Beyond care plans

There’s more to care than providing the basics – we should
also help people to develop forms of self-expression through hobbies and
interests, says Yasmin Alibhai-Brown.

In a climate dominated by performance indicators, outcome
measures and Best Value regimes, service providers are now almost entirely
focused on the material, tangible and measurable.

Measurable needs are assessed, and met by measurable
interventions. Those at the receiving end too are getting used to totting up
how many times the carer appears and how many hours she or he is allocated to
carry out strictly defined tasks. But looking at my ageing mother who lives,
with other older people, in a flat in a very well run housing association
sheltered property, I observe the limitations of re-defining people who need
social care as customers.

Older people, looked-after children, families in trouble,
dysfunctional teenagers and children, and people with mental illness are
probably provided with basic care most of the time. They get help with bathing,
cleaning and shopping, distress management, maybe some specialist input by
expert therapists. But there is rarely any attention paid to the fact that
human beings harbour all sorts of interests, personal histories and desires. In
an excellent collection of essays, The Good Life, published by Demos a
few years ago, the editors rightly point out that "a fulfilled life has
some ‘project’, a goal or end". I know that my mother often just wants her
carer to sit, have a cup of tea and stick old photos in an album. She is
willing to forgo the shopping and cleaning on these days. But the carer has her
"to do" list and is not allowed to respond to these requests.

This is deprivation – as is the lack of warm physical
contact in the lives of the many who need social care. For all sorts of reasons
and sometimes with the best of intentions (child protection is one) touch,
strokes and hugs do not feature in care packages.

One social worker told me that many of her clients needed
physical affirmation and encouragement to take up interests more than they
needed routine care packages. She understands the enormous healing potential of
hobbies, interests and leisure activities and reports seeing transformations in
people which astounded everyone. She is an exceptional woman who, in her own
time, for example, helped a bereaved pensioner to get an allotment and he got
his spirit back within weeks.

A few years ago I wrote a book for Age Concern on the needs
of elders from 10 different immigrant communities in Britain. Many of the
Jewish elders I talked to wanted space to share their memories, which for too
long had been hidden inside their hearts. Most Chinese older people were
silenced by loneliness and wanted the chance to meet others and play
traditional board games. Asians craved the space to reminisce and to play
cards.

I saw some excellent small scale projects which endeavoured
to fulfil some of these clear desires. In one residential home with a mixed
population, volunteers had been recruited to do a local history project using
photographs. This was used as a springboard to get the residents to develop
life books of their own with information about places they had lived and using
photos they had.

At a children’s home I visited when researching a book, I
met two young, bright teenagers who were very keen on the media and had started
a cuttings album of stories they found interesting. They analysed these and
then wrote down their views, commenting on the tone, the perspective, the bias,
and the kind of newspaper ideology the pieces sprung from. It revealed their
vast potential, which was being ignored.

We know that drama and art can be used for therapeutic
purposes for people with mental illness, but why not extend both the kinds of
activity and the people who can access them?

With the government stressing the importance of volunteering
perhaps this is an area that can be better developed. It could work like this:
local authorities and voluntary agencies would recruit writers, drama experts,
gardeners, chefs and others in the local area who would be asked to contribute
a few hours of their time to go into institutions or groups and share their
enthusiasms.

Professionals and artists in the US do this regularly in schools
and young people’s projects. Those who wanted to could then be helped to
develop their interests, thereby motivating people who are often patronised and
turned into passive recipients of care or support. We need to do this because,
as the shampoo advert on TV says, these people are worth it.

Yasmin Alibhai-Brown is a journalist and broadcaster.