BBC1 Care

All about caring
21

Independent review :

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Care review : Sheridan Smith’s dementia drama on BBC1 makes for difficult viewing.

An upbeat ending comes only as the mildest of reliefs.

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_Are you suffering from an excess of sprightliness and festive cheer? This ought to help: Care (BBC1), a 90-minute drama about dementia. If that wasn’t unpromising enough in the banter stakes, it comes from that Merseyside Michelangelo of misery Jimmy McGovern, who has co-written the story with newcomer Gilian Juckes, based on Juckes’s own experiences.

To complete the all-star Liverpool lineup, they have recruited Sheridan Smith and Alison Steadman. Smith plays Jenny, a single mother of two, whose own mother, Mary (Steadman) suffers a crippling stroke. Although she survives, she is left badly brain damaged, and unable to communicate her thoughts. For the most part, Care is an agonising trip through this most horrendous of experiences, the television equivalent of a long walk through a car park in driving rain.

Inevitably with McGovern’s work, the key trauma takes place not in isolation but within a whole infrastructure of grinding difficulty. Jenny’s useless ex-husband contributes nothing to the upbringing of their children. The care home she finds for Mary has been worn down by underfunding and can barely provide basic attention to its patients. Her sister Claire (Sinead Keenan) is not much use either.

With little money or assistance, Jenny’s difficulties pile up. Everyone wants the best, but there simply aren’t enough hands on deck. The action proceeds with a kind of grinding inevitability, aside from the odd clunker in the dialogue: “Oh s*, I’ve been drinking,” Jenny said to herself before leaving the house when Mary went missing from the home, in a way that nobody would ever say to themselves.

Smith has recently been in the papers more for her turbulent personal life, so it is gratifying to see her back to what she does best. She has a rare gift and can conjure more sympathy in a single glance or exasperated sentence than fewer actors manage in a whole career. She could make you root for Myra Hindley.

Few conditions are bleaker than dementia, especially when it is brought on so suddenly. Mary is lost as a mother instantly, as clearly as if she had died, yet there is the double burden of gaining, in effect, another child, truculent and frightened and inarticulate.

As well as the impact on the sufferers and their loved ones, there is the corrosive effect the condition is exerting on the whole country’s healthcare resources. If there is a price to be paid for everyone living longer, this is where it seems most apparent.

The programme’s only directorial flourish is the words that appear next to Mary as she tries to communicate. Her intended words are childlike – the brain damage has not merely affected her speech – but they are at least clear. It gives a novelistic sense of interiority to Steadman’s portrayal, and we feel the frustrations of all sides keenly. An upbeat ending comes only as the mildest of reliefs. The overall message, that we are nothing without communication, might be vital, but that doesn’t make it easy to watch._** >


If that review is copied across the media , " The Message " … if there was a clear one … was lost ?

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Background to the tv drama :

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Jimmy McGovern : " We can’t dodge the issue of care for the elderly any longer. "

Screenwriter hopes new BBC production, called Care, will spark debate on growing social problem.

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The screenwriter Jimmy McGovern has called for a national conversation on attitudes towards care of the elderly and infirm, saying politicians needed to stop “dodging” the issue and that more television dramas should tackle such social problems.

McGovern, the writer behind award-winning programmes such as Cracker, Hillsborough and last year’s drama Broken, has made Care, a 90-minute production for the BBC. It tells the story of a single mother who has to care for her elderly mother after she has a stroke and develops dementia, and how the local health authorities refuse to take responsibility.

“I know we’ve got Brexit and all that going on but it would be great if this drama helped to start a debate about care,” McGovern told the Observer. “It’s a question that needs to be addressed rather than dodged, as it is now.”
Care, which stars Alison Steadman, Sheridan Smith and Sinead Keenan, is loosely based on the experiences of McGovern’s co-writer, Gillian Juckes.

McGovern said: “I was interested in the way her work tackled the hoops you have to go through to get care for somebody. We have featured millions of dementia stories in Moving On [McGovern’s successful daytime BBC TV strand] but they’re all about the onset and how people cope. This stood out because it was about the hoops you have to jump through to get your mother into care.”

