Should David Cameron be Sectioned?

There's a change.org petition calling for David Cameron to be detained under Section 2 of the Mental Health Act (the petition isn't that specific; the authors know nothing about mental health so they've just said he should be sectioned). The petition lays out a case as to why Cameron would qualify:

1. David Cameron MP appears to think he is Jesus Christ, and compares himself with Jesus

Cameron hasn't said he is Jesus. He said that Jesus invented the Big Society and that he, David Cameron is carrying on his work. It is a pompous and ridiculous thing to say, especially as the Big Society is whatever Conservative politicians say it is - mostly volunteers stepping up to replace essential services that have lost government funding and Food Banks, the need for which barely existed before they came into power.

However, John Lennon compared his fame to that of Jesus Christ. In one song, he claimed to be a Walrus. Extreme arrogance is not the same thing as a Messiah Complex.

Meanwhile, even sincerely believing oneself to be Jesus Christ is not itself grounds for sectioning.  On a recent television programme, Ian Hislop interviewed a perfectly sane and pleasant man who believes he is King Arthur.  It is possible for people to believe incredibly unlikely things about themselves and the world around them without even being unwell.  Eccentric, for sure. Factually misguided, almost certainly. But as a generality, unless there is considerable personal distress, there is no illness.

The argument continues:

2. He does this despite doing the opposite of what Jesus is recorded to have done, so David Cameron is clearly delusional.

By this thinking, every professed Christian who is homophobic, smacks their kids, accumulates massive wealth or in any way treats other people in ways they themselves would not like to be treated, could be delusional. Only they're not. This is just a mixture of misinterpretation and common or garden hypocrisy. Many if not most of us profess ethical beliefs we sometimes fail to follow.

In some ways, this is the opposite to mental ill health. Some mental illnesses are characterised by a person having beliefs they find impossible to compromise on. Sometimes, it is not the belief that is the problem (e.g washing hands helps guard against infection) but the inability to compromise on that belief to any degree.

3. He refuses to listen to the vast majority of the country, instead pretending everything is fine and refusing to explain himself, instead making idiotic ramblings and carrying out dangerous actions whilst pretending nothing is wrong

He refuses, he pretends. He is not oblivious - he chooses to ignore the people who, as Prime Minister, he is supposed to serve. This is not a sign of ill health, just a sign of a poor governance, ignorance, arrogance and selfishness. David Cameron is behaving very badly. It is possible to do that in perfectly good mental health.

4. He has already harmed thousands. He is a danger to himself and others.

There's no evidence that David Cameron is any danger to himself (his immortal soul notwithstanding). There's no evidence that David Cameron is a direct danger to others. There is no evidence of violence towards others. He has made decisions which have harmed people, even led to deaths, but very indirectly; he has spearheaded austerity measures which have put already very vulnerable people in increasingly vulnerable positions. He is responsible for that.

But this is the point; someone who is not in control of themselves will lash out and could harm people fairly randomly. They have diminished responsibility. Cameron is in control. He is surrounded by advisers and he sits through parliamentary debates where the consequences of his actions are discussed at length. He knows full well what he's doing and chooses to do it anyway.

Other arguments set forth by supporters of the petition include that David Cameron is a psychopath. Psychopathy is a controversial and complex area, but there is some evidence that Cameron exhibits some of the characteristics you might associate with this condition.  However, there are two things to be said about this.

The first is that Cameron is part of a government who collectively exhibit these traits. He is part of a very small but very powerful cultural bubble where it is normal behaviour to dismiss the suffering of others (particularly groups which represent a convenient scapegoat) and to line one's own pockets whilst professing to have the country's best interests at heart. It is impossible to tell whether Cameron would behave as badly in a context where the people around him weren't behaving this way, and giving him permission to do likewise.

Meanwhile, psychopathy, if it can be said to exist, is in the nature of a person and thus untreatable. If someone has not committed a crime, it becomes legally very tricky to detain someone for treatment (Section 3 of the Mental Health Act) when their condition cannot be treated.

