Eggs and Care

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I was sitting in a posh hotel restaurant a few weeks ago, having slept well in a bed big enough to sleep six comfortably, watching a man frying eggs. I began by wondering about his motivation – frying the perfect egg? Possibly the company brand kept him engaged or perhaps the promise of improved status up the line if he could demonstrate he could be trusted with the small things – like eggs.

Then I drifted off to thinking about the eggs and our relationship with them. Most readers will know about eggs being marked 0,1,2,3, to show Organic, Free Range, Barn and Caged in that order. I am not sure if I am allowed to say ‘Battery’ any more as most are in some level of company – but you get my drift and it helps my point later.

The quality marking is not about the egg although food purists might argue that there is a distinct variation in the taste of the eggs. I would concur that free range eggs certainly seem to have a yellower yolk. But this is actually more about the situation of life and the contentment with which the chicken lays the egg.

The organic egg is laid by a well cared for chicken, living free, going where it likes and not tainted by any biological treatments at all that might threaten the Soil Association certification of it’s owners. This bird is gifted with all of the advantages from little bursts of flight to dust baths and we suspect, feeling good, it produces a lovely egg which in turn will do us the least harm when we eat it.

The free range egg laying chicken, like its organic sister can come and go as it likes. It will be in company of other chickens with space and freedom to roam and a comfortable and spacious place to sleep and a warm straw lined nesting box in which to lay its eggs. It might have had a bit of chemical stimulus to protect it from disease or such like but nothing that might harm anyone eating its eggs. It will feel the sun on it’s beak and the rain on it’s feathers and in that happy state will lay a good egg.

The barn chicken will largely live life inside and may well have had treatments but can wander about and interact with other chickens. Like the others, it will have time to scratch about and supplement the farm food with an insect or worm here and there and a dust bath may still be possible. It will be safe from foxes and will have a comfortable nesting box in which to lay eggs.

The caged chicken will be cared for intensely, it will be kept in its own space with a small number of other hens. It will have had its beak trimmed to protect other birds and will receive all the medication it needs to keep it well and make sure it lays a lot of eggs but it is unlikely to get much fresh air, it will not walk about outside at all and life will be short for most with some lucky ones ‘rescued’ to live out life in a field, lay if they like and avoid the fox if all goes well.

These last group of chickens often moult feathers and can often be bald after their ‘confinement’. Most people acknowledge these birds may be depressed as this is not the life of a bird. I hesitate to be over critical as we consume something like eight million eggs a day and to produce this many eggs at a reasonable price demands an industrial solution. I am using the story of eggs as an illustration for what follows and the parallels that exist between the two.

My thoughts about eggs and the care of the chickens that lay them made me think about care provision particularly for older people as I have been visiting a friend of late who resides in a ‘luxury’ care home, so luxury that I suspect the weekly cost of a room in the posh hotel I was in would be cheaper when purchased on a long term basis. In fact, there is a story that travels around the care sector about an American lady who needed a care home, according to her children but who opted instead to join a cruise liner as a ‘permanent’ resident. This was possible with a short break each year when the ship was serviced and refitted. During her stay, she was treated with great respect and care, had full access to medical and nursing support and to cap it all, she saw the world.

In the parallel world of eggs and carte, the ‘organic’ range of people receiving support would surely be those with good health, wealth enough to meet their needs regardless and an understanding of what they needed to do to take best care of themselves – a truly ‘personalised’ state. This compares well to the level of independence we all experience when we have no particular need of care.

The second group of ‘Free Rangers’ would similarly have most of what they needed, could come and go as they like with enough resources to cover most things but perhaps with a little help here and there with support or health treatments – certainly an independent person, applying choice and control in their life. They would live their life in company with others as they wished and be able to access the support they needed but with some limitations – often money in many cases. Many of our churches have a sizeable group in this bracket, often providing a lot of the voluntary effort to the whole community but gaining from the association they have with others and the mutual support that comes from ‘being known’.

The ‘barn’ people would be those stuck in the house. They would have with regular visitors both formal and informal, friends and family – in a Catholic context, hopefully an occasional visit from the priest and regular access to Holy Communion through an extraordinary minister. Within the range of their houses, they would be able to carry out most things for themselves, getting food, drinks, dressing and washing. They might have support to undertake those things that were difficult from a home carer or a distinct nurse for any health issues but still be in charge of their life to a large degree.

Then we come to the ‘caged’ people and my friend. I have noticed he and others rarely or never leave their room. An aspiration among the people caring for them for greater involvement in the home community is limited by the (poor) motivation of the person and the relatively poor ratio of staff to residents that can be maintained for the fees charged. In his room, he is handled with great care and using all necessary risk minimising equipment. His medication is delivered by a person in a hi-viz (‘Do not disturb!’ in big letters) jacket, on time and in the right dose and carefully recorded. He is washed, dressed, groomed, fed with great precision and with his supper he will take a glass of wine as was always his wont. Some memories of his independent state persist. He has a lot of visitors, proportionate to some of the other people who live there.

This care process is technically, nearly perfect and fully compliant but he gets demoralised and depressed as he fends of recurring infections (how does the bacteria get in here?). He has not been motivated to socialise and as a consequence, if he had feathers, I think they would have started to fall out. This is deemed to be his ‘fault’ because he chooses his situation and opts to be disconnected from the wider community. This depressed state caused by isolation and lack of recognition or esteem by the rest of humanity is what leads to a downward spiral, which ideally should be challenged by everyone who loves the person and professionally by everyone who claims to provide care and support to them. Anything less, is accepting that this level of support, with its consequences is tolerable

There is also an irony that the system that produces the cheapest egg because of its industrial modelling and may therefore warrant some excuse, compares closest to the highest cost care for older people!

If we can work this out about chickens, why is there a problem in working it out in our care for older people?

*This article is developed from a shorter blog written for the National Care Forum in June 2016. It is worth noting that my friend did perk up a bit and did go out when cajoled by a friend including the Sunday Mass but the improvement was temporary and as I write, he is back in hospital with another selection of infections.