Who will care for older people? A case study of working with destructiveness and despair in long-stay care

The reduction of services for older people is illustrated in a case study of a long-stay NHS service which has been transferred to a private, profit-making company. The effects of cuts in this service are most keenly felt in the very poor conditions of employment now offered by the company to new carers. Other illustrations of cuts are described in attempts to make savings on food or incontinence pads. The difficulties for staff, patients, their relatives, or indeed society at large, in challenging such destructiveness, may be understood in terms of the particular vulnerability of older people to projections of a dreaded infantile dependency and helplessness, in a society in the grip of a destructive narcissism which views ordinary human needs as a weakness.