About " Life in and out of the geriatric home", by Sara Plaza Casares (El Salto, 4 January 2021)

After having closed 2020 by sharing the encouraging news that The Eden Alternative initiative was finally arriving in Spain, and after a couple of weeks of disconnecting from the hard year behind us, I entered 2021 with the knowledge of a case that has made my hair stand on end. On 4 January, the coordinator of the health section of the newspaper El Salto, Sara Plaza Casares, published an article entitled "Life inside and outside the nursing home" in which she reported the story of Esperanza Pérez Martínez, a 72-year-old woman who had escaped from the old people's home where she was staying because she couldn't take it any more. I think the story has enough substance to be told here in more detail. 

According to the article by Plaza Casares, Esperanza entered the Santiago Rusiñol home in Aranjuez a year and four months ago, after becoming homeless and obtaining a place managed publicly by the Community of Madrid. After living a real hell within the walls of this centre, now denounced by the Patient's Ombudsman Association to the Public Prosecutor's Office, she decided to take the extra pay from her pension of just 400 euros in November to leave her prison behind and regain her autonomy. 

As Esperanza confessed in the interview, she felt that inside the nursing home, the "geriatric home" as she calls it, she was nobody and had no say in the future of her own existence. Over the months, she experienced the lack of privacy resulting from the need to share a room with people whose cognitive impairment was very high. He was also deprived of his right to manage his time as he saw fit. But above all, he watched as he suddenly lost his identity, becoming little more than a number under strict regulations that seemed to him more at home in a medical centre than in a community for the elderly. 

There are two extracts from the interview that particularly shake me. The first is the question that Esperanza, in her blessed innocence, asked the caretakers of the residence as soon as she entered: "Can I be late?" She says that the caregivers' eyes "glazed over" with surprise when they heard this unexpected interpellation. Already the simple fact of 'may I' admits the idea that it is the carers who have to 'give permission', which is something that in a Person-Directed Care model we have to aspire to must be banished. Esperanza could not understand, of course, why, because she lived in a care home, she was no longer free to go out for a drink with her friends. The other one comes from this first point, because, armed with courage, she contacted a social worker of the Aranjuez City Council to convey her discomfort about this situation. However, she again hit a wall. The response she received was as follows: "You are already in a nursing home and forget about it". It is simply heartbreaking. Esperanza thought, rightly, that this was no life at all.

In addition, the normative event of moving into a nursing home was joined by the historic event of COVID-19. Nearly 80% of the residents of Santiago Rusiñol were infected with the virus, including Esperanza herself, and nearly 20% have died since December 2019 to date. During the worst months of the pandemic, Esperanza's distress was compounded by isolation. When she was infected, she spent days bedridden, alone, with no one to talk to and unable to leave her room for an entire month. Her only contact with the outside world took place during the once-a-week scheduled doctor's visit. With no company, feeling useless for not being able to fend for herself, and bored to death with worry, Esperanza set about plotting her escape plan of no return. 

As it was, she took her Christmas bonus, ordered a taxi and left with nowhere safe to go. She knows that sooner or later she will run out of the money that pays for the room she is now staying in⎯the money that pays for her freedom⎯. But despite the hardships she faces and the uncertain future that lies ahead of her as she looks downcast from the horrible experience she has lived through, she has no plans to return to a nursing home ever. "I'd rather live on the street than go back to the nursing home", says this brave septuagenarian who has risked everything to regain control of her destiny. 

Hope... what an auspicious name for someone who rebels against the prejudices of ageism and ableism; for someone who breaks the chains with which the biomedical model of residential care subjects institutionalised elderly people! If she has shared her ordeal with the world, it is because she is well aware that her companions are still imprisoned by this situation, which is repeated in countless residences, and she wishes to encourage those who suffer from the loneliness, hopelessness and boredom of life in this type of obsolete community, while alerting others to this sad reality. I wanted to pick up the baton and help with this post to give visibility to this whole problem and to stir consciences in order to inspire other elderly people to raise their voices against a care system that, for the moment, does not measure up. 

In my next post I want to carry out a necessary reflection that has kept me busy in the last few days about the title that Plaza Casares chose for her article in El Salto. I was very annoyed to read the word "geriatric" again in a newspaper article. I spend hours reading scientific and informative literature on gerontology and geriatrics and this term has not been used since the last century. Fortunately, the term "nursing home" is even further away. In a couple of weeks I will talk to you about the importance of the language we use to refer to the elderly, to caregivers or to the communities in which they live, among others, and the urgency of adopting a new respectful and inclusive vocabulary as part of the cultural change that is on the horizon of the ageing process.