I don't need to say, of course, that the idea of a petition to section someone is, if we take it seriously, absolutely terrifying. In days of yore, it was quite easy for wealthy men to get troublesome wives and daughters diagnosed with a serious mental illness and shuffled out of the way into institutions for the rest of their lives. In the mid-twentieth century, it was not uncommon to find people who merely deviated from the general population in some slight way - gay men, sexually active unmarried women, for example - put away and subject to dangerous and damaging treatments for little more than the failure to conform.

Do we really want to imagine a world where it would be possible to persuade doctors to detain and medicate people by a popular vote?  Does that even work as a joke?

So what can this petition achieve? Well, it has already has several effects which one is free to witness both on the petition site and elsewhere in social media :

• It has caused a great deal of amusement at the expense of people with mental illness. Despite the earnest tone of the petition, we shouldn't take this seriously, because it's just a laugh! Mental illness is so funny!
• It has reaffirmed our cultural connection between mental ill health and bad behaviour; David Cameron is bad, therefore he must be mad. The petition states, "This is not an attack on those with mental illness" but saying a thing does not make it so. 
• It has reaffirmed our cultural belief that mental illness is actually worse than evil. The fact that Cameron has overseen so much suffering in the country is one thing, but the reason he ought to be removed from power is because he is mentally unwell. 
• It has promoted ignorance of what mental illness is and how the Mental Health Act works. 

So well done to everyone. And people argue e-petitions are a waste of time. 

The History of My Adult Life In About 100 Objects.

I am eighteen and I am leaving home. I take what I can fit into a suitcase and a shoulder bag and carry on and off a series of trains. Seven or eight months later, my parents deliver what I couldn't carry, namely Ho Chi Minh (my hamster), his cage, my lava lamp, a considerable collection of artificial flowers and a few books. A lot of my old stuff stays with my parents. Some of it will be given away over the years. 

In the brief tense mistral before we moved in together, my boyfriend presented himself as an anti-materialist, aspiring to having no more personal possessions than would fit into a backpack. I soon realise why he would have such an aspiration; at thirty-four, this man cannot fit his cuddly toy collection into a single suitcase. 

We arrive together, open a joint bank account and share the rent, but I live like a guest in my boyfriend's flat. When we argue, he threatens to send me home. He chooses all the furniture, all the stuff. Things we share are sometimes given away or sold without my knowing. Even my own things are sometimes half-offered to other people before I, cornered, am asked whether I'm happy to let them go. I usually am. It's only stuff. 

My possessions are referred to as my shit. Anything of mine; clothes (now bought to his taste), my computer, art materials, stationary is shit. At the same time, I am constantly berated for not taking care of things - if an item of clothing gains a hole, a paintbrush loses bristles with use or an old computer has hardware problems, it is because I've been mistreating my shit.

Making cups of tea and cooking, I dirty too many teaspoons in one day. We have twelve, so he hides nine of them. A few years later, I find the other nine by accident, but they are more trouble than they are worth. They remain in their hiding place.

A spherical paper lampshade reflected by two opposing
mirrors, ad infinitum.

I am not a materialist. What do things matter? Objects are about status and insecurity; people want stuff to show other people what they have, to seem important, individual or fashionable, because acquisition becomes a hobby and stuff is mistaken for love or achievement.

I'm not like that. I am cool, easy-going. I can believe this while being fascinated by aesthetics, reading art and design books and blogs, making art, crafting all the damn time. But that's different; I make stuff, I give it away and leave others to make of it what they will. I paint but none of my pictures remain in our home (not like my partner's paint-by-numbers effort, that is mounted, framed and hung on our living room wall.).



There are things I would like to have to make my life more comfortable and pleasant, but I know the objections it will meet: it will be a waste of space, it will be a waste of money, it will gather dust, it will generate condensation, its presence will cause accidents, I will use it wrong and break it, I won't use it at all, it will create work for other people and it isn't worth having. Often, on top of all this, my motivations for having a thing are wrong and misguided; I am naive, I don't know what I really want or need, and I am too easily influenced by others.

That one is true actually - during this period in my life. I am way too easily influenced by others.



I am twenty-three. After eighteen months of barely leaving the flat and never alone, my friend is selling off her old electric wheelchair and my Granny offers to buy it for me. Everyone thinks this is a really good idea. I get the electric wheelchair. Weeks later, I persuade my partner that I am safe to go out alone.

