Last week, I spoke to a man called Richard Kempner about the recent death of his mother, Sheila. It was a difficult and impossibly moving conversation, made all the more affecting by the fact that the previous night he had forwarded me photographs and videos of her that went back nearly 30 years.
On Easter Saturday, she died, aged 86, in the care home where she had lived since late last year. For 20 years she had suffered from an increasingly debilitating immune condition – but after she moved in, her health had taken a noticeable upswing. Then, for the three weeks prior to her death, lockdown meant that she could not see any visitors and remained confined to her room. Despite these precautions, her family were then told that a case of Covid-19 had possibly “impacted” the care home.
Not much more than a week later, Sheila’s apparent infection with Covid-19 was confirmed by a “virtual” diagnosis from the home’s GP; she spent her dying moments deprived of the love and attention of her closest relatives. As her son understood it, what her story seemed to come down to was the lack of both testing for care workers and personal protective equipment. “Covid walked into her room,” he told me. “Because she couldn’t, and didn’t, walk out of it.”
What he told me highlighted something that has now become a central part of the UK’s experience of the virus, and a growing sense of collective shame: the neglect of the 400,000 older people who live in British care homes and the people who devote themselves to their wellbeing, something made even clearer by the fact that the level of deaths in these settings – estimated to be at least 7,500 – seems to have been woefully underrepresented in official statistics. Along with the fact that the pored-over daily figure for Covid-19 deaths omits care homes, this compounds a sense that such fatalities do not quite count.
“The truth about what’s really happening to older people in care homes needs to be shouted about, not hidden,” said Richard. “I can only assume that they [the government] are doing that because they’re embarrassed about how they’ve handled this whole situation.”
This aspect of the UK’s Covid-19 story blurs into things that long predate this crisis. Some of them highlight the fact that care for older people is still based around an archipelago of homes and so-called “providers”, and the continuing absence of any solution to the issues collectively grouped under the heading of social care. But there is something else at the heart of how badly many older people have been treated – and, indeed, the discomfiting sense that some see the deaths from Covid-19 of people over 70 and those with “underlying health conditions” as the natural order of things. Perhaps the latter is part of our collective coping mechanism. But it also highlights a set of prejudices about older people that have sat in the culture for far too long.
Up until a month ago, residential settings for older people rarely figured in the national conversation, and too few of us thought about the vital work so many dedicated people do in them. By way of grim symbolism, the archetypal care home existed in our shared imagination as somewhere distant from everyday life, and somehow still and silent. People in power seemed content for such places to remain a byword for low-paid work. Earlier this month, the TV journalist Robert Peston called people who live in some care homes “inmates”, which is quite a Freudian slip.
Not much more than a month ago, a charity called the Centre for Ageing Better published a report called Doddery But Dear?, full of grimly familiar cultural observations. “Metaphors such as ‘grey tsunami’, ‘demographic cliff’ and ‘demographic timebomb’ present old age in terms of crisis,” it said, “reflecting a perception of old age and the ‘baby boomer’ generation as a societal burden.” Two years ago, research published by the Royal Society for Public Health found that a quarter of people aged 18-34 believed it was normal for older people to be unhappy and depressed – and across all age groups, nearly a third of people surveyed agreed with the statement “being lonely is just something that happens when people get old”. Strikingly, two-thirds of the respondents said they had no friends with an age gap of 30 years or more.
There are plenty of other manifestations of these generational estrangements and the prejudices they incubate. Whatever the substance of the debate about assisted dying, its most unthinking supporters sometimes risk reducing frailty to a pretext for euthanasia, as if the future will make care for people approaching the end of their lives unthinkable. And what of Brexit? Far too many people have fallen into the habit of using the generational split in views about the EU as an excuse for thinking of older people as impossibly reactionary and therefore worthy of sneering contempt. To make things even worse, the insecure realities of 21st-century life for younger people have fostered the idea that if older people have been lucky enough to buy their home and receive a half-decent pension, that somehow characterises them as the recipients of unjust luxury. These things have fed into a dysfunctional mess of stuff that resonates with where we have ended up: the key issue right now may be the rank incompetence of people in government, but our attitudes to older people are relevant, at least.
We should worry about age-based divisions getting worse. It seems that sooner or later, as the terms of the current lockdown are changed, millions of people will be encouraged to tentatively go back into the world. But there is also talk of those aged over 70 – millions of whom are fit, active and as involved in their communities as anyone else – being instructed to carry on living under lockdown. The result will be the strange spectacle of a society seemingly devoid of older people, with their friends and relatives still instructed to keep them at a distance: the reverse, in fact, of what an age-segregated society like ours demands.
That is yet another example of the cruelties of this virus, and how much it cuts across some of the most basic aspects of our common humanity. As an increasing number of people are pointing out, the coronavirus period will soon demand some kind of reparations to the young people whose lives have been so upturned by lockdown and its economic and social consequences. But contrary to the either/or nature of too many modern arguments, that should not preclude an equal focus on our neglect and stereotyping of older people, and the extent to which those things are also part of this unfolding disaster.
Before we get to thorny questions of policy, the first thing we need is a shift in attitudes, something we can learn from others. Five days ago, for example, I spoke to Javed Iqbal, a community worker who lives in Alum Rock, in the east of Birmingham – an area badly affected by the virus. As he talked about a huge community effort emanating from local mosques, he explained that he had lost 11 older relatives to Covid-19, a loss not just to him and his family, but wider society. “These are the pillars of our community: our elders,” he said. The words stuck in my mind for days afterwards – a stark reminder of what the secularised, divided part of the UK’s demographic map lacks, and which we urgently need to recover, as these horrific times push us even further apart.