Like last year’s Broken, which told the story of how a parish priest, played by Sean Bean, affected a troubled community’s lives, Care deals with big issues in an intimate character-driven drama. “Social issues are where my mind is right now,” said McGovern. “It’s a shame that more dramas aren’t tackling those sorts of story, whatever genre they’re in. Because a big problem in writing television dramas is a sense of structure – how are you going to tell the story?

In crime dramas, it’s all there already – the perpetration of the crime, the discovery, breaking the news, the arrest, the trial… If you’re riding that gravy train, you’re duty-bound to say something significant about the human condition. The rest is so easy that you should do or say something that matters. In Cracker we used to have flights of fancy the whole time because the other stuff looked after itself.”

At the heart of Care is Jenny (Smith) and her battle to convince various authorities that her mother (Steadman) is not well enough to be left alone at home. McGovern says it is this tension between what constitutes care and what constitutes treatment that he would like to see more widely debated.

“It’s the core of the film,” he says. “I found while making it is that there’s a massive difference between treatment and care. Treatment is something that can get you better, but care is just care – looking after someone. But if treatment can’t get you better, you shouldn’t be in hospital. That’s central to this piece – that people are saying I know you need care but this is a hospital and if we cannot make you better we’ll kick you out. We need the beds.

“It’s the same with palliative care – you shouldn’t be in hospital for palliative care when there are other people who can be cured. It’s ruthless but it’s so essential.”

With such an emotive subject McGovern admits that casting was crucial. “The likes of Sheridan, she’s just so human and people will watch her because they love her,” he says. “There’s a scene where her sister says the best thing a mother can do for her kids is die and Sheridan just says you’re so wrong and it’s a lovely little exchange because there’s so much that’s not being said. She’s very touching, very human, she does the pain wonderfully well. Similarly with Alison, she’s so impressive because she’s pitched it just right. It would be really easy to go over the top and she doesn’t and that’s why it works.”

McGovern is working on two further projects. One, a new series that he hopes Sean Bean will star in, is some way off and will tackle “a huge social issue. I can’t talk about it now but it’s something that’s been ignored for far too long”. The other has been given the green light by the BBC and is a dramatisation of the racist murder of 18-year-old Anthony Walker in Huyton, Merseyside in 2005. “I can’t write two things at the same time,” McGovern says, “and right now Anthony is in here [he points to his head] and I’ve got to let his story be told.”

Despite being one of the few writers tackling social issues and place working class stories centre stage, McGovern says it would be a mistake to see his work as political: “If you look at a writer like Jim Allen [who was behind Days of Hope, Raining Stones and Land and Freedom] then I’m no such thing. It just happens that I write about people with problems and because those problems are rarely seen on TV, it’s seen as political. It’s not – it’s about characters and stories that need to be told.”

Care is on BBC One on Sunday 9 December, 9pm

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Sallly wrote: "i really hope this isn’t some glossy for TV ending that nicely ties up the ending in a way that doesn’t happen in real life… "

Bad luck, Sally - it was a TOTAL COP OUT!!!

Honestly, what an ending!!!

I haven’t yet watched the whole thing from the beginning, but the ending was just INFURIATING!!!

Yeah, like we all get to sit in front of shocked and sympathetic appeal boards who award full CHC funding!!!

NOT.

I was really shocked by the ending. If the author wanted REALISM he would have had the daughter’s turned down AGAIN, and the mum put back into the council-funded care home. THAT would have been REAL.

I shall watch the whole thing all through this evening and see if my opinion modifies, but I don’t see how it can. A stupid, unrealistic, fairy-tale ending that is NOT likely to happen for the vast majority of people.

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The few glimpses I got of Alison Steadman were brilliant - she really captured that ‘aggressive vacancy’ look.

Scary and chilling.

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At least the discharge nurse got to say her piece pretty cogently -

Spelling it out that CHC would take a nurse away from a sick child to mop up an old woman who’d just messed herself…

Brutal, but true.

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Crosses over into the CHC RATIONING thread :
https://www.carersuk.org/forum/support-and-advice/all-about-caring/chc-rationed-high-time-to-ask-some-obvious-questions-33311?hilit=chc%20rationing

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Oh dear … the Daily Chuckle has it’s say … unfortunately :

" How to terrify older people into being scared of dementia ": BBC Sheridan Smith drama Care - about a woman struggling to look after her sick mother - sparks outrage over its ‘callous’ portrayal of healthcare workers

**_Care tells story of a woman struggling to cope with her dementia-stricken mum.

The family encounter endless red tape as they fight to secure proper care for her.