There are periods when I can get out alone. There are periods when I'm too ill and genuinely unsafe. During such periods, I am reminded of the poor wisdom of having an electric wheelchair.

I am twenty-six. We move. It becomes impossible for me to take my powerchair out at all without help and, although there is an able-bodied person in the house all day long, there is no help available. Not that, I am reminded, there is anywhere worth going. Now it really does take up space. Now it does gather dust. I offer it as a long term loan to a friend. I consider selling it to replace my failing laptop.

Later I will think, What on earth was I thinking? The chair is not quite my legs - I can manage in the house okay without it. But it is my outdoor shoes.

I think they call this pattern "Damask"; a black and white
vaguely floral pattern on a plastic surface.

I am twenty-eight. Always in trouble for being clumsy, I buy a plastic tray to place under the kettle and tea-making area to reduce spills on the worktop. It is black and white and boldly patterned. This is the first and last object of visual interest that I ever impose on our shared environment. When the house is tidy, the only signs of my presence are the spines of books, CDs and DVDs. Even my shoes are hidden under the bed.

We live in a two bedroom bungalow, using the box room as a living room and the living room - the biggest room in the house - to store my husband's piano, guitars, keyboards, synthesizers, drum-kit, dolls house, swords, computer equipment, exercise bike, lazer-cutter, a plastic model kit collection which dates back to before my birth and two full size manikins.

Off to the goth festival, my husband says he needs some new plain black t-shirts. I check around and find 17 spares; 17 completely unworn plain black t-shirts in addition to the ones he wears every day.

During later pleas for my return, he will cite this physical dominance of our space as a behaviour he's prepared to change, as if that's why I left. At the time, it really doesn't bother me - I don't really notice, to be honest - and even with hindsight, it is the very least of my concerns. I can manage with little space, but I have no peace; no peace, no basic respect, nothing that would look like love to someone who has known love.

That particular year, he smashes three things in violence; a tray (though not my nice new one), my laptop and a bathroom door I was leaning against. The broken tray and the door - now little more than a frame with cardboard taped over the middle - will still be on display when I go. He still intends to fix them.

I am not a materialist. What do things matter? If I have not worn an item of clothing or listened to a CD during the previous year, I put it on eBay. Books, I often give away if they can't be sold. Art and craft materials are trickier, as they are not easily resold and little bits and bobs do come in handy later on.

A heart-shaped cherry quartz (red) bead with other
round beads, including opals if I remember correctly.

Somewhere in my head, I have confused two ideas. One is that it is morally wrong to buy things we don't want or need, which are often produced unethically and at great environmental cost, and may well end up being thrown away without use. The other is that it is morally wrong to have stuff. To even hold onto stuff - to take up space. At least for me.

Thus, I regard my bead habit as a vice. I buy interesting beads. Not very expensive beads (I know they exist; I window shop) but fancy glass or semi-precious stone beads, mostly from eBay. I do make jewellery sometimes, but I have a stock I will probably never use; a collection of small and beautiful things I can bring out to look at then store away out of sight.

My Gran gives me her old dressmaker's dummy. I am delighted, as I am an odd shape, have little money and dabble in making and adapting my own clothes. But I have no room for it. It sits at my parents' house for a few months and then they take it to a charity shop. A dressmaker's dummy costs about £100. Because it is not an essential item, even for making clothes, I can't imagine a time when I will be able to afford to replace it.

A great collection of purple clothing and fabric.

I am twenty-nine. I am leaving my husband and must sort out my stuff. I have to throw some things away. I try to sell decent clothes and give away some of my books but there isn't much time. I am sleeping on the sofa and, together with the physical effort of all this single-handed sorting out and the tension of living in this house, sleeping with the door barricaded and my walking stick beside my pillow, my spine is suffering. It feels as if the weight of all this stuff is bearing down on me.

The last day - the last morning, before I set off to Wales, is a nightmare. I can't stop finding bits and pieces that I need to make a decision about; a CD, a hair accessory, a pen. I have to leave the house in a mess, which I know will invite complaints. I have had ten years of such complaints, often with fists. Once I'm in the car, I couldn't really give a fuck.

My Mum has been listening to a Dubliners tape and when she starts the engine up, it automatically plays Don't Get Married. Later, this will seem funny. At the time, it is not even slightly funny.


