4. MARCO TEÓRICO
5.6. EVALUACIÓN DEL PROCESO DE ENSEÑANZA-APRENDIZAJE
Few private Homes, either philanthropic or proprietary, existed in Tasmania prior to the 1950s, and when they did appear, the residents were of a different type to those in the public institutions—middle class, respectable, with money to pay for services and a different expectation of conditions and care. Coercive control was rarely used within these establishments, and they did not exist to keep their occupants sequestered from society; they have subsequently played no part in this chapter. Nevertheless, many instigated rafts of rules and regulations that were reminiscent of those within the public institutions: for example, the fifty-one residents of the Derwent Court Nursing Home, in
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Sandy Bay, Hobart, were not permitted to bring in jewellery or money, as it was against the Home’s policy, and could only leave the premises with the approval of both the doctor and Director of Nursing, and had to return by 4pm.161
On the whole, however, the private Homes placed more emphasis on care and less on custody. Even where ostensibly coercive methods were used to control resident behaviour (such as locked doors and physical restraints), the intention was therapeutic rather than punitive—for the resident’s ‘own good’, rather than to protect society. These measures will be discussed further in Chapter 5.
This chapter has shown that the roots of the Tasmanian aged care sector were firmly embedded in the custodial model of the convict system that dominated the state so strongly throughout the 19th century and beyond. The earliest institutions were closed total institutions, coercive and custodial. The inmates were locked in at night, and granted day leave only by the favour of those in charge. Although technically they could leave if they chose, there was nowhere else to go; they might find the gates closed against them, with only the gaol cell or beggary to fall back upon. Only the most desperate would enter, and that was entirely satisfactory as far as the authorities were concerned; even without a Poor Law, the government had achieved its aim to set up a system that no- one would want to use unless they had little choice. The public did not mind, either; the conflation of prisoner and pauper as members of a ‘criminal class’ made control the main imperative, and there was little consideration of care.
In the 20th century, as the emancipists died out, their place was taken by the impoverished lower classes, a group that still had little claim on public sympathy, particularly when the populace as a whole were suffering the exigencies of the First World War and the Great Depression. It was not until after World War Two, a time of social upheaval and regeneration, that new solutions were sought to better answer the problem of a growing aging population; the opening of Cosgrove Park and the blossoming of the private sector would change aged care a great deal in the following decades. But no matter how hard
161 Derwent Court Nursing Home: Information Booklet (Hobart, 1986). Jenny Hockey notes that this
‘compulsory shedding of possessions, responsibilities, and personal space’ not only erodes aspects of the resident’s social identity, but also reminds them of the impending reality of death; ‘Residential care and the maintenance of social identity: negotiating the transition to institutional life’, Growing Old in the Twentieth Century, (London, 1989)
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the new Homes might try to cast off the past, the legacy lingered; particularly for St Johns’ Park, which provided a direct link back to convict days. Is it any wonder that even in the 1990s people still spoke forebodingly about ‘going behind the clock’?
The custodial nature of Tasmanian aged care for much of its existence also affected the image of those who worked within the sector, who were seen as custodians rather than carers. Even when nurses were finally employed, it was not seen as necessary to find technically accomplished or highly knowledgeable nurses to give appropriate care. Whilst coercive control might be deemed acceptable by the public and the authorities, it often caused discomfort to those nurses and attendants employed in the Homes who were forced to treat their patients in a way that contradicted the accepted social identity of the ‘kind and caring’ nurse. It may also gave free rein to the few who enjoyed exercising their power over the weak and powerless in their charge, giving rise to the stories of ill- treatment and abuse.
Goffman specifically identifies asylums, prisons, army barracks, and boarding schools in his examples of ‘total institutions’; it is interesting to note that in Tasmania, each one of these was utilized by the government as homes for the aged after they outlived their usefulness for their primary purpose. The use of second-hand buildings was to set a precedent for another aspect of aged care in Tasmania: that of ‘making do’ and ‘good enough’, and this will be examined in the next chapter.
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Chapter 3
‘Good enough’ and ‘making do’
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…we would deprecate as pernicious any attempt to make institutions designed for the relief of pauperism more attractive than the home which the honest self- denying workman can hope to secure for himself in old age by the observance of temperance and economy. … Public charity should not be so much a boon, as a mitigation of the consequences of the neglect or violation of wholesome general laws.1
Despite the lack of a Poor Law in the Colony of Tasmania, it was clear that the public institutions for paupers were modelled on the English workhouses: isolated from the community, gated and walled to keep the inmates away from respectable society. But unlike the mother country, the colonial government did not build new forbidding edifices to house the poor. They did not need to. The end of transportation created a wealth of disused and obsolete imperial buildings to be pressed into service by the government to house the old and infirm: convict barracks (Impression Bay), convict hiring depots (Brickfields), prisons (Port Arthur and Cascades), military barracks (the Launceston Invalid Depot), and an orphanage (The Queen’s Schools at New Town).2
It was not just the buildings themselves that were ‘good enough’ for their inhabitants; the records reveal that furnishings, food, clothing and care for the elderly inmates were often basic at best and sometimes considerably less than adequate, and in this, too, the
Tasmanian government was clearly influenced by its English counterpart. In 1834, the English Poor Law was amended to include the principle of ‘less eligibility’, which ruled that the relief given to paupers should not allow them to live in conditions ‘really or apparently as eligible as the independent labourer of the lowest class’3; in other words, life in the workhouse should not be as attractive as life in the community. The reasoning behind this principle was to deter all but the most desperate people from seeking
1 TLC, 17, 1871, Paper 47, page xxiii
2 The latter remained a Home until 1993 in its incarnation as St John’s Park, and there is still an aged care
facility on its site. Although the oldest original buildings no longer house old people, the Infant’s School, which became the female division of the New Town Charitable Institution, is still in use as the head office of the current operators, Southern Cross Aged Care.
