Leaving a home for a home

When Simon Parkin's grandfather moved into a nursing home, his grandmother was left alone in her cold house. Who has it worse, he wonders?

 

Every summer holiday I’d lay awake on the narrow bed and listen to the only other piece of furniture in the room – the hulking wardrobe, as the beetles dined. This was the nightly ritual at my grandparents’ cottage, where the insects would feast en masse during the dark, tapping their mandibles loud against the wood till they finally stilled, replete at dawn. It was the closest I came not to adolescent rage but to adolescent madness: whipping from my bed, torching the light and poring, murderously over the bedroom furniture for something, anything to obliterate under thumb.

Nowadays the diners are gone, dispossessed by decay perhaps, as the wardrobe’s grain grumbled past its sell-by years ago. The house is all decline, its ceilings fissure-scrawl maps, its walls threaded by varicose veins of damp. It’s been this way since I can remember – close to three decades - but it never really seemed to matter very much before. The house was held together by warmth and love.

The beetles aren’t the only evictees. My grandfather departed shortly before Christmas, siren-wailed into a local hospital’s waiting bed where the staff mended what they could before making the grim pronouncement: he could not return home. His care was too much for my wearied grandmother to provide; he would need to find a new place to live.

The benefit of terminal illness – and it’s a grim benefit, but a benefit nonetheless – is the schedule it brings. Sure, the sentence is elastic: they might give you two months and you cling on for twelve, or two weeks and you’re wilted and gone in a day; but terminal illness and its prognosis sets the pace of one’s decay.

Mere old age - the sort of old age my grandparents are suffering - has none of that. It’s all unwelcome surprise, slo-mo shock horror. Death grows in us like a baby, its presence felt more each year, its strengthening kicks acting as reminders of our inexorable decline. But death’s final birth remains, for many, unannounced. It arrives to crown old age when we’re least expecting.

This is the problem for the elderly couple separated by unsynchronised degeneration. One remains in The Home, healthy but lonely, clinging to the household debris of memories. The other is sent to A Home, cared for but lonely, sitting in some medicinal chair facing a window on to a road that winds back to the old house and its memories.

Who is worse off in the arrangement? The left-behind, with her uneasy freedom and schedules that swivel around the visiting hour appointment, or the intrepid handicapped, deafened with drugs and the aggressive scent of industrial-scale linen-washing? He too awaits the visiting hour, but with a sapless tongue, his time now measured by the rising yellowy-tide in the catheter bag and the unwavering TV schedule.

“I’m not going yet,” my grandmother says, defiantly, all weekend as I stay with her. “There’s too much to do around this place anyway. And I’m certainly staying put till I’ve drunk all of the homemade wine.” We both laugh, long and eagerly – more than the joke deserves, but less than we need to.

Over our weekend together this becomes our battle cry of united defiance whenever a reason for moving out reveals itself. “Not yet!” she says. “Not yet!” I echo.

But she is preparing. She’s been preparing for years now, asking my brother and me to point out the household objects we’d like to inherit when the day comes. She would stick Post-It notes to these items’ bases with the relevant sibling’s initial drawn on in marker pen. I always saw this as a morbid request, and felt greedy and uncomfortable in answering her. But she was just preparing, trying to take care of things; being a good grandmother.

“I’m worried that he’s not eating enough,” she says, later. “Maybe I should move in to ensure he’s getting enough food?”

I point out that she is paying an extortionate amount for her husband to stay in The Home’s care and that it's the staff’s responsibility to ensure he is putting enough away. “Yes,” she says. “Yes you’re right. I’ll get your father to have a word with the staff.”

“That’s the spirit!” I say.

“Not yet!” She smiles, ruefully.

The government has been trying to improve the lot of our ageing population of late, or at least trying to appear to try to improve their lot. For many, the final years of life consume everything that was built up beforehand, at least in financial and material terms.  Last month the coalition committed to fund any care that an individual might require over £75,000 (a full £40,000 more than economist Andrew Dilnot recommended in his review). That, of course, doesn’t go towards the cost of care in a new home, only treatment. Regardless, a financial solution can only ever be a partial solution. There are deeper, wider factors for any couple facing a care home, ones that grow yet wider if the couple in question cannot move together – factors to do with guilt, loyalty and the incomprehensible pain of a separation that was not asked for.

I have my own cause for worry too. The house (fissured, varicosed) is also close to freezing. My grandparents were born pre-war and, like many farmers of their generation, live as if rationing was still in angry effect. Heat is doled out from the electric fire in momentary burps, before the ‘off’ switch is thriftily flicked and yet another woollen cardigan slipped into.

“You eat too quickly,” she admonishes, often.

To be this cold inside a home is unsettling for the contemporary human, who reasonably expects walls and rugs to offer adequate shelter from the cruel elements. I take two hot water bottles to bed and watch as steam rises, not just from my breath, but also the ambient heat of my fingers. She’s not ready to move out yet, psychologically but also physically. And yet, this is no place for an elderly lady to decline, drawn smaller by the temperature, diminished by the absence of warmth and love.

