There are rhythms to the deployment of carers. Some arrive according to a rigid timetable set by tablets. If a certain medication has to be taken at regular intervals, with no more than a 10 or 15 minute variation, the carer has to turn up at those times.
This tends to mean that the carer who arrives is more often than not the same one. They have their regulars and a regular schedule so they can get from one client to the next on a predictable timetable. They are, of course, not paid for travel time and the pressure to get from one job to another can lead to road accidents. One we know was trying to save a second or two and crocked her car gliding into the one in front, damaging it enough for it to be out of action for a week. She was unable to get work until it was fixed because they are all dependent on cars to get from one job to the next. She now drives very carefully because the pressure isn’t worth it.
Because they travel by car, they come from quite a range of places, from Forest Gate in the West to Canvey Island in the East. One had moved from a flat off Tottenham Court Road in the heart of London down to Purfleet – because the housing is more affordable – and taken the job for the excitement; explaining that “Nothing ever happens in Purfleet”.
Pay for each visit is presumed to match the half hour or 15 minute slot that the company is paid for. This does not always match reality. If a client has a medical emergency it can take longer, so there has to be a scramble to fill the slots that are down the line. If all goes well, the routines of getting a client onto the commode, sorting all that out, getting them washed, dressed and chatted to can be done more quickly. In the case of housebound people with no family support, the last job is the only social contact and conversation they will get all day and is a crucial part of the job.
One that came to ours a few days ago said that she has a core of bedbound people who are her regulars. Somehow she has got into the habit of singing to them, and taking requests. Some of the old ladies like the Ronettes, and bands like that, but she has one old gentleman who is into heavy rock and usually wants something by Metallica – which is truly above and beyond.
Some carers are chatty, some quietly get on with things and converse functionally. Most are pretty upbeat. Most of them are women. Many are black. Most of the white ones have tattoos. There is a high turnover. A core of veterans keep things going while newcomers either adapt or, finding it too much, leave.
Some of them wear fans around their necks because, even during a heatwave, some of the clients have their heating on, and cranked up high.
None of them are in a union.
I complement one on her pair of colouful converses and she says that she loves them, has 14 pairs, but is now boycotting them because of Nike’s sponsorship and partnership deals with Israel.
Several have said they like coming to us because we are friendly and take an interest. Many of the clients have dementia, so can be terrified and aggressive. Some are racist and don’t hold back about it even though they are being looked after – possibly because they are being looked after and resent it. This is sometimes the case with relatives too.
If the family is covering meds and, to a lesser extent, food, the schedule for visits can swing quite wildly, with the getting up arrival ranging from slightly before 7am one day to well after 9am the next. During the Summer holidays schedules get stretched because carers with children have them on their hands, but as Winter approaches they also get harder to fill because its getting dark, dank and miserable and, people get ill.
Some of the overnight crews, who are always in twos and arrive in the wee small hours to give bedbound people a turn, or deal with pads, can be loud – car door slams, a conversation that would be loud for the middle of the day erupts up and down the path to the back door, a scrabble for the door lock, the door goes crunch and the loud conversation imposes itself on the living room downstairs for a while, before the whole thing repeats itself in reverse on the way out. Others arrive with the stealth of Ninjas, but greater consideration. Some of them close the side and front gates on the way out. Some let them swing in the breeze.
