An Extra Pair of Hands by Kate Mosse review – the dignity of care

Looking after the elderly is a feminist issue, but this moving and unusual memoir also speaks of the pleasure and privilege that leaven the heavy burden of caring

By the age of 59, women have a 50/50 chance of being a carer for an elderly or sick relative. Care is a feminist issue, as Mosse rightly points out. Indeed I would suggest it is the feminist issue, and yet it attracts a fraction of the attention of the #MeToo movement. Our economy and culture are stubbornly constructed to ensure care is provided either for free – by loving female relatives – or cheaply by low-paid care workers who are predominantly women; they have been built on centuries of socialisation of girls to be caring and attentive to the needs of others to the point of self-sacrifice. Without the unpaid labour of the estimated 8.8 million adult carers in the UK, the NHS would collapse and the treasury would have to stump up £132bn to cover the shortfall. Yet the carers’ allowance is the lowest state benefit (£67.25 a week). Meanwhile, the UK’s dysfunctional care system robs families and the taxpayers of vast sums to offer often mediocre care – with disastrous consequences during the Covid pandemic.

Against this hideous backdrop of inertia, neglect and crisis, Mosse tells the moving – and very unusual – story of how, over the last two decades, she and her husband have taken in three of their parents to live with them. For Mosse, it has been “a pleasure and a privilege” to share her family life with the older generation, and she pleads for greater appreciation for the elderly. Her account is heartfelt, but it’s not one many of us will recognise. Mosse is the first to admit she has been exceptionally lucky on several fronts. She wrote a bestseller, which enabled her to buy a big enough house for an annexe. She and her husband were self-employed, so their time was flexible and they could juggle the constant rounds of medical appointments and responsibilities. She collaborated with siblings living close by. She had the financial resources to pay for private care when needed. Finally, she says that everything she learned about care was from her own deeply loving parents. Good relationships plus money is the care equivalent of the jackpot.

But even with Mosse’s advantages “it’s hard”, she bluntly admits, and “often it feels as if there are no good options, only less bad ones”. She notes that the origin of the word care is the old German word chara for “burden of the mind”. On several occasions, she comments on the “numbing” repetitiveness of daily tasks, but perhaps even more painful is the powerlessness entailed in caring for the elderly as you witness their process of loss – of faculties, of freedom and independence – with only limited ability to relieve or ease it. The paradox about carers is that a strong satisfaction lies in “fixing things” – making someone better, cheering them up – but that may not be possible. Mosse admits sadly that “however much you do, it never feels enough.”

Mosse is a model for the option often favoured by politicians (usually male ones) who suggest that families need to step up to meet the demographic challenge of an ageing population, revealing how they simply have no grasp of what care of an elderly person entails. Their ignorance is shared by many: our society has invested huge resources in medical advances and in the NHS care to extend lives, but far less in imagining how our long, increasingly fragile lives are to be supported. As anyone with an elderly parent knows, just keeping track of all the medical needs is a herculean effort.

As an epigram to the book, Mosse quotes Adrienne Rich: “Freedom is daily, prose-bound, routine remembering.” Throughout the book she weaves in family history; stories of her childhood in West Sussex, the marriage of her parents and the wonderful character of her mother-in-law who took an entertainment troupe round local care homes to regale residents with music and song. Thus Mosse portrays the riches of reciprocal relations of care between one generation and the next, and is a helpful corrective to the negativity that sometimes burdens the subject.

Mosse finds it hard to shoehorn her thoughts into the impoverished bureaucratic language used in the “care industry” and complains at being designated a “carer”, with its implication of inequality and the passivity of the dependent. Here, she indignantly insists that her surviving mother-in-law may now be dependent, but is also still very much her strong-willed, vibrant self. Mosse refers to herself deprecatingly as an “extra pair of hands” even if she is now “full-time”. The book’s title speaks to the importance of tact in protecting dignity and respect, and Mosse describes admiringly how her mother cared for her father when he had Parkinson’s. “She never spoke for him, never took over unless he wanted her help, never let the things he could no longer do become more important than the things he could do.” She questions how and why we fetishise independence when the reality of human experience is always interdependence. Here is a book that sees, in this, a cause for celebration.


An Extra Pair of Hands: A Story of Caring, Ageing and Everyday Acts of Love is published by Profile (£12.99). To support the Guardian order your copy at guardianbookshop.com. Delivery charges may apply.

Contributor

Madeleine Bunting

The GuardianTramp

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