In the Midst of Life

decisions are made by government think tanks, by teams of professors at the British Medical Association, by ethics committees consisting of philosophers and theologians and senior judges. But having come to their conclusions, and issued their reports, they can walk away from the problem. They don’t have to do the work. The work is left to care assistants, who receive barely a living wage for work that is arduous and demanding, and for whom the strain can sometimes be insupportable.
    We are a rich nation, and like all rich nations we need a subculture of underprivileged people to do the dirty work that we would not want to see our sons and daughters doing. Much of the work of care assistants falls into this category, and they are the ones who will look after us in our old age. It is worth remembering that, when our faculties, our senses, our mobility and our organsfail us, health care assistants will be more important to us, and have far more power over us than doctors.
    Let me end this chapter by reproducing some of the NVQ introductory literature, which can be obtained online. It is addressed to prospective health care assistant candidates at the initial entry level:
    NVQ Care Programme Information Pack
There are no academic qualifications needed to be a care assistant. All care assistants are expected to undergo a twelve-week induction programme
[this is frequently not observed -author’s comment].
Direct experience is not necessarily required for the job, but it is useful to have some experience in working with people. Care Assistants are in high demand and it is relatively easy to get a job. The main employers are social services, hospitals, private or NHS nursing homes and agencies.
     
Personal skills
:
Care Assistants need to have excellent interpersonal skills and the ability to work with all kinds of people in situations which can be stressful or emotionally draining. More specifically they should have:
A friendly approach and the ability to put clients at ease, whatever their physical or social needs
The ability to be tactful; and sensitive at all times
A good sense of humour
A high level of patience as shifts can be long and often stressful
Excellent communication skills
The ability to deal with aggressive or anxious clients
A certain level of physical strength
Good stamina
The ability to stay calm under pressure
The ability to think quickly and solve problems as they arise.
    Working Conditions
:
Care Assistants usually work shifts, which means their hours and days of work vary from week to week, and may include night shifts or weekend work. Shifts can be long and demanding, so care assistants need to have good stamina and both physical and emotional endurance.
     
    The contempt with which this hedonistic society looks upon simple virtues is reflected in the pay reward. We offer care assistants £11,000 a year: that is £5.70 an hour, with no guaranteed sick pay, holiday pay or maternity leave, and no guaranteed pension.
    Would you, the reader, do it? Could you? Would you advise your son or daughter to become a health care assistant?

 
     
    Truly, truly, I say to you, when you were young you girded yourself and walked where you would; but when you are old, you will stretch out your hands, and another will gird you, and carry you where you do not wish to go.
     
    —
St John, ch.21, v. 18
     

CONGESTIVE HEART FAILURE
     
    The year was 1968, and I was night sister of a small provincial hospital. I walked into the ward, and there he was – Dr Conrad Hyem. We recognised each other instantly, though it had been many years since the night in Poplar when we parted. No doubt we had both changed. I was a married woman in my thirties with two children. And he? Well, he was very much changed. He looked frail, sitting up in a hospital bed, breathing with difficulty a bluish tinge around his nose and lips, and an anxious look in his eyes. The ward was quiet after the daytime bustle, and peaceful. A single light glowed above the bed of the frail old man suffering from congestive heart failure. I went over to him, sat on the edge of the bed, and took his hand. He squeezed it, and a crinkle in the corners of his eyes showed his pleasure.
    ‘Jenny Lee,’ he whispered, ‘after all these years … I have not forgotten you. How could I? And now you come to me when I am dying. You are thrice welcome. What a happy chance.’ He sighed with contentment, and squeezed my hand again, such a weak little squeeze. ‘A happy