Some viewers criticised the BBC1 drama for its depiction of healthcare workers.

Other said it struck a chord and accurately reflected their own experiences._**

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BBC drama Care divided viewers with its portrayal of a woman struggling to find care for her dementia-stricken mother.

The moving 90-minute programme, which aired last night, tells the story of Jenny (Sheridan Smith), a single mother of two whose own mother Mary (Alison Steadman) suffers a crippling stroke that triggers vascular dementia and leaves her part-paralysed and struggling to communicate.

It follows the family as they encounter red tape and seemingly endless box-ticking to secure long-term care for Mary.

Some viewers were left offended at the ‘callous’ and ‘careless’ portrayal of healthcare workers, with one tweeting: ‘Why do TV dramas about hospitals and carers always show abuse against staff?? It is completely unacceptable #Care.’

However other families who have encountered similar situations insisted it was ‘spot on’ in its representation of their own experiences.

Unfortunately it accurately reflected my recent experience and that of many other relatives I met on my mother’s journey,’ one posted.

After Mary suffers the stroke she is assessed by hospital staff who make it clear that they want her to be discharged as quickly as possible to free up her bed for another patient.

Jenny encounters another roadblock in the system when she has the idea of caring for her mother herself but is told her home would have to be safeguarded and modified if this was to happen.

The family experience further frustration when Mary is briefly accepted into a care home but wanders away and goes missing.

Once she is brought back by the police, a member of staff tells Jenny plainly that they are underfunded and understaffed, making it impossible to care for the patients living there.

Jenny’s sister Claire (Sinead Keenan) also highlights the issues when she delivers an impassioned speech about how she feels the NHS effectively writes off caring for elderly patients because it is a drain on precious resources and funding.

The sisters eventually have a breakthrough when they access the NHS’s Continuing Healthcare programme, although it took seemingly endless effort.

The depiction riled NHS staff and supporters who pointed to the tireless work many carry out on a daily basis.

One tweeted: ‘Very disappointed in the representation of #Occupationaltherapy in #BBC1 #Care . Having previously worked on a stroke unit as an OT I can see how inaccurate this was! Totally offensive and so frustrating to see! #NHS #Occupationaltherapy #doyourresearch.’

Another added: ‘Absolutely ridiculous portrayal of OT in #care. No compassion. No explanation to the person/family about the whats and whys. You wouldn’t be asking for the baseline 3 weeks after being admitted to hospital. I don’t know what that kitchen assessment was about. Just awful.’

However it struck a chord with other viewers.

‘Glad to see that #Care is highlighting the struggles that families have to go through to get quality care for their loved ones,’ one tweeted.

‘There is too much red tape and box ticking in the care system, and too many private health partners who simply don’t care about people.’

Another posted: ‘I’m seeing a lot of people saying this isn’t accurate depiction, but as far as for me and my mother who care for my Nan with Alzheimers. It’s spot on. #Care.’

Care is available to watch on BBC iPlayer.


COMMENTS SECTION at the bottom … HIGHLY RECOMMENDED !

All the focus tends to be on both the System and paid care workers.

As for us … zilch !

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I’ve not watched it yet. My husband is away this week and I didn’t want to watch it on my own, but I will do so.

Very sad that the ending DID gloss over the failings of the situation, I will brace myself to not rant at the TV too much. It does actually sound like our story. We were granted funding on appeal of the decision basically to get Dad out of hospital after 6 months. CHC funding enabled us to find him specialist care in a specialist home. Only for it to be withdrawn 6 months later! He has been yo-yoing in and out of CHC ever since. My suspicion is you have to shout for funding or you don’t get it, so if Sheridan Smith can give people the idea to do so, then that can’t be a bad thing.

Also what of all those who don’t and never will qualify for CHC??? Or don’t have anyone to shout their side? But, I guess that doesn’t make great telly!

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On behalf of CUK ( Michael ) , details posted elsewhere :

The BBC Action Line contains a link to Carers UK’s website (see below) and Emily Holzhausen (our Director of Policy and Public Affairs) was interviewed on Radio 4’s Woman’s Hour in response to the " Care " programme.
http://www.bbc.co.uk/programmes/article … ort-carers

Excuse me , and most other male carers , said station is hardly of interest to us ?

