An interesting and illuminating event that happened in New Zealand last week was the fuss accorded to some photographs of old people in care, published in the New Zealand Kai Tiaki, a professional nursing magazine. I found the fuss strange, indeed disturbing. It seemed to me that the folk of New Zealand seemed to be shocked and perturbed at the reality of nursing care in the frail and ill elderly, the reality of what it is to grow old in our modern society: that we are so immersed in the make-believe of cinema, magazines and TV, that our perception of what it is to be a human being, both our living and dying, has been severely distorted. If that is the case then it also seemed to me that it was long past time that such images should have been published. I was particularly intrigued by the rather vociferous questioning by one local news reporter, Sean Plunket, who did seem, and I stand to be corrected, personally affronted by the publication of these photos. Of course, there is also a distinct possiblity that it is the media that are most affronted and are hyping up the chorus of disapproval.

There was an additional component to the fuss, in that the photo essay was part of a campaign for getting increased wages for care-givers in old people's homes and hospitals, who are generally paid at or near the national minimum wage, about NZ$10 per hour. This scandalously low pay for a continuously hard and difficult job is probably only tolerated by our society because so many of our carers are Maori, Polynesian or immigrant, and because they are women. Additionally, aged care in New Zealand is a privately run business, subsidised by large government payments, in which carers are the pressed meat in the sandwich between the government's desire to save money and the providers wish to make a profit. In this case, only government legislation in regard to carer pay rates will help. It is an urgent priority, as this lack of pay is a blot on this nation's self-image as a caring and compassionate society. An article in the Listener earlier this year explores this subject further.

I have not had permission to publish the pictures here, so I will describe some of them to you. One is of a very old, very frail, cachectic man sitting on a shower chair, but over a toilet, naked, but for a towel over his lap. He sits stiffly back against the chair and his head is erect and his mouth is open and he stares into the distance. He is obviously unwell. He is being washed by a carer who kneels before him. She is Polynesian, and is smiling at the old man. 

Another picture shows a naked old lady, again bony, skeletal nearly, but more alive than the man. She sits on a bench seat, naked, being showered by the carer, She is enjoying her wash, she is  smiling, as the carer showers her, and obviously laughing when she is being dressed. Her body seems to be failing her, but her spirit obviously isn't. It shines through the photograph. There are other pictures illustrating the daily life of old people's homes. One I particularly liked was the parking lot for the walkers. 

The pictures were taken by a professional photographer, they were beautifully done, in black and white, and the whole photographic essay was a touching testament to the humanity of the old and the humanity of the people who look after them. They are compassionate, intimate and life-affirming. They are proof that humanity does not wain, even at the extremities of life.

Some people, and this includes some professional nurses and carers, have said that these photographs are an abuse of the elderly. (Link) Sandra Goudy the Senior Citizens Spokeswoman for the National Party, issued a statement calling the publication of the photos of nude rest home residents "an outrage." "Nurses and clinicians specialising in geriatric care are outraged at photographs of naked rest home residents," said TV New Zealand in their online report. A spokesperson for the gerontology section of the NZNO says the publication of the photos is a form of elder abuse. The section has also lodged an official complaint with the organization and the magazine, according to the TVNZ report. Obviously the NZNO, the New Zealand Nurses Organisation, thought the photographs were justifiable. Anne Manchester, the journal's editor said "People who are happy to look at attractive young bodies have second thoughts when you add a few wrinkles." She also gave further explanations which you can find here

The photographer, Alan Knowles, had obtained permission for taking the photos, with the knowledge that they might be published, from the patients and their families. He was commissioned by the NZNO and the Service and Food Workers' Union. In the nursing journal each subject is named, as is the carer, they and their carers are thus identified as ordinary human beings who are as entitled to give permission to have their photos given and published as is anyone else, and as entitled to celebrate who they are.

Following what I though was a self-righteous outrage by some groups, and Sean Plunket, about these photos, I sent this e-mail to the morning news programme on Radio NZ.



You can listen to a discussion about this fuss between Kathryn Ryan, who now presents the Nine-to-Noon programme, and Charlotte Paul, Professor of preventive and social medicine at Otago University. Please click here. Charlotte brings to the fuss ( and that's what it was, so that's what I call it) some professional insight and clarity. It is worth listening to.

As I said initially, I was disturbed by the outrage and censure and fuss that accompanied these photos. If there was a genuine lack of informed consent, or some families are upset, then of course this is unfortunate, and I hope the matter can be cleared up. But I hope too that they will come to recognise in time that in fact the picture of their father or grandfather was not in any way degrading, but was a sympathetic affirmation of what life truly means. For the professionals that were critical, I respect their views, though I disagree with them, but for the others, I thought there was something mean and petty, shallow and self-righteous about it. We will all get old, this will be the reality of life for many of us, including Sean Plunket and Sandra Goudie. I say to them, and anyone else who would join the chorus of disapproval, that if you wish to have the humane and generous care that is given so freely and for so little by the carers in these photos, and all the other carers, maybe you would care to join me and others in recognising their worth and in calling for better wages and conditions for them.




PS Since writing this I have communicated with the photographer, Alan Knowles, and he has reassured me that informed permission was obtained from the subjects and their families.