When I wrote It’s No Fun last week, it sparked off a whole range of other memories and thoughts, and I need to get them off my chest. Some of you, I’m sure, will relate to them.

My first experience of care homes was back in the late 1980s when my grandma went into one. She was eighty-eight at the time and lasted another ten years. I visited her most weeks – an interesting experience. There was the unique smell of the place, a mix of cooked food (albeit lingering from hours earlier) and cleaning chemicals barely masking something less savoury. I say it’s unique, but not to that particular home. I’ve been in several since then, and they all smell the same. There was also the ratio of residents to visitors. Very often I’d be the only one there, even though it was usually a weekend when, presumably, people have more time to visit.

What struck me most about visiting was how things changed for my grandma. She’d moved there because she’d had three strokes in a relatively short space of time. She was still active, but living alone in a first floor flat with no relatives nearby didn’t make sense any more. As a retired nurse who’d continued to work part-time at a nursing home until her mid-80s, she was pragmatic about the move.

At first, she was fit enough to go for a walk every day, and getting out and interacting with people outside the home clearly did her good. As getting out became harder for her, though, deterioration became more obvious. Her memory increasingly failed her, to the point where she wasn’t sure who I was. From one week to the next, I didn’t know whether I’d be Ian (my dad), Geoffrey (his twin brother) or David (either my dad’s older brother or my granddad – both of whom died decades earlier). Very occasionally, I might be me.

I’m still convinced the key difference for her was the lack of stimulation. I was in my thirties at the time with a young family and trying to earn a living. The time I had available to visit was limited, so I usually saw her just once a week. My dad was nearing the end of his working life, but he lived closer, so popped in to see her 2-3 times a week. In reality, even surrounded by other people, and with up to four visits a week, the mental stimulation wasn’t enough.

When I looked around the lounge at her home, and saw the other residents, there was a common theme. Most of them were sitting on their own and not interacting with the people around them. Staff would come along and speak intermittently, but very often with raised voices that gave the impression they were talking at the residents, not with them.

Incidentally, I don’t blame the staff for this. Or the management, for that matter. Even back in the 1990s, budgets for the care sector were limited, and that has a knock-on effect to staffing and facilities. Unfortunately, the financial cost takes precedence over the care itself.

Although some care is paid for privately, the vast majority is funded through governmental agencies. Even if your house ends up being sold to pay for it in the long run, payment for the care you get will, in the short term, be the responsibility of your local authority. But that also means you get very little say in the type or standard of care provided. As with the rest of the healthcare system, what service is provided is dictated by budgets and tick-boxes – not the needs of the individual. There will be exceptional people within those structures who do go the extra mile, but they’ll be few and far between. Low budgets mean low wages, and cost-cutting.

So, if you have a loved one in a home, or likely to be in one soon, do bear this in mind. For them to maintain a higher degree of mobility and awareness for as long as possible, they’ll need visiting often and by as many people as possible. Going into a home isn’t an easy option.

And, in general, their deterioration won’t be the fault of the staff or the home. It’s the system. And that’s not going to change any time soon.