We are shocked most by the realisation that we knew about nursing homes all along, writes Marie Murray.
'Ambition drove many men to become false; to have one thought locked in the breast, another ready on the tongue" - The War with Catiline, Sallust.
Shocked. Shocking. We are shocked by recent revelations, not least the Prime Time undercover uncovering of the reality of elder abuse. We are shocked to learn the carelessness with which we "care" for others. News channels are clogged with our concern. Airwaves reverberate with our amazement. Formal declarations of "shock" have rung out throughout the land, tolling the end to corrupt practice, to confusions in communication, to administrative inaccuracy, to unintentional misappropriation of money, inadvertent misallocation of files and undesirable dereliction of duty.
The rhetoric of refutation and rebuff has begun. No ricochets of remorse. Not a mea culpa, in sight. Instead a plethora of platitudes: the reading of reports, the commissioning of inquiries, the implementation of inspections, the examination of facts, the calling of meetings, drafting of legislation, enactment of regulations. The full rigours of obfuscation can commence.
The truth, if truth be identifiable on this island, is that we are not shocked by what we have learnt about abuse of the elderly in this society. We are shocked by what we knew. Shocked at us, ourselves: shocked by who we are and what we have become. We are shocked that we did nothing. Shocked we do not do enough. Shocked that economic imperatives, sustainability of public finances and ideologies of self have superseded social objectives and community concern.
Who can say they did not know the inadequacies of services? Prime Time exposed us all. This was not consciousness-raising. It was conscience raising of the most challenging kind. We did not know? We did not know the elderly were vulnerable, could be victims of physical neglect, emotional isolation, financial exploitation, callous coercion, physical assault, bruising, battering and sexual abuse.
Who did not know that the vulnerable are always prey for the unscrupulous: the greedy, the cold, the calculating, the unfeeling, the opportunistic. Who did not know that provisions were inadequate, pensions a problem, poverty a reality, frailty a fact and that deceptions of the dependent, the demented, the dying are inevitable when institutions are not inspected?
We did not know the elderly could be robbed? Subventions stolen by the State? Self-respect denied? Have we not seen them stretched on trolleys, shuffling their indignant way, half clad, to nearby toilets, hoping that on return they will not have lost the least of their entitlements: a public plinth on which to lie? We never held a nose, averted eyes or crept uncomfortably from the defilements of dependent age? Let no more doubt obtain. We have put our hands inside the wounds of Christ, followed cameras into the cavities of neglect. We know.
The psychology of ageing is well documented. The neglect of the aged is not. High on the list are physical constraint, being dirty, thirsty, hungry, sore, helpless, waiting for food to be cut, an object retrieved, being shouted at, punished, small ailments neglected, major medical needs denied.
There may be indeterminate waiting for personal purchases; sweets, cigarettes, whiskey, newspapers, poor contact with friends, denied choice of food, access to snacks, to self determination about waking and sleeping, the choice of activities or the right to personally seek professional advice. All these neglects are possible and we know that they occur.We have left carers unsupported, slave labour to fiscal state sustainability, impoverished by their concern for their husbands or wives, their mothers or fathers, all those who are dependent upon them whom they love. Their love is exploited; they are weighed down by duty, lacking regard, with little respite, less recognition, absent or insulting remuneration with options unimaginable.
The controversy between Kohlberg's ethics of rights and Gilligan's ethics of care are relevant. The ethics of rights and justice are abstract: they proclaim what hypothetically we should do. The ethics of care are concrete, what we actually do and our personal responsibility in the process. We have heard much of the former and need more of the latter.
In a radio transmission in 1939 Franklin D. Roosevelt reportedly said: "Repetition does not transform a lie into a truth." It would seem he was wrong. Repetition is the new rhetoric of "ethics", the ethics of rhetoric having outgrown the need for such senile sensibilities as accuracy. Hyperbole replaces honesty, oratory replaces reality, where the truth is the said and the said is spun, woven with tiny truth threads sufficient to satisfy.
But somewhere at this moment, a fading voice calls, again, and again, for the newspaper dropped on the floor out of reach. Who will pick that up?
Marie Murray is Director of Psychology at St Vincent's Hospital, Fairview, Dublin.