“My husband needs a fire especially now that it has got cold but I am not able to carry in the bucket of coal,” says the woman who cannot bend down. She says Bridie used to fill the coal every day, wash her husband, empty the commode, make the bed, make breakfast, and hoover – all chores she cannot manage now.

“I am worried sick at the thought of the budget,” the woman admits.

Depression

Bridie says many of her clients are depressed. “One said recently it would be better if they legalised euthanasia. They feel like such a burden. They watch programmes like Prime Time and hear all the talk about cuts. They are terrified about the budget and keep asking ‘do you think our pensions will be cut?’”

Mary, another home help, says that HSE officials have been out assessing one of her clients, an elderly man with dementia with a view to cutting his home help allocation from 45 to 30 minutes a day. “The poor man is soaked in urine every morning so has a shower every day,” she explains. “He used to go to a day care centre three times a week but they can’t handle him and that has been cut to one day. He knows me so I can handle him.”

Ann Gilmartin, who lives outside Sligo, says that after her husband had a stroke and she broke her hip they had home helps “falling over each other” and were getting five calls a day at one stage. Now they get half an hour, five days a week.

Her husband frequently gets mini strokes and has early stage dementia while Ann needs a walking aid and goes upstairs with difficulty. “I can’t tell you how wonderful my home help is and what she gets done in half an hour, ” says Ann who was a prominent Labour party activist .

“To be honest, we’d both be in a nursing home if she didn’t come as I could not manage. Why can’t the Government see that home helps are saving them money?”

Ann, who has noticed her husband become increasingly depressed, goes for physiotherapy once a week.

“I call it my sanity hour,” she said. “To be honest, I think it’s disgraceful what the Government is doing. I am really worried about the budget.”

HSE savings

In a statement, the HSE said that 11 million home help hours were provided annually at a cost of €195 million and it was hoped that savings of €8 million could be achieved by the end of December.

“However, it is the HSE’s intention that the impact of these reductions will be minimised by ensuring that services are provided in the first instance for direct patient care.”