I'm not often moved to write about a TV programme, but then not every programme depicts the heart-breaking problems facing older people in the UK today in such graphic detail as BBC2's 'Protecting our Parents'.
Made as a partnership project with the Open University, it follows Birmingham's older adults care teams over the course of a year, from the perspective of older people, families and professionals. At its heart the programme features personal and often very distressing accounts of the interactions between older people and health and social care professionals, as well as hauntingly reflective pieces direct to camera.
It is undoubtedly very uncomfortable viewing at times. The footage inside Birmingham's Heartlands Hospital frequently captures some very poorly people being treated, while the scenes inside people's own homes have a uniquely personal quality that makes the experiences these older individuals are going through very vivid for the viewer.
Users of social media have offered a variety of responses to 'Protecting our Parents', but it isn't uncommon to see people saying they find it too difficult to watch, don't wish to get old, or feel very frightened about the idea of themselves and family members ageing. If, however, it makes people think about ageing, health, social care and the wider implications of having an increasingly older population then it will have done some good.
Setting aside the editorial process that this programme will have gone through, and the inevitable questions about whether an entirely balanced depiction is being given to the viewer, there are some inescapable themes. Many of the older people featured are, first and foremost, lonely and isolated. If they weren't, and their support networks both within their families and their wider communities were better, I don't think their experiences would be so acutely distressing.
Yes they are in poor health, often with multiple conditions, increased frailty, recurring falls, frequent infections and some individuals are living with dementia, but none of this means that their voices are any less important than mine, yours or anyone else's. Watching some of these older people being bullied, questioned and cornered makes me want to climb into my TV screen and advocate for them. Which is another very important point: In amongst an array of professionals, there has (as of Episode 2), been a distinct lack of advocates. Whether that is because they weren't available, or didn't want to be filmed, isn't clear.
The financial implications of the increasing needs that these older people have are continuously starkly highlighted. Whether it the cost of their time in an acute hospital bed, the 999 calls and paramedic attendances, care at home or in a care home, money - or lack of it - haunts the experiences these individuals are having. It also dictates to the professionals involved in their care just what is and isn't possible, leaving all concerned in a situation of juggling wants and needs with what is affordable.
Then there is the thorny issue of just how much these older people understand. It is a basic assumption under the Mental Capacity Act 2005 (for England and Wales) that an individual over 16 years old has capacity unless it is established that they don't. When you are working with the complexities of people who are ageing the pressure is on to see if they are capable of making a decision, which can stray into the territory of trying to 'prove' that they have dementia.
Whilst offering people who genuinely have dementia a timely diagnosis is important, the idea of trying to fit square pegs into round holes just because our disjoined health and social care system cannot provide for an ageing population is wholly unacceptable. Not only does it do these individuals a great disservice, but for those who genuinely have dementia it is likely to delay their access to specialist care and support.
Overall 'Protecting our Parents' raises more questions than answers about how we approach caring for older people. It asks our professionals to be more empathetic (and not stand over patients please!), it requires our policy makers to rethink the UK's approach to caring for its ageing population, and it asks us as citizens how we feel about ageing, if we are prepared for getting older, how we want to be treated as an older person, and if we are really ready, willing and able to protect our own ageing loved ones now and in the future. Tough questions, and no easy answers.