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About the
Author
Pam Hunter was born in Tweed Heads, She spent the next fifty years travelling to many countries of the world as a respite from a life committed to the pursuit of excellence for herself and the ever-changing profession of nursing. Midwifery was her main love but she was also wooed by academia, pursuing teaching and eventually obtaining a Masters degree. A short time working in psychiatry and research was followed by a twenty-year affiliation with diversional therapy and aged care. Now living in This is her first novel. Chapter 1The white Honda Civic wended its way down the crowded thoroughfare to a destination just past the main shopping centre. The driver, Claire Meredith, unsure of her surroundings, had sketched the streets needed to find her way. So
far the trip had gone to plan, but she had several reasons for feeling anxious
as she checked her watch and scanned the directory to ensure that she was in the
right street. To lose her way now would mean being late for her nine o’clock
appointment with Ted Velva, the current proprietor of Westmore Nursing Home. She
couldn’t afford that. She needed the job. The
position of Director of Nursing, her first since selling the business she had
owned with her partner Lila Winsome, was not the career move Claire had wished
for. They had run Group Homes for the Aged, and Claire’s ambition had been to
develop the homes so they could continue to work for themselves. But Lila’s
need for money made it necessary to sell the business. The hardest thing for
Claire was she couldn’t afford to buy her out. She had to forgo her dream of
self-employment and go to look for a job. Dressed
in a straight skirt, business blouse and court shoes, the petite
fifty-five-year-old, whose appearance belied her age, had been a hospital matron
for the past ten years and knew that she would have no difficulty doing the job.
The major obstacle was whether Ted could work with her or not, a factor over
which neither of them had control. It was not Claire’s nature to consider
whether she could work with him, but in the long term that was to become a more
crucial question. Stopping
at one of the many sets of lights on “Come
on lights, change,” she muttered, her nerves getting the better of her. The
lights did her bidding. With another quick glimpse at her plotted course and a
sigh of relief, Claire set off again, hoping that she could drive a little
faster from here on. But it was not to be. Trying to control her anxiety she
drove on, her destination only a short distance away. She turned her attention
to the next issue, parking. After
parking her car, Claire walked back up to Unfortunately,
at the time, Claire was unable to visualise the beautiful building that once
stood there. Caught up in her professional ambitions she missed the heart of the
matter. It was only in hindsight that she learned to appreciate the history that
was Westmore and to marvel at the social and political changes that had affected
its development. A
hundred years later it still stood as a reminder of the past. Set back off the
road, the once-beautiful old mansion could almost go unnoticed except for a
large sign positioned above the huge front doors identifying it as ‘Westmore
Nursing Home’. Originally
built as a home for an accountant and his family, it had high ornate ceilings,
large rooms and a cottage-like front entrance. The front door opened into a
hallway that ran through the centre of the house and emerged into a secluded and
cosy back yard. Conversion to a nursing home had been kind to the integrity of
the original design, with most extra facilities added to the back of the
building. There
were no shade trees and the front veranda was fully exposed to the morning sun.
Ideal for Ted’s
parents had bought the nursing home in 1970. They gave it to their son two years
later but retained a lifelong interest in its day-to-day management. They knew
that it was not an easy way to make a living and fully supported Ted in his
demanding role. Despite regular, guaranteed government funding, expenses -
mostly staff salaries - were high. Learning to cope with the continual drain on
resources was an ongoing battle. It was much more than simply setting up house
for a group of elderly people. Relatives, government agencies and staff all had
varying degrees of interest, and a say, in how the facility was managed.
