Commentary on Protecting my mother

Protecting my mother offers a moving account of a daughter's experiences of her mother's placement(s) in long term care and her exposure to poor care and/or abuse. The article highlights a number of the key features of the care of nursing home residents that need to addressed if standards are to improve and abuse become a rarity. The very dependent and frail nature of most residents renders them vulnerable to receiving poor care which may, if unchecked, become routinised abusive or neglectful practice. Risk is compounded for residents with dementia who often have limited communication skills and high levels of need. The fact that most residents are not known by care staff on admission is a primary challenge to offering good care, an issue that is compounded by a focus on tasks rather than relationships. The combined impact of dependency on staff for survival and having no, or few, opportunities for advocacy places residents in a profoundly powerless position to complain about mistreatment. This experience is mirrored by relatives. A primary deficit is that the emotional well-being of residents is given limited attention by the care home sector or agencies tasked with inspecting them. Raising the status of care home work; improving pay, conditions and training; and embedding person-centred values in care home practice are key to raising standards. Ensuring that all residents have access to an advocate and improving the capacity of safeguarding systems to address abuse in care homes are also important elements of reducing risk.