3 Bernard Harris,
The origins of the British Welfare State: society, state and social welfare in England and Wales, 1800-1945, (Basingstoke, 2004); direct quotation from Ronald Mendelsohn, The Condition of the
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admission to the workhouse, and its effect was to subject those desperate people to conditions of misery and harshness that affected the image of the entire British welfare sector for decades to come. The quotation at the start of this chapter, from the 1871 Royal Commission into conditions in the Tasmanian charitable institutions, shows that the Tasmanian government had adopted the principle even without an enacted Poor Law.
Over the first decades of its existence, the overseers of the nascent Tasmanian welfare sector made sure that the occupants of the invalid depots were given less than the poorest community dwellers. Even when the institutions became old age homes, their inmates did not automatically enjoy an improvement in living standards. Until the second half of the 20th century, the government Homes were second hand and second rate, but ‘good enough’ for people with no other choice. That this situation was considered acceptable for so many decades is partly explained by the fact that it was not just the inmates of the institutions who were forced to endure some hardships. There were many lean times amid the boom years for all Tasmanians, and the population as a whole was not wealthy; the ‘labouring class’ made up more than forty per cent of the population until the second half of the 20th century.4 The government, too, struggled financially, and economies were essential to ensure that all necessities were covered. Nevertheless, there is evidence that the elderly inhabitants of the charitable institutions were intentionally well down on the government’s list of priorities until the mid-1950s. This lack of status also affected the nurses who cared for the elderly inmates. They endured sub-standard working conditions, low wages, a lack of training, and a lower standing and reputation than workers in other health care settings. Many of these factors continue to affect the sector to the present day.
This chapter will explore how the need for thrift combined with a disdain for the lowest classes to create Homes that were ‘good enough’ for old folk and the people who looked after them.
4 Shayne Breen, ‘Class’,
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‘Quiteadequatefortheclassforwhomitisprovided...’
…two apartments, which during the rain are inundated both from above and below, in which cooking, washing, and all other necessary operations are performed, and in which the patients are all huddled together…5
The Vandemonian invalid depots were basic indeed. Even when a new Invalid Hospital was built at New Norfolk to replace the original old and leaking convict barracks, inmates were provided with only the bare necessities. As overcrowding became a problem, sometimes they did not even have that: in 1836 there were only enough bedsteads for half the occupants, no sheets on those that were provided, and insufficient furniture and utensils to go around. The meals were badly cooked, and inmates’ clothing was ‘motley … varied in colour, kind and condition’.6 When the invalids were moved to Impression Bay and later Port Arthur they enjoyed less crowded conditions, but their surroundings were little better. The buildings at Impression Bay were ‘generally dilapidated’7 and the old penitentiary buildings of Port Arthur had been considered too decrepit even for prisoners, but were considered suitable for impecunious old men for a few years until a new paupers’ house was built.8
Perhaps the remoteness of the early institutions kept their inhabitants out of mind as well as out of sight, but this changed when depots were opened in more central locations in both Hobart and Launceston. Townsfolk were now able to visit and inspect the premises, and the newspapers began to publish articles about life within the depot walls. Both visitors and the Press occasionally decried the poor conditions, but very little was done about them. With an inmate population almost entirely consisting of ex-convicts, it was difficult to arouse much concern in the public mind, and it is likely that the newly christened Tasmanian government believed that they were doing enough. After all, they had a new colony to run, a new parliament to establish, a new economy to build, and these remnants of the old imperial convict system were almost certainly deemed less worthy than the many other calls on the public purse.9
5 Ralph Gowlland,
Troubled Asylum, (New Norfolk, 1981), page 4
6 Report to the Lieutenant Governor from the Principal Medical Officer, 3rd October 1836, quoted in Kelly,
A Background to the History of Nursing in Tasmania, page 52
7 Piper, Beyond the Convict System, page 46 8 Maggie Wiedenhofer,
Port Arthur: A Place of Misery, (Port Arthur, 1990)
9 As part of the ‘criminal classes’, they were not considered to be ‘deserving’: David Rothman,
The Discovery of the Asylum: Social Order and Disorder in the New Republic, (Boston, 1971)
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The new government had started well enough, it seems. The opening of the Brickfields Invalid Depot (Brickfields) in Hobart Town in 1859 was greeted with approval by the
Mercury, which had been advocating for some time for a refuge for invalids within the
