What I’m really thinking: the care home visitor

I come whenever I can, a round trip of several hours. And although the care staff are always welcoming, I see the disappointment in their eyes when I leave. With a couple of short breaks, I can usually last three hours. It’s all I can take of the mumbled sentences that make no sense, watching television while he sleeps and swapping pleasantries with the staff, who always seem surprised by my presence.

They assure me that there is a steady stream of other family and friends who drop in. I try not to take it personally, although it feels like a criticism. I am thankful for the way the staff look after our relative but we all know he barely registers my presence. As far as I can tell, he is happier in the company of the people who care for him and clean and feed him.

Frankly, I feel like an inconvenience, a stranger interrupting his routine. I have thought about not coming any more and I secretly wonder how a civilised society can allow a person to subsist in his condition – not living, merely existing in a gradual, unstoppable decline.

He lies there bedridden, half-paralysed and hovering between worlds. I am in no doubt that he receives the very best palliative care, but I can’t help thinking that society shows him less compassion than it would an animal in making him endure this.

The whole experience has made me think about making a living will, and also about the wider issue of end-of-life care. I also question my own motives more now. Do other visitors wish their loved ones dead, to end their suffering and ours?

• Tell us what you’re really thinking at mind@theguardian.com

What I’m really thinking: the care home visitor

One in four UK babies miss out on health visitor checks

One in four babies born in the UK are not receiving mandatory checkups from health visitors during the first two years of their life.

A fifth of babies do not receive the recommended reviews after they turn one, and one in four miss out at the age of two, according to the government’s commission on social mobility.

Health visitors, responsible for assessing a child’s early years development, are supposed to carry out checks straight after birth, at six to eight weeks, at one year and then at between two and two-and-a-half years.

However, the commission found that one in five children had not received the mandatory 12-month check by the time they reached 15 months old.

London children were the least likely to receive the right number of health visits, the report found, with fewer than half receiving the final two checkups.

A survey of parents found that the vast majority wanted the health visits to continue, with just 5% saying they did not feel they required advice during their first six months as a parent.

“Despite the conventional wisdom that parents fear interference from the ‘nanny state’, in reality many say that they welcome advice in the early years of their child’s life,” the commission said.

It said it was concerning that one in four two-year-olds did not have their health and education needs reviewed by a professional. “Despite this being a crucial period for families, there is still too little support for parents in the earliest stage of their child’s life. With the socioeconomic gap in outcomes emerging early, providing support to parents at this point could reap dividends for social mobility later on in life.”

The Conservative party’s 2010 manifesto included a key pledge to increase the number of health visitors. NHS Digital figures show the number of full-time or equivalent health visitors in England fell by almost 1,000 between October 2015 and August 2016.

In December a survey of health visitors by the Institute of Health Visiting found that 85% of respondents felt their workload had increased in the last two years. Some were having to look after between 500 and 1,000 children, when the maximum recommended is 250.

Labour said the commission’s figures showed the government was failing to invest in early years support. Emma Lewell-Buck, the shadow minister for children and families, said: “Becoming a parent for the first time is an exciting but scary time and it is shocking that not all parents are getting the support they need.

“The Tories promised more health visitors by taking away money from Sure Start Centres. Six years later we have lost over 700 centres and we are still waiting for the health visitors. The Tories have completely failed to invest these crucial early years.”

A spokesperson for Public Health England said: “Ensuring every child has the best start in life is one of our key priorities. We are supporting local authorities in commissioning services that support families and provide early help when needed.

“We are also working with councils to give health visitors professional guidance and leadership, as well as evidence of what works, to help them meet their public health responsibilities.”

The commission also said parents were finding it more difficult to access local children’s centre services, citing a 2015 survey which found more than 60% of children’s centre managers said they were cutting back on services to meet their budgets.

Government figures in December revealed that 156 Sure Start children’s centres had closed in England in 2015, almost double the number in the previous year.

One in four UK babies miss out on health visitor checks

A day in the lifestyle of ... a wellness visitor for homeless families

Tracy Bromley helps households living in hostels and refuges, as effectively as the Gypsy and Traveller communities, achieve access to wellness, housing and social care providers.

I like to be in the office by 8am, or could start off the day functioning from house. This flexibility implies I can log on to the network to accessibility clinical data without having obtaining to travel throughout rush hour – it truly saves time.

As a expert well being visitor for homeless families, I cover a wide geographical area, but carry a smaller sized caseload than generic overall health visitors. This indicates my team and I can offer you an enhanced services to the vulnerable households we appear soon after. It is my task to assess the well being needs of homeless families and help them access overall health providers and other mainstream providers.

There is no normal day at work with my role: no two days are ever the identical. The families that I work with are transient in nature, and I travel to their short-term accommodation wherever they are primarily based. This may include households who are residing in hostels or bed and breakfast accommodation, people of no fixed abode and the Gypsy and Traveller community. I also operate with families who are living in refuge accommodation possessing fled domestic abuse, and would really like to build a vulnerable families wellness-going to team.

The bed and breakfast hotels are spread across the town, and it is normal for me to check out a family members who are residing in one area. Private amenities are typically shared, and it is commonplace for there not to be any cooking facilities. The mothers and fathers that I meet truly worry about having to feed their family on takeaway food and, for those who are already on a reduced revenue, the value adds to their concern.

When I knock on the door, households are actually pleased to meet someone with whom they can share their worries and who is sympathetic to their crisis situation. In the course of the day I could liaise with housing officers, as households actually benefit from getting assistance to get an update on their application for housing.

The factor of my function that I discover most rewarding is gaining the trust and self confidence of my consumers and being ready to advocate on their behalf. The households that I operate with could quite effortlessly be ignored as they do not often have a voice. It is essential that I increase awareness of the influence that homelessness has on the well being of families, so my day might include attending meetings with other agencies. I am operating to enhance communication between wellness and social care.

In the course of the day my automobile gets my workplace and en route I will cease and make calls, perhaps to a midwife, children’s social care or to our neighborhood meals bank to acquire a parcel for a family members in need to have. Lunch is generally in my auto this provides me room to catch up.

My eclectic nursing background has led me to my present function, and my passion is working with varied groups. I may finish the day by visiting an unauthorised traveller encampment that has pitched up on a nearby website. We know that the wellness of Gypsies and Travellers in the United kingdom is much poorer than that of the common population. The families on web site are pleased to see a well being visitor and ask for assistance with receiving their children’s “needles” (the Traveller phrase for immunisations) completed.

Due to the fact of the transient nature of their accommodation, homeless households are less probably to be registered with a GP. Part of my work is to facilitate obtaining this sorted out as quickly as attainable, which in flip assists all of us in direction of the aim of improving the well being outcomes for homeless families.

When I am not working I adore to travel. I notably like cities and I am working my way by means of my must-see wish checklist around the world.

This article is published by Guardian Specialist. Join the Healthcare Pros Network to get normal emails and exclusive gives.

If you would like to characteristic in our Day in the Existence series, or know someone who would, e-mail healthcare@theguardian.com

A day in the lifestyle of ... a wellness visitor for homeless families