Sleep is death’s brother. But in this sort of cold, they’re twins. There’s no longer even the insect’s tap to act as a heartbeat indication of life any more, the questing micro-jaws whose nibbles and scrapes can keep a man warm through mere irritation. All that’s left is the air of cold immobility that precedes decay. And the questions - those unanswerable questions.

My grandmother wakes me first thing with a rap at the door. She’s still wearing the headscarf she slept in, tightly wrapped and tied beneath her chin. She’s eager for me to hit the road, grateful for my company and the various errands I helped her with, but ready for me to be on my way now. The new day has brought with it fresh challenges and to-dos which I am not to be a part of and, moreover, she’s worried she’s keeping me from my own familial responsibilities. This is the curse of the kindly matriarch left behind: managing everybody else. “Come on,” she says. “Time for you to get home.”

We lock eyes and I smile.

“Not yet!” I say. “Not yet.”

 

A cottage. Flickr/markhillary, used under a Creative Commons licence.
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Air pollution: 5 steps to vanquishing an invisible killer

A new report looks at the economics of air pollution. 

110, 150, 520... These chilling statistics are the number of deaths attributable to particulate air pollution for the cities of Southampton, Nottingham and Birmingham in 2010 respectively. Or how about 40,000 - that is the total number of UK deaths per year that are attributable the combined effects of particulate matter (PM2.5) and Nitrogen Oxides (NOx).

This situation sucks, to say the very least. But while there are no dramatic images to stir up action, these deaths are preventable and we know their cause. Road traffic is the worst culprit. Traffic is responsible for 80 per cent of NOx on high pollution roads, with diesel engines contributing the bulk of the problem.

Now a new report by ResPublica has compiled a list of ways that city councils around the UK can help. The report argues that: “The onus is on cities to create plans that can meet the health and economic challenge within a short time-frame, and identify what they need from national government to do so.”

This is a diplomatic way of saying that current government action on the subject does not go far enough – and that cities must help prod them into gear. That includes poking holes in the government’s proposed plans for new “Clean Air Zones”.

Here are just five of the ways the report suggests letting the light in and the pollution out:

1. Clean up the draft Clean Air Zones framework

Last October, the government set out its draft plans for new Clean Air Zones in the UK’s five most polluted cities, Birmingham, Derby, Leeds, Nottingham and Southampton (excluding London - where other plans are afoot). These zones will charge “polluting” vehicles to enter and can be implemented with varying levels of intensity, with three options that include cars and one that does not.

But the report argues that there is still too much potential for polluters to play dirty with the rules. Car-charging zones must be mandatory for all cities that breach the current EU standards, the report argues (not just the suggested five). Otherwise national operators who own fleets of vehicles could simply relocate outdated buses or taxis to places where they don’t have to pay.  

Different vehicles should fall under the same rules, the report added. Otherwise, taking your car rather than the bus could suddenly seem like the cost-saving option.

2. Vouchers to vouch-safe the project’s success

The government is exploring a scrappage scheme for diesel cars, to help get the worst and oldest polluting vehicles off the road. But as the report points out, blanket scrappage could simply put a whole load of new fossil-fuel cars on the road.

Instead, ResPublica suggests using the revenue from the Clean Air Zone charges, plus hiked vehicle registration fees, to create “Pollution Reduction Vouchers”.

Low-income households with older cars, that would be liable to charging, could then use the vouchers to help secure alternative transport, buy a new and compliant car, or retrofit their existing vehicle with new technology.

3. Extend Vehicle Excise Duty

Vehicle Excise Duty is currently only tiered by how much CO2 pollution a car creates for the first year. After that it becomes a flat rate for all cars under £40,000. The report suggests changing this so that the most polluting vehicles for CO2, NOx and PM2.5 continue to pay higher rates throughout their life span.

For ClientEarth CEO James Thornton, changes to vehicle excise duty are key to moving people onto cleaner modes of transport: “We need a network of clean air zones to keep the most polluting diesel vehicles from the most polluted parts of our towns and cities and incentives such as a targeted scrappage scheme and changes to vehicle excise duty to move people onto cleaner modes of transport.”

4. Repurposed car parks

You would think city bosses would want less cars in the centre of town. But while less cars is good news for oxygen-breathers, it is bad news for city budgets reliant on parking charges. But using car parks to tap into new revenue from property development and joint ventures could help cities reverse this thinking.

5. Prioritise public awareness

Charge zones can be understandably unpopular. In 2008, a referendum in Manchester defeated the idea of congestion charging. So a big effort is needed to raise public awareness of the health crisis our roads have caused. Metro mayors should outline pollution plans in their manifestos, the report suggests. And cities can take advantage of their existing assets. For example in London there are plans to use electronics in the Underground to update travellers on the air pollution levels.

***

Change is already in the air. Southampton has used money from the Local Sustainable Travel Fund to run a successful messaging campaign. And in 2011 Nottingham City Council became the first city to implement a Workplace Parking levy – a scheme which has raised £35.3m to help extend its tram system, upgrade the station and purchase electric buses.

But many more “air necessities” are needed before we can forget about pollution’s worry and its strife.  

 

India Bourke is an environment writer and editorial assistant at the New Statesman.