Terry Prone: Even great nursing homes involve losing crucial everyday freedoms

Freedom is myriad tiny choices that people who are free take for granted. White or beige coffee filters. Toast or porridge. Driving the long way or the short. Now try living without that autonomy

People who are free take tiny everyday freedoms for granted — but we lose it all when we are consigned to a nursing home, even when it's ‘for your own good’. Stock picture: iStock

Three books. Treats for the new year. A collection of short stories. A World War II. A thriller.

Nothing in common, on the face of it. Yet all three bringing the reader, unwarned, into the same situation. The nursing home. The old people’s home. 

It’s like a triple whammy, a smack to one side of the face, then the other, then back to the first, cheeks reddening, eyes tearing up.

Here’s the first, from Bernard MacLaverty’s Blank Pages and Other Stories:

“It was a double-edged sword, his mother being in a home like this. It stopped him worrying about her. Although it started him worrying about his own callousness in putting her there. But what would he do? He lived in another country.”

Here’s the second, from Matt Brolly’s Dead Embers:

“If he wasn’t sitting face to face with Gladys he would have said the voice belonged to a confident person in their fifties. Not some frail old lady, whittling away her last few days in a box-shaped, prison-like room, the lure of the next romantic doorstopper the only thing to look forward to.”

Here’s the third, from Kate Atkinson’s A God in Ruins:

“Occasionally Viola had found them gathered, like zombies… at the door, staring mutely through the wired glass at a world that was forbidden to them now. They were prisoners, serving the lees of their life sentences. The walking dead.”

Three writers portraying residence in a nursing home as a fate considerably worse than death. Two of the three using the same parallel — prison.

Let’s do the fairmindedness routine, shall we? A good many nursing homes are models of care, respect, and concern for those who live within their walls. All are checked on by the rigorous Hiqa.

'Blank Pages and Other Stories' by Bernard MacLaverty — just one of three books that frame entering a nursing home in terms of incarceration. 

Let’s go further. 

Many of us have experienced the wonderful relief of finding a well-kept, well-managed nursing home that happens to have a free room for someone we love. Where they’ll be safe and sound. That feeling of relief enhanced by months of being woken in the middle of the night by an older relative mystified by the hairdressers being locked or by a neighbour conveying in courteously coded language the indicators of confusion and odd behaviour. Or by witnessing some action so demonstrably dangerous to themselves and to others that it was all you could do not to yell a warning and yank them by the arm, as if they were a toddler about to run out into traffic.

After a few months or years of that, a nursing home looks like a godsend. To the one who’s not going into it. To the free citizen.

To the one who’s going to live in it, it looks like a prison. A loss of the crucial self-definitive freedoms.

When it boils down to it, freedom is not the grand possibilities conjured, La Pasionaria-fashion, of dying on your feet or living on your knees. It’s not that big and binary and defensible. 

Freedom is the myriad tiny choices taken for granted every day by the free. White or beige Melitta filters. Toast or porridge. Wearing clothes that do not suit you but that you still like. Responding to an exigent friend or deciding to ignore their calls. Driving the long way or the short.

Meaningless until removed, those freedoms, those choices, and then as devastating as an amputation, with all the consequential false-limb pain.

Most of us were able to choose to have toast or porridge or whatever for breakfast this morning. Imagine if you were no longer able to make such tiny, everyday choices. 

A generation now stands on the cusp of the nursing home option. A generation who’ve done it to others and now face having it done to them. A generation who, maybe a while back, urged their offspring to kill them rather than submit them to an old folks’ home. Urged them with the brainless bravado of the currently unthreatened. 

That generation is on the verge of entering into a new world where, you realise, you are part of one of the two “for your own good” cohorts.

Before children are old enough to tell their elders to stick a sock in it because they are going to make their own choices, whether those choices are good for them or bad for them, they are coerced, in honeyed tones, by someone playing the “for your own good” tune.

Ditto when you get old. 

Except, when you get old, the implicit threat is of benign incarceration. 

It’s not that anybody wants to put you in a home. Mostly, they don’t. Even the State doesn’t want to put you in a home. Nursing homes are closing down, so the powers that be would much prefer if you stayed put in your own house with a package. 

But what they want to do to you and what they can do to you are two different things, just as your rights as a free citizen and your rights as an older free citizen are two different things.

As an older free citizen, you do not have the right to endanger yourself or others.

Fascinating, that. 

Because it’s the only widely-applied prospective denial of rights. It’s future tense. You don’t have to actually set fire to yourself or someone else: Once it looks as if, due to age, you might at some stage do so, you’re goosed. Put the arse of the electric kettle down on the heated hob, and you lose more rights than if you’d mugged a tourist with a box cutter.

Strangely, we all know folk who’ve repeatedly got behind the wheel of their car sufficiently over the alcohol limit to endanger everybody on the road that night, themselves included. 

But, you know what? 

Unless they actually run someone down or a Garda checkpoint catches them, they’re good to go. Crime can’t be assumed in advance. Even if they get caught, their sentence is relatively short. Bits suspended. Other bits lopped off for good behaviour. So, even if a younger person proves they’re a danger to themselves and others by their driving, their sentence is short.

In sharp contrast, the older person gets found guilty without harming anybody and their sentence is for life with no time off for good behaviour. The older person found guilty of intent to endanger themselves or others gets an indefinite sentence: Committal to a nursing home with
smiling helpers, efficient nurses, high standards. And locked doors.

Once you’re in the nursing home, you have no power whatever and no right to escape. You cannot demand a lawyer to discuss habeas corpus. Well, you could, but it will avail you naught. No activist will find you and fight for you. No Innocence Project will work to free you.

The care may be great, your family may frequently visit, other residents may be as smart as Richard Osman characters, the food may be delicious, but you don’t have the code for the exit door. When you try to sneak out alongside one of the cleaning staff, you are detected and brought back.

For your own good.