Governments were not about to hand out more than necessary. Many owners took the
opportunity to exploit for personal gain the many loopholes in regulations. They
bought personal groceries, household equipment and furnishings on the nursing
home budget. The Velvas were basically honest people, but when it came to
keeping afloat they were as guilty as everyone else of taking advantage of
loopholes. With
no medical or nursing skills between them, their basic problem was to provide
nursing care for the residents. They employed a few registered nurses to take on
this responsibility. Whereas in other facilities the matron usually lived on the
premises, at Westmore she lived in the house next door. She was the housemother,
on call at all times. Few nurses questioned the standard of care provided,
believing cleanliness and nourishment were all that was necessary. Most of the
elderly were called ‘babies’ and the staff generally accepted that little
could be done for them. They had been admitted to the nursing home to die. During
those early days, the situation in public and private hospitals was not
conducive to a high standard of care, and caring for the aged was not a popular
occupation for nurses. Few registered nurses were employed and they were usually
married women with children. They saw nursing as a way to work outside the
rigours of a general hospital environment, giving them more time and energy to
care for their families. Assistants-in-Nursing
(AINs) made up the majority of staff. They were women without any nursing
qualifications, let alone in aged care. They could apply for a position at any
nursing home and legally be accepted to care for the chronically ill. In
all developing countries, as life expectancy and women’s participation in the
work force increased, there were no longer stay-at-home mothers to care for aged
and disabled relatives. There was pressure on governments to provide
accommodation with around-the-clock nursing care. Nursing homes owned by
charities or private enterprise quickly sprang up. Controlled by the minimum of
government regulations, each successive political leader saw little, if any,
kudos in financing aged care. It was considered the responsibility of the
family, usually a spinster daughter, to care for an ailing relative. In many
countries that remains the case. In Accommodation
was upgraded, but it was recognised that boredom, loneliness and feelings of not
being wanted were among the many remaining problems. Fifty years on they remain
so, although post basic education for registered nurses and the introduction of
diversional therapists in the early 1980s offered some relief. It
took more than a century to achieve minimum progress in the institutional care
of the aged, but early nursing homes satisfied the needs of a variety of people.
Some members of the public were loath to accept public hospital treatment
because of its poor reputation, preferring to pay for private care. But there
were others who saw this alternative as predominantly a moneymaking concern,
lining the pockets of the doctors and nurses who had a vested interest in them,
while not offering any improvement in the standard of care. It
was against this background that Westmore and other nursing homes were
developed. At Westmore, two-level extensions accommodating twenty people were
added, bringing the bed capacity to forty-nine. Permission for such extensions
during those early days was easy, but today, with strict controls on all beds
and a government policy set at zero expansion, it’s a different story. Curiously,
though nursing homes were always basically a social service, they were run as
businesses. Consequently, many people who view this as exploiting the aged for
profit believe that all aged-care facilities should be fully funded by the
Government, with no access by private enterprise. Since
the 1970s, much has been achieved in aged care. It is therefore unfair to judge
past carers - doctors and matrons - on the basis of what we know today. Most of
them did the best they could. But they left a burdensome legacy in that most
people have a morbid fear of ending their life in a nursing home. Not all
proprietors were honest nor did they have an interest in the welfare of
patients. They were there to make money; most matrons were chosen because they
understood that. It is probably correct to say that many of the problems
existing in nursing homes today have their roots in past events. Proprietors
have always maintained that government funding is insufficient to keep their
nursing home functioning according to expectations. It was well known throughout
the industry that many proprietors maintained two sets of books, one for
government inspection, the other telling the true story. Consequently, trying to
obtain money from them for the benefit of patients has been like trying to get
blood out of a stone. Mostly
unaware of Westmore’s colourful past, residents and staff created a history of
their own. Claire became part of that when she was appointed Director-of-Nursing
in January 1989 after a hair-raising interview with Ted Velva. His lack of
management and people skills were immediately obvious to Claire, who came away
from the hour-long meeting feeling incompetent. Furthermore, it took him
forty-eight hours to offer her the position. During this waiting time Claire
thought seriously about not taking the position if it were offered. How could
she work with such a disturbed man? Her gut instinct kept telling her to wait
for the next job opportunity, but she was desperate to get back to work. Her
lifetime fear of not having enough money to live on was gnawing at her despite
having made considerable profit on the sale of her business. “There’s no one to look after me. I’ve got to do it myself,” was a common thread to Claire’s thinking. No one could deny that this was true. Her family was barely able to take care of themselves and Claire’s insecurity was insatiable. There was never enough of anything - money, love. For this reason she accepted the position.
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