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Blog: Why are the media still using terms like “bed blocker”?

Nobody should accept derogatory language that seeks to locate the blame with the person currently in hospital - as if they are somehow responsible for another person having to wait

By Liz Howard, BASW England Professional Officer

I was horrified to see this article recently in the Blackpool Gazette using the term “bed blocker” - not only in the headline but also in the main text:

This term is not new, unfortunately it has been in circulation since the early 2000’s and potentially even before.

Typically, it is a label applied to older people, particularly when there are concerns about waiting times for NHS care and a reduced number of beds in hospital available for other people.

In the Gazette article, the concept of beds being blocked is extended further by not only suggesting the person is refusing to be discharged but won’t accept the place that is being offered: Patients who are healthy enough to leave but are refusing to take the ‘next available’ nursing home bed.”

The finger of blame is pointing clearly at the individual but the article then goes on to suggest that it is also family members who are at fault because of their unreasonable expectations.

The recently published People at the Heart of Care sets out a 10-year vision for social care reform that seeks to put people at the centre of social care. This reform is underpinned by the principles of choice and control, personalised care, and fair access to adult social care.  Are we really saying that this no longer applies once you are in hospital?

Why is this term still being used?

Much has been written about the power and use of language in social work. Unfortunately, the term “bed blockers” is indicative of the way that we treat people in need of care and support.

The impact of ageism has continued to prevail throughout the pandemic with the term bed-blocker forming part of the ageist narrative that feeds negative stereotypes of older people, regarded as non-contributors to the economy and therefore their lives are of little value.

The situation with pressures on hospital beds and the need to discharge people quickly coupled with ageist attitudes provides justification for the action being taken. Anyone that questions what is happening, in this case family members, are viewed as troublemakers and the cause of the problem.

Hospital Social Worker Sarah states: “This use of this language seems to be increasingly common.  As does the enforced 'choice' of placement.  I honestly cannot believe how little noise there is about this”

What are we doing to challenge the use of this term?

We at BASW do not accept this term, no-one should accept derogatory language that seeks to locate the blame with the person currently in hospital as if they are somehow responsible for another person having to wait.

This term depersonalises people which results in a loss of respect and dignity, this then creates the perfect conditions for other dehumanising actions to be taken and justified. In this case, moving people out of hospital to places that are unfamiliar without their consent, or against their wishes or those of their family.

Poor language aside, there are other issues raised by this article. As Janet Reynolds, social worker says: I don't think people are aware of the reality - that for most people moving to a nursing home is going to be a permanent move with major financial implications, and often a difficult and distressing decision to have to make.

"This article perpetuates a simplistic analysis of this issue i.e., that the problem is just older people in hospital beds when they shouldn't be, rather than attempting to explain what the current problems with the social care system are really about.”

Another social worker who previously worked as a Hospital Social Worker commented: “I thought we had stopped using 'bed blockers' a long time ago? It is an emotive term and makes elderly people feel very guilty; with an element of blaming the victim.

"Although arrangements may sometimes not be ideal, it is important that these patients are treated as people, and that the situation is explained to them and their families, including that their first choices cannot always be possible. This process is something to which social workers can constructively and effectively contribute, and they should always be kept in the discharge loop"

So, what does all of this tell us about societies attitudes to older people?

The Public Accounts Committee[1] who delivered a damning report at the end of July 2020 cited the government’s response to social care during the pandemic as slow, inconsistent and, at times, negligent.  

The decision to discharge people from hospital into care homes without testing in place, is well documented a contributory factor in the 19,394 deaths of people in care homes involving COVID-19.

The current crisis in social care is widely reported. Demand is outstripping supply, there are waiting lists for assessments of need and support, Local Authorities are operating with significantly reduced budgets following a decade of austerity.

For a so-called civilised society, the lack of action from the government to support the health and social care system falls far short of what we should expect.

While ever there are pressures on resources there is the potential for oppressive language and stereotypes, allowing the blame culture to persist.

As social workers, we are duty-bound by our regulatory professional standards and our code of ethics to challenge discrimination and promote social justice. We must take action to challenge ageist and disablist narratives and not allow the current rhetoric of blame for the current health and social care crisis to rest with people and families.