town environs. The ‘remarkably clean’ premises included a paddock ‘laid down with English grass’ for the leisure activities of the inmates, a small library and ‘perfectly new’ bedding, and the inmates were reported to be contented and happy.10 This pleasant state of affairs appears to have deteriorated quite quickly, however. Only four years after the opening, Dr E Swarbreck Hall, a long-time member of the Hobart Benevolent Society and a keen advocate for the destitute, protested about the conditions in the hospital ward:
…the beds are straw only, not even a hair mattrass [sic] or an air-cushion or a
water-bed; for men, many bed-ridden for months, with backs mortified from long constant pressure. … There are some half-dozen arm-chairs with wooden seats, and the only other sitting provision for these aged sufferers are forms without even backs … a short time since, a poor man 108 years old, died on one of these comfortless straw beds…11
Plate 1: ‘Brickfields Invalid Depot’ by Miss Shoobridge, 186512
In reply to a suggestion that the ‘comfortable quarters’ of Brickfields had made men seek admission ‘without necessity’, he ridiculed the idea that people capable of working—or even begging—would try to gain admission to such an unpleasant place if they did not
10 The
Hobart Town Daily Mercury, Thursday, 4th August 1859, page 3
11 Letter to the
Mercury, Saturday, 15th August, 1863, page 5 Straw mattresses were common in the
hospitals, where they could be burnt after the patient was discharged (see Janet McCalman, Sex and Suffering, (Carlton South, Vic, 1998), page 79), but here the men were forced to lie on them perpetually.
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need it. (This, of course, demonstrates that the rule of ‘less eligibility’ was in fact succeeding in its goal.) Dr Hall claimed that the condition of the men within the depot made it an infirmary and as such, it should have ‘all the comforts and requisites’ of a hospital, including medical care.13 Instead, the bed-bound men lived in a ‘bare, gloomy barrack room’ and subsisted on half-rations14, being cared for by their fellow inmates. This latter situation was not in itself unusual; the official government policy was that able-bodied inmates would provide care in all medical and charitable institutions in the colony, as a cost-cutting measure.15 The difference was that in the invalid depots, there were very few able-bodied inmates at all, and most were too old and infirm to be of much use to their fellows.
The second Hobart institution, the Cascades Invalid Depot (Cascades), did not enjoy even a brief period of approbation. Cascades was infamous for its unpleasant setting, being dark and damp all year around, and questions were raised almost immediately about its suitability for frail old people. Dr Hall went so far as to say it was ‘a positive cruelty’ to banish invalids there:
The accommodation … is altogether insufficient. … For bed-ridden old men, some nearing their hundredth year … to have only straw beds and pillows, and those who can sit up no easy reclining chairs …is a condition I am sure that any feeling person … can readily appreciate and deplore. [Their] sufferings ought to be mitigated by every appliance and comfort that human skill and Christian kindness can devise.16
But there was little Christian kindness to be found. Dr Benson, the medical officer of Cascades, agreed that the place had been build ‘on a morass’ and was ‘not cheerful’, but protested that many inmates were dirty or incontinent, and that
the bedding is suitable and clean, and can easily be changed. There is always an abundant supply of dry straw on hand, and I have witnessed no ill effects which could possibly be attributed to the use of such for filling mattresses.17
13 Robson,
A Short History of Tasmania, page 46
14 This meant they received only half a pound of meat a day, rather than the one pound given to other
inmates of the institutions, and of the gaols and armed forces. Whilst this might sound quite a lot, it was ‘inclusive of bones’, which could dramatically lessen the amount of edible matter.
15 AOT, CON74/1
Instructions for the Management of Convict Hospitals, (Hobart, 1845) Similar
arrangements existed in the other colonies, and, indeed, in England, where trained nurses were still some decades away.
16 TLC, 17, 1871, Paper 47, pages 83-84: evidence of Dr ES Hall
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It seems clear that the two gentlemen ascribed very different social identities to the invalids, and this could explain their opposing views. To the charitable doctor, the men were ‘sufferers’—weak, inactive and basically good—and the conditions in which they lived did not correspond to the way in which he believed such people should be treated. To Dr Benson, they were reprobates—weak, yes, but actively difficult and basically bad. He was therefore content to accept the situation. The members of the Commission agreed to a great extent with Dr Benson. Whilst they admitted that they would not have
recommended the Cascades site for selection, they believed that the inmates were not in such a state of health as to require their removal to another location. Besides, economy was a major consideration, and this was managed in a ‘remarkable’ manner, with accommodation that was ‘as commodious, cleanly and comfortable as could be reasonably expected [and] quite adequate for the class for whom it is provided…’18
Plate 2: Plan of Cascades Invalid Establishment, 1877.19 The old prison cells can be seen in the