Akin to your ceo appearing as a guest pundit on Match of the Day ?

( And probably doing a better job ? )

So far , our role has been completed ignored … as poster earlier.

Much better conducted on a program … say Panorama … following exposure of our Plight … and no " Gender " issues as both sexes would tend to watch it ?

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I think the reason it came across as a cop out was how easily they won the appeal for CHC funding!

The appeal committee were clearly ‘on her side’ and shocked by it being turned down in the first place, and the hospital discharge nurse didn’t have a word to say for herself.

Now, OK, I know I do need to watch the whole programme through from the start, but picking up on what the author himself seems to have said, and various trailer-blurbs (kindly provided here!), the key ‘issue’ seems to be that the mum’s collapse is described as:

A stroke that causes vascular dementia.

I suspect THIS is the ‘weasel’ in the plot.

As we know here on the forum, if there is ONLY dementia, (eg, vascular dementia, Alzheimers) then dementia ‘in itself’ is classified by the state as a ‘social problem’ NOT a ‘medical condition’. So folk with dementia (like my MIL) are NOT eligible for CHC at all (except for any ‘other’ - ie ‘real’ - medical issues, where some money may be paid by the NHS for that ‘nursing care’ )(as, again, was the case with my MIL - she got about £120 a week from the CHC funding, the bulk of the care required for her dementia was self-pay).

BUT, if the dementia has been caused by a ‘medical trauma’ (eg, stroke), THEN is that judged to be ‘social’ or ‘medical’???

Enter the Weasel!

The daughters in the drama seemed to be able to convince (very easily!) the Appeal Panel that it was Stroke that caused their mother’s need for care, and therefore on that basis she should get CHC.

Yet the PROBLEMS that the stroke had caused were all ‘dementia-symptoms’!

That, to my mind, is why the whole drama was a pointless whitewash - because it utterly failed to show any realism of how ‘cast aside by the NHS’ those with dementia are.

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Also, not sure where the drama was supposed to be set (‘Up North’???), but £700 a week for a lovely upper crush residential care home for someone who was going to have high nursing needs (wheelchair, aphasic, behavioural aggression etc etc!) was DIRT CHEAP.


Again, total cop out.

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Oh, AND let’s hope the poshie private care home has a Secure Unit as well - since Alison Steadman seems to have wandered off from the cheapo council funded one!!!

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Crosses over into yet another thread … GREEN PAPER one … and the patient with both cancer and dementia conundrum ?

NHS and / or social care … different systems with different ways of funding.

Threads … all just part of the bigger picture … no wonder they interlock so much ?

34

Hi,
Bear in mind that most carers with carees suffering from stroke and/ or dementia probably won’t want to watch this, therefore the main audience will be the general public; I think it was hard hitting.

The reality of juggling working, caring and childcare was portrayed, helicopter relative included, financial difficulties affecting the whole family ( children couldn’t go on trip/holiday,) hospital very ready to discharge the mum ASAP, the often hidden taboo of dementia causing aggression…
It will have opened the eyes of many.

I didn’t think the CHC part was glossed over, the hospital did try to discharge without a CHC being done properly and accurately. The family had gathered crucial evidence, that couldn’t be disputed and although the panel agreed CHC in the first instance, it did deem the assessment needed to be done again …

I do agree the fees for such a nursing home were unrealistically low and of course there wasn’t enough time to show the ongoing battle families have over attention to detail in the care of their carees.

Melly1

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Yes, that’s a fair point, that most of the public haven’t a clue when it comes to the cost of care, etc etc. And probably quite a few people would think 'ah, stroke, that’s obviously a medical problem, so it comes under the NHS, why shouldn’t it?..not realising that if the stroke causes dementia (or behaviour perhaps indistinguishable from dementia???) then dementia falls under means tested SS/Local Authority Council funding.

I don’t know (not having watched anything but the ending yet!) whether that tricky issue was raised by the programme? If not, it certainly should have been!

I’m not saying a second assessment wasn’t necessary, more that I think the attitude of the Appeal Panel was FAR too sympathetic and ‘lenient’.

We really need to see some stats - ie, how many stroke patients presenting-with-dementia-like-symptoms DO get CHC funding (if the symptoms are as severe as that of Alison Steadman’s character). (And if that varies noticeably on a geographical/post code basis).