My worldly possessions now consists of a stream-lined quantity of clothes, art and craft materials including my beads, paints, fabric and two easels (one freestanding, one tabletop), a ukulele, a guitar, a manual wheelchair, a powerchair, a camera, an Asus EEE-PC (the original - it will give up the ghost in exactly two weeks time), a Mac Mini computer (no TV or monitor), an ancient sewing machine, a great quantity of books, a box of CDs, a dozen DVDs and a further box of miscellaneous bits and bobs, including the lava lamp mentioned ten years earlier, now minus its cap.

We carry it in my parents' two cars. We stop off in Bristol overnight and part of me wishes my folks' cars would be stolen from outside the hotel. I am a problem and my stuff is part of that problem; I can't lift and carry it, I can't even drive it about. There's too much of it and yet, this is all I have.

A double-string of literally jet black multi-faceted beads. 

My ex asks for his wedding present back. It's an antique jet necklace and despite appearances at the time, he wasn't thinking of me when he bought it - he wanted it for himself and merely gave it to me to wear rather than keeping it in a drawer. I try to work out how much it is worth, although it would be practically impossible for me to sell at value. So I sell it back to him. I need the money and negotiate the return of The Wire and Battlestar Gallactica boxsets, which I originally bought anyway, not expecting him to like them. I'm not even all that keen on Battlestar, to be honest. 




I am lodging with a friend, who is having a very hard time and has particular anxieties about stuff and clutter; my landlady has too much of it and doesn't want any more in the house. This is fair enough. I count 27 tins of rice pudding, distributed randomly around a pantry serving a household where nobody eats rice pudding. There may be more, tucked out of sight.

Of course, my stuff isn't any problem. Only, you know, it's a bit of a problem. No, it's no problem. But, you know, it is taking up space. Only, it's not any real problem at all. My friend and landlady is, she reassures me, always true to her word and I believe her.  But that word changes a lot.

A collection of pillows and cushions.

I continue to sort through my stuff, looking again at the things I already chose to keep and choosing to let some of it go. There are some basic things I need to buy and frankly, that's exciting. I buy a v-shaped pillow and extra regular pillows. I buy a waste paper basket. I buy my own towels, which are floral and cheerful and alarm my landlady. I have never had such choices before. I was sometimes consulted, but I didn't buy things myself, spontaneously, not things for living with every day.

There's no chair in my room and the bed moves away from the wall when I lean on it. My back pain is getting worse because of this and the physical tension of living with flashbacks, panic attacks and nightmares which intersperse a period where I am now happier than I have ever been. I decide to buy a deck chair - a fairly posh one, for comfort - as I can lean back in it and it can be folded away and take up almost no space at all. I shouldn't speak to my landlady about this, because it makes her nervous. She'll hardly ever see it, but I am bringing more stuff into the house.



I am not a materialist. I'm vaguely aware that as a divorcee, I am entitled to the value of half the stuff that my ex-husband and I had between us, but initiating a straight-forward no-property-involved divorce from a safe distance of three hundred miles is difficult enough. That's the truth of the matter. There are times when I get angry about it, feel a coward or irresponsible for letting all that go, but honestly?  It's okay. I am breaking free.

A wooden picture frame with a curly swirly
tree pattern. 

In Tregaron with Stephen, I see a beautiful picture frame. It is about £16, which is an awful lot to pay for a picture frame, but Stephen buys it for me - for us, for our eventual home. It is the single most beautiful thing I have ever possessed up to that point. It might be months before I see him again (in fact it will be three weeks but we don't know that), so our photo in that frame mean the world to me.

A few years later, we will watch horrified as a very similar frame is featured in this monstrosity. Fortunately, if inexplicably, it is featured on its side. Like an inverted crucifix.



As I travel back across to England to visit family, my friend and landlady's tune-changing and with it, the spectre of homelessness, weigh heavy on my mind.  While I'm away, despite reassurances that it wouldn't happen, someone else is invited to stay in my room. My friend and landlady complains about having to move all my stuff around - I've got so much of it - in order to prepare the room I rent for her guest.

I'm not really well enough to travel back, anyway. I ask my parents if I can live with them for a bit.

