A number of residents had crept back to bed after lunch, and I had to brave a battery of objections and excuses before they would reluctantly agree to pay lip service to their care plans, even if these only recommended socialising in the T.V. lounge. Checking inside the wardrobes and beneath the beds for those who were astute enough to play hide and seek, I reflected on how much easier it was to let the residents have their own way. They were extremely persistent in their evasive tactics, and could be both manipulative and aggressive in the pursuit of their objectives. Small wonder, therefore, that the staff often played into their hands by actively colluding with the patients’ hedonistic tendencies. Visits to seaside ice cream parlours and fish and chip restaurants, for example, were usually very popular, even though some of the patients were massively overweight and had diet care plans, while ‘social evenings’ with plentifully flowing wine and lager were equally popular for comparable reasons. Similarly, the daily fixation with television was rarely challenged because staff also liked to spend their time watching football and soap operas, as well as endlessly prattling undercover of repeat films and newscasts. Even when the patients remained square-eyed in front of children’s television, this would still be perceived as a useful distraction from more disruptive activities.
Conversely, when social skills, domestic skills, gardening or personal hygiene interventions were suggested to the residents, these were almost invariably greeted with sabotaging tantrums, increased ‘delusions’ or mute unresponsiveness; so it was not entirely surprising when staff started to take the easy options themselves. This was the point that the unit had reached meltdown; where the day-to-day collusion, the mirror-like reflection of staff-patient lethargy and self-interest, and the obscuring of all things with worthless paper work, had murdered the unit stone dead.


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