The whole ending just left me with a sour taste though - how nice, how easy, how lovely-jubbly, etc etc etc! We just get the poor old NHS to fork out a fortune (how many nurses could they hire for £700 a week, the cost of the poshie care home??) and phew, that’s OK for us then, isn’t it? Job done! Evil NHS defeated! Boot-faced Discharge Nurse left with egg on her miserable lying face (etc etc etc)

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One comment made on the Daily Mail’s review was that one of the sisters blissfully announces that she’s going to give up work and look after mum, and live off Carer’s Allowance…

Don’t know whether that happy idea got shot down in flames for the character!!!

37

For that old circular argument , said Daily Chuckle believer could also add :

" She chose to care … what’s her problem … why pay her for it ? "

… and so the general public’s conception of us will continue …

Even poor old CUK … and their releases :

" They would say that , wouldn’t they … ther’e merely protecting their members/ interest. "

( Thanks to Mandy Rice Davies’s infamous comment on Lord Astor for the first bit … now 55 years ago ! )

… and so on … round and round in ever decreasing and frustrating circles … eventually disappearing over the event horizon.

38

I’ve been wondering since I saw the end of this yesterday whether any TV drama could have the effect of Cathy Come Home in these days when we are overwhelmed with information and documentaries. I don’t think this was very effective, but I don’t see how it could have been. It did not come over as though the author was really familiar with the care situation - for example, the CHC appeal was like an old-fashioned drama round the table, and I suppose that is the way it is done in a play, and there wouldn’t be time to show the form with all the categories. The whole thing was designed as a conflict between individual characters, as these things usually are. You couldn’t really show ten social workers or nurses consecutively being incompetent - it would take too long. I didn’t think it was dreadfully well done - the acting was OK.

The test to see if the mother could look after herself in her own home seemed a bit unconvincing to me, but again, it was the style of the drama.

CHC came over as easy to get - and let’s face it, you don’t usually get it for dementia. This dementia was the direct result of a stroke, presumably to make the story fit in 90 minutes. Financial problems were touched on, but seemed to have more to do with the main character losing her job and her feckless ex-husband than with carers’ allowance.

I did see Melly’s message and I can see that some of it is right - have not read all this thread though.

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I found myself wondering why they opted for stroke as the cause of the mum’s need for care. There were several reasons perhaps, including the dramatic (and very scary) car crash at the beginning. I guess that also showed the HUGE contrast between ‘old Mum’ (perfectly ‘normal’) and ‘new mum’ (vacant and aggressive and frustrated etc etc etc).

I do also wonder whether the author chose stroke precisely BECAUSE it (could have!) highlighted the ‘artificiality’ of the divide between ‘medical illness is covered by the NHS/CHS’ whereas ‘dementia is means-tested by the SS’. But since they really didn’t dwell on this at all there wasn’t really any point in having her need ‘dementia care’ because of ‘medical stroke’.

The whole thing seemed to be a polemic about the ‘bad and mean old NHS not forking out for the luxury care home, whinge, whinge!’…as if the entire problem of the UK’s dementia care cost could just be ‘sorted’ if the mean old bad old NHS forked out the extra £300 a week (that’s what the private care home manager reckoned was the difference between what the SS would contribute, ie, £400, and what family - or NHS! - would have to pay as top up to meet the £700 a week private cost).

Like I say, the ‘core issue’ - whether stroke-induced dementia is ‘medical’ or ‘social’ - was just never addressed.

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I also thought having ‘subtitles’ for Alison Steadman trying to talk was a bit disengenous or whatever the right word would be.

Does anyone have ANY idea whether, when a stroke patient tries to speak, they are actually mentally capable of expressing ANY rational thoughts? (Or, indeed, whether someone with severe dementia is?)

There can only, sadly, ever be ‘supposition’ that it can. Perhaps ‘hope’ that it can??

I do think Alison Steadman really portrayed the poor woman very well.

I, too, thought the kitchen competence scene a bit daft, simply because the first minute of the test clearly showed that the mum hadn’t a clue, so why keep going on at her until she ate the teabag…?

(I’d never heard of such a test, by the way - not in four years of being on this forum! Totally new to me! Has anyone here ever had it applied to their caree??)

(Mind you, it’s a lot more useful than the ‘count backwrards from ten and who is the prime minister’ test for capacity!)