Having helped me carry my worldly possessions back and forth between East Anglia and West Wales, my folks feel able to remark about what an enormous amount of stuff I have. I'm thinking that when they were my age, they had a three bedroom house, a garden shed and a garage full of stuff, whereas all mine fits in one room, along with my borrowed furniture. But this is not my house, I wasn't sure they'd cope with my return and I am extremely grateful.

My Mum offers to help me go through everything and throw out the things I don't need. This offer is repeated, in various forms, such as, "I'm about to put these two boxes in the attic. Shall we just go through them? We might only need one box."

I now have four very beautiful ceramic spoons with goldfish
on them in my bedroom.

I am living in a room with no shelves, so I look at my books again. Of course, I have books which I may never read. I have books I have read but will not read again. What is a reasonable number of books for a person to keep? There must be a number, depending on circumstances, just like there's a reasonable amount of money to spend on a winter coat, according to one's income. Only books are not a winter coat. I mean, stories are important, reading is important, but the possession of physical books? They are not a winter coat. I have no winter coat.

My folks' house is probably about middling on the clutter front. But both my parents despair of the habits of the other and thus, both my parents believe their house to be cluttered. Mum is sentimental and has trouble letting go of trinkets and objects, even quite ugly things, inherited or received as gifts. My Dad has a collection of wire, along with phone chargers and sundry defunct or dysfunctional tech. They'd both like to have a good clear-out but they never have time. In truth, each would like to clear out each other's things.

Now they both want to clear out my things.


At some point, I have acquired some tea-towels. They are stored with other things in a box in my parents' garage. A mouse (or possibly a gang of mice) eat them.

I keep a scrapbook of cards these days, and favourite ones
get put in frames (a framed greetings card on a bookshelf)

My parents were once poor but they're now quite well-off. They don't feel well-off and so don't expect that even I, homeless by some definitions, should see things and money differently. It is inconceivable to them to fix or make do with something if a new one can be bought, because obviously, everything is so cheap.

When I was a child, my Mum made or altered most of our clothes. My Dad and I made a guinea pig hutch and a garden bench for my grandparents. My grandparents made stuff for us; furniture, curtains, toys. We all made stuff and, because perhaps I got sick so had the time plus very little money, that carried on for me.

Now they mock me for patching things up, making do with old stuff or making new items as if it is all a false economy; way too much trouble when I could just go out and buy things. As if I could, just go out and buy things.

My Mum observes I have a hole in my skirt; I should throw it away and buy a new one - she will buy me a new one, as a present, such is her enthusiasm for the disposal of the first. All my clothes are in a poor state of disrepair but this skirt is thinning fast, practically opaque in places. Still, I don't let it go.

A great amount of paperwork. Fortunately, I don't possess
this volume of paperwork any more.

In fact, I find myself incapable of throwing anything away; blister packs, broken pencils, torn and useless scraps of bubblewrap. My room becomes a tremendous mess - it looks like the room of someone with a serious mental health problem. It is a shocking sight, especially given that my presence is almost undetectable in the rest of the house; I pick up after myself, wash my dishes, tidy the cushions when I get up from the sofa. Part of me believes, because I have been told it over and over and over and over, that I am simply a slob and that this is what happens in a room occupied by a slob with no-one to shout at her about it. But another part of me looks at the room with barely a patch of carpet in sight and wonders whether the flashbacks and panic attacks might be worth mentioning to the doctor.

Also my back, which is getting worse and worse.

It is my thirtieth birthday. Stephen gives me a photo album containing the story of my year. There are hardly any photographs anywhere, print or digital, of me during my twenties. It is almost as if I have started existing again after a period of non-existence.

My Extensive Mug Collection, 1980-1999 and 2010-2014
(Four different mugs in muted colours)

I am thirty. Stephen and I begin collecting for our
bottom drawer. Mum calls it this; back in the day when almost everyone lived with their parents before and sometimes after getting married, young couples would begin to collect bits and pieces for their future home in a literal or metaphorical bottom drawer. Some of our things for our future life are stored, quite literally, in our bottom drawer.

Stephen and I begin to live together in two places, relying on our parents to transport us between Surrey and Suffolk every two or three months. We try not to carry too much stuff on these journeys and thus we end up buying more things. The first extra thing is a camera tripod. The second thing - after much discussion, because it feels like pure excess - is an extra pair of ukuleles. We don't double our clothes, but once we live in one place, we will probably have enough to cope without a washing machine for two or three weeks. We end up with duplicates of other things by accident, because we forget what we've got and where.

Our bedroom wall: A pale-coloured wall with a collection of
paintings, prints and photographs in a variety of frames.

We sort out our bedroom at my parents' house. We erect shelves, during which I have my final really powerful flashback.

My parents cope badly with us changing things in their spare room, putting pictures on the wall, changing the agony-making mattress for a memory foam one, installing a linen basket. It's not a problem, of course - we are welcome here; it is our home. Yet there is tension. I imagine it feels like the occupying forces are taking down their tents and establishing their own bricks and mortar. I imagine this but I don't know what else we can do. I have lost patience with mixed messages.



There are many things which I have wanted for a long long time, but which I could not justify before. Not because I couldn't afford them (although sometimes I couldn't), but because I couldn't present a case that they were absolutely essential, they wouldn't take up space, they wouldn't cause additional problems and I wouldn't waste them, break them or forget to use them.

Most of these things are presents from other people. But I am allowed to express my desire for them, accept them and keep them. They include:

My notebooks. Some of these are full already.
(A collection of notebooks of different sizes with
various patterns).

1. An MP3 player. Now I even have blue tooth "sleep phones" - a headband with earphones inside it so I can listen to music, podcasts and audiobooks in bed. 
2. A shower seat. So, you know, I can have a shower. 
3. A kettle in my bedroom.
4. Houseplants.
5. Doc Martin boots. 
6. Multiple and variously-shaped pillows and cushions.
7. A king-size duvet on a standard double bed. 
8. A special table for painting in bed. I am allowed to paint in bed. 
9. Notebooks - not just one notebook, which I must fill cover to cover before starting on another - but multiple notebooks I can use for different purposes.  
10. After my second EEE-PC dies, a laptop computer that is neither second-hand nor the very cheapest one on the market. 

Surrounded by pillows, my back improves.

Two red "Le Creuset" soup pots. They are super cute.

Despite their remarks about over-crowded living conditions, my parents often buy us presents when they're out and about; a cushion with a fox's face on it, a plastic saucepan for the microwave. At Christmas, birthdays and on the occasion of our two weddings, we receive many lovely presents; things we would never have thought to buy if we were stocking up from scratch ourselves. We have a few super cute pots for soup and miniature casseroles. Stephen's parents save up their Tesco vouchers and buy us Alessi cutlery, which is extraordinarily posh. My sister-in-law brings back beautifully ornate hand-painted bowls from Istanbul. We have a collection of decent cookware and utensils, even cake tins in our bottom drawer.

Our future home will be filled with beautiful things we couldn't possibly afford ourselves. We often get things out to admire them and fantasize about using them every day.

This is now and I am thirty-three. We hope to have a place of our own within the next six months. We're going to need a lot of stuff we don't have now. We have use of two beds but we don't currently own one. We do own a chest of drawers and have inherited a rocking chair but the latter needs reupholstering. Mice are beginning to eat it.

I'm looking around and thinking, do I want to take everything with me?  Because honestly, I still have things I don't really want, things I don't really need but which look like they might be useful, or valuable in some way. We are going to need more stuff, so I'd like to have less of the stuff I don't need.

I own a vase. A white vase the shape of a Florence flask
with peach-coloured lilies on, on my bookshelf.

I am not a materialist. Things matter because they are useful, they bring us pleasure and they can be infused with meaning.  Having beautiful things and useful things that I could live without but which bring me immense pleasure (like my MP3 player) makes me feel very fortunate and very free. Having beautiful things is like being able to eat delicious food or listen to fantastic music (on my MP3 player). There's a big difference between taking pleasure in objects and connecting their value with personal worth (did I mention that my MP3 player is an iPod?).

There is no moral to my story. It is just about bad luck, good luck, mixed luck, a bad back and stuff.



Mum isn't in a great mood. I bring two A4 sheets of cardboard - the sort from the inside of reinforced envelopes or the back of paper pads - into the kitchen.

"Can I throw that out?" asks Mum.

"I was just about to," I reply.

"Good," she says, grumpily. "We don't have room to keep stuff like that here. When you have a place of your own, you can have as many old sheets of cardboard as you like." 

Care & Familial Responsibility

When I wrote Why does disability make people more vulnerable to domestic abuse?, I talked about how carers are often seen as universally saintly and this can mean that it becomes harder to question whether they're doing what they should be. There are other, related effects. We praise carers, but - as with the sanctity of motherhood - believing that people are endowed with magical powers of patience and wisdom, we tend to stop supporting them (what could a mere mortal do to help?) and certainly don't value what they do in any material way.

The week before last, Jeremy Hunt gave a speech vaguely advocating that families care more for their elderly - that we should aspire to be more like cultures in which care homes are "a last resort." This is so cynical, it makes my skin crawl. Then the lovely Glosswitch wrote about caring for her brother, and her fear that her caring role will increase as her parents age.

What are the rules for caring for a sibling, anyway? I'm not sure but I've always felt they must be different to those that apply to parents or offspring. Indeed, I've often hoped I'd find them written down somewhere: 

Rules for Caring: 

• children – definitely 

• partner – of course 

• parents – probably 

• grandparents – maybe 

• siblings – siblings? Who do you think you are, Mother Teresa? Surely everyone draws the line at siblings, not because we love them less but because it's just too hard.

So I really want to talk a bit about care and familial responsibility. This post is a little epic and Glosswitch's bullet points won't be the last.

Apart from any kids who you brought into existence, I don't believe you're responsible for any family member just because of blood. Yet we're all responsible for the people we love, for people who have loved and cared for us, and that's the same whether they are blood, related through marriage, or our close friends. If you love people, you need to look after them as best you can, whatever that entails.

But that doesn't mean that you should ever have to perform care. Two things worth mentioning before we go on:

1. Here, I'm talking about responsibility. Sometimes, people have no real choice about becoming a carer and that's a terrible thing. This post should demonstrate why this choice is essential.
2. Fortunately, most people never even face this prospect. We're sometimes presented with a picture of old age where everyone needs round-the-clock care. In reality, most people grow old and remain independent until death or shortly before death. Hooray! 

Right, back to what happens when folk do need care..

Granny Kelly told me a story about when her own grandmother, who lived next door, was sick. This was the 1930s and my great great grandmother had a morbid fear of the hospital - everyone she knew who had gone in alive had come out dead. So Granny's mother cared for her bedridden mother, whilst running her own home and bringing up her three children.

One day, Granny's aunt came to stay with the old lady and give Granny's mother a rest for a few days. The aunt didn't even last to midnight, before she came round to Granny's mother's house, knocked on the door and begged for her sister's help. She could not cope with her poorly mother. She could not perform care. She had to go home. So she did.

This is the first reality of care within families: Some people are extremely ill-suited to this. I could look around my family now and tell you who would do well caring for their parent, partner, sibling or child should they become disabled  (I could tell you some of these things from personal experience).

This is not about how nice people are or the quality of love in their hearts.

Although needs vary, I'd say a typical carer needs to be pretty good at

• Working to a strict routine; meals at these times, drugs at these times, the same every day.
• Being able to rest and sleep during breaks, as opposed to the one long break most people have from the end of work in the evening to the beginning of work next day.
• Flexibility. All plans may change.
• Not getting easily bored.
• Not panicking in a crisis. 
• A certain kind of detachment when it comes to bodily fluids, effluent, injury and nudity.
• Respecting the inherent dignity of a human being, even when they are helpless.
• Reassuring people.

For some people, in the right circumstance, this stuff comes quite naturally - I've written before about how tasks we could define as "care" can merge with the natural teamwork that takes places within a partnership or family. But people and family dynamics vary hugely.

Take reassurance as an example. This is an essential skill for many carers; people often need reassurance when they're distressed, confused or in pain - let alone when they're having symptoms that will one day kill them. And that isn't something that comes naturally to everyone. If you think about times you've been in a real panic, then think through your friends and family and consider how many you're bloody glad were nowhere in sight. Some very lovely people have a habit of pouring petrol onto flames.

This doesn't mean that people can't or don't learn new skills - people often do. But if they can't, you're looking at a very miserable carer and very poor quality of care.

And that's plain old innocent aptitude. There are loads of families - there are elements of this within my own - where there's a great deal of talk of love, charity beginning at home, doing anything at all for one's nearest and dearest, but a complete lack of action or support when help is really needed.  Some people find illness in others irritating and lose patience when their partner has a cold, let alone something more long-term. In fact - as anyone with chronic illness will have learned - many people just don't have the stamina for any kind of problem that goes on and on and doesn't have a simple solution and a happy ending.

It would be great if everyone acted in the best interests of the people they love.  However, when they won't, insisting that they should does no good to a disabled or elderly person (nor indeed, does reminding them that their family could function differently).

Then there's the fact that some disabled and elderly people are extremely difficult to deal with. Some people who require care aren't pleasant people.  Some parents have given their children a lifetime of ill treatment before needing help in their old age. Others are decent caring folk who nevertheless become ill-tempered and demanding when living with illness, pain and impairment. Just as some people don't cope at all well with care, many people cope very badly with needing help, and find it much easier to snap at family members than they would at a professional performing a paid service (a professional who could resign their position if they feel mistreated).

And that's before we talk about conditions. Caring for someone with severe autism is very very different from caring for, say, someone with muscular dystrophy. Meanwhile, most conditions effect different people very differently - coping with someone who has profound dementia but is cheerful and co-operative is a completely different kettle of fish to dealing with a loved-one who - through no fault of their own - is now aggressive, even violent towards you.

And all of this is before we talk about what is practically possible. My Gran has four children, ten adult grandchildren and a few adult great grandchlidren (she is a great great grandmother), most of whom live within the same town. But when her health deteriorated, there was nobody who could take on a full-time caring role. There was nobody who met the following essential criteria:

• In possession of a house with a spare room and bathroom that was physically accessible to Gran or
• Able to practically move into the small spare room of Gran's bungalow.
• Not working or studying full-time. 
• Not chronically ill.
• Not on the list of people Gran strongly disliked and mistrusted even before she got dementia. 
• Not on the list of people Gran had so deeply hurt or offended, they may not show at the funeral.

So my Gran went into a care home. It was the last resort, but really, it shouldn't have been: my Gran suffered a series of falls at home, including one where it seemed clear that she had left the gas on, had later smelled gas and had fallen in her hurry to leave the house. The general feeling was that Gran would suffer a great deal leaving her home and she would stubbornly resist. In fact, she adjusted to it in the blink of an eye and quickly became happier than we've ever known her. She's currently insisting that she is engaged to another resident of the care home, although she's forgotten who that is.

Of course, this isn't the way things are, but our experience. It would have still been the right thing to do even if she'd hated the care home - she was made safer, and none of us could keep her safe otherwise. No amount of love or concern keeps someone safe when they really can't be left on their own for any period of time.

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So, what if you love someone who needs care but you're not in a position - whether through personal, practical or financial reasons - to perform that care? Well, the great thing about care work is that it can be performed, to a very high standard, by professional people. But (a) someone has to make sure that's happening and (b) good care only gets you half way to good quality of life. There are a thousand things we can do to support our disabled and elderly loved-ones and their carers (paid or otherwise) without ever having to see them naked.

People often fail at these things for a few different reasons:

• The sense that anything done to support disabled people is a tremendous chore/ act of charity. 
• Guilt. I feel guilty I can't do more, so I'll pretend there's nothing I can do.
• The thing mentioned above about problems that go on and on and can't be fixed.
• It really is easy to get on with my busy life and let time (and good intentions) fly by.  
• Generalised squeamishness about age, illness or disability.
• If I can't be the hero of the hour, I'm not playing the game.

Jeremy Hunt talked about loneliness, but as Aditya Chakrabortty pointed out, young people are more likely to be lonely than older people. Disabled people of all ages, especially those not in work, are much more vulnerable to loneliness than say, my Granny Kelly who at ninety, keeps a calendar jam-packed with family visits, trips out with friends, concerts and church events.

But receiving good quality care is a necessary but not a sufficient condition to a disabled person avoiding loneliness and having a good quality of life. We all need to look after one another, best we can.