Thursday 17 February 2011

What Price, an Old Person's Life?

Old age is a state of mind

There has been a lot of talk in the news lately at the appalling neglect and general bad treatment many old people suffer when in hospital.  I was particularly interested to hear a Southampton hospital mentioned.  I could be wrong, but I assume it was the Southampton General where my aunt spent 5 weeks last Autumn, it doesn't have a good reputation locally.  It was a very distressing time for all her friends and family as we didn't really know why she needed to be there and she didn't seem to be getting treated very well.  Her essential medication, which keeps her Parkinson's under control was not given to her for two or three days after she was moved onto a ward after being discharged from A&E, so she was shaking violently for several days until she was given her medicine and it had time to take affect.

She only needed to be in hospital because the manager of the Care Home she had just moved into felt she couldn't cope with her and refused to have her back after my aunt's broken wrist had been dealt with.  She told the hospital that her medication needed adjusting as my aunt was falling over several times a day and this was the second time in three or four days that she'd been taken to A&E.

The hospital did nothing until we rang up after about a week to find out what was happening.  Then we had to telephone the Parkinson's Nurse ourselves as they didn't have the gumption to find out her number - she is the only one in their area.  A week or so later we found out that someone had contradicted her instructions and cancelled the visit from the Psychiatrist.  I think it was my sister who discovered this and pleaded with them to re-book the visit.

The long and the short of it was that although promptly sorting out the correct dose and type of medication my aunt needed and assessing her mental state could have resulted in her being discharged from hospital several weeks earlier, it all seemed to much trouble and without us continually phoning or seeking out staff to speak to when visiting her we felt she would quite possibly have been left in a corner and forgotten. Friends and family members also helped her to drink and also gave her food as she always seemed ravenous. She was unable to eat or drink without assistance.

She was on several different orthopaedic wards during her stay, because she had broken her wrist, but that was not the reason she was in hospital.  The wards with mostly older patients was where she was treated the worst.  When she was moved to a ward with a wider age range we noticed an improvement in the attitudes of the nurses.

This seems to reflect other people's experiences.  It seems that for some reason the staff on wards for the elderly seem to lack the motivation or basic human compassion to give basic care to these vulnerable patients, many of whom are able to do little for themselves and cannot even speak up for themselves.

I wonder why this is.  Is this simply a reflection of the general attitude of our society?  I read in my mother-in-laws' paper that some women over 50 find that men don't seem to see them any more and tend to ignore them, yet 50 isn't very old these days, it is merely middle aged.

There is also a tendency in our society to only value anything for it's monetary value.  The biodiversity and great benefits our woodlands and forests bring to us seem to have been forgotten by our government eager to raise money.  People who don't earn a wage and pay taxes such as stay at home mums and many elderly folk don't seem to be found as interesting as high-flying executives earning big bucks.

Another problem raised during discussions about how we treat our old people in hospital was that there seems to be too much emphasis on the medical treatment and technical side of thing to the extent that the humanity and human needs of the people undergoing the treatment becomes lost from view.

I wonder also if the staff at some of these hospitals are overly stressed and perhaps undervalued, demoralised and even demeaned by there over-stressed, target-driven superiors?

Whatever the cause, we cannot consider ourselves to be truly civilised if we continue to allow our old people to be treated in this way.

Do you see all old people the same, or do you appreciate that people age differently and there are many active and capable people in their 70's and even 80's.

How do you view those old people who are frail and vulnerable?   How would you like your parents to be treated when they reach that great age, if your parents are still alive?  How would you like to be treated yourself when you reach that stage in life?  Could that change the way you treat the elderly?

8 comments:

  1. Hi Karin,

    We really have strong feelings on this subject, my Nan experienced similar treatment in hospital on 2 occasions. The first time, I persuaded her to discharge herself - she would have died if we hadn't brought her to live with us. The second time, she did die & we suspect it's due to them giving her the incorrect medication.

    Answering your questions: We're all different, regardless of age & we like to think that we see & treat people as individuals. We work for some very sprightly people who are 80+, they are full of life & then there are some folks in their 60s who just sit in front of the TV all day - slowly becoming immobile... Sime's Mum is already receiving care packages at home & on the whole - the team are very respectful & she is very happy with her care.

    I think the way forward is to live in mixed age communities, not a commune as such - but to have friendships with people of all ages can benefit everyone. Older people can be given a new lease of life when surrounded by younger people. Likewise, younger people can learn so much - the skills & wisdom of older people are really important in other cultures. We definitely miss out here in the UK.

    My Nan taught us lots!

    Kay :)

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  2. Hello Kay, I'm sorry to hear that your Nan received such poor treatment. I've a feeling most people will have at least heard of some elderly person (a friend or relation of a friend for instance) who has been mistreated in some way by the NHS. It does seem a very wide-spread problem and so far Mr Cameron et al don't seem to have come up with a solution for fixing 'broken' care for the elderly. I'm glad your mother-in-law seems happy with her care.

    My aunt seems to be treated much better in the nursing home she is now in, and my mother-in-law has had good care at home previously and the care home she is now in seems very good, too. On the other hand I know someone whose mother's care package is provided by the council and they put her to be after lunch, wake her up at five and then put her to bed again at eight and she is so bored she scratches her leg till it bleeds and needs a dressing.

    I had a feeling the regular readers of this blog would have a good attitude to elderly people and you have proved me right, Kay. I agree, more interaction between young and old people as well as all ages in between would be a good idea. This can happen where families are able to keep in touch across the generations on a regular basis and in some churches there is good interaction between all ages at least on occasions.

    A community where people had time to spend with people of all ages helping out as needed and as they are able would be an ideal set up, although there would be those older people who are hard to look after due to illnesses like dementia and the incontinence that tends to accompany it who might need to be cared for elsewhere by specially trained people as tends to be the case already. I don't know if you would see them and very frail people who fall over a lot and need constant supervision as part of such a community or if it would be only for the fairly fit and well elderly.

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  3. Hi Karin,

    You've got us really thinking about this subject - we've been discussing for the last hour!

    Sime & I both think that there is room in a community for people who become severely disabled or ill. The other members would surely want to care for their elderly friends & it can be a sharing & rewarding experience for everyone.

    We have older friends, who don't have any relatives near by & if anything happened to them - we'd definitely be there to help!

    Kay :)

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  4. I think that's a good attitude to have, but I wonder how it would work out in practice. I think there would have to be a formal care plan in place with specific people allocated time slots, otherwise it would be a case of everyone could look after them but nobody is actually on hand a lot of the time because they think other people are there.

    The care would also need to be shared out between several people as it can be both physically and emotionally draining. I suspect even lovely, easy-going people could become very difficult when affected by dementia, although both of my relatives were difficult beforehand, so I can't be sure.

    This would also have to take place in a community where many people were around in the daytime rather than working all the hours they could as so many people seem to have to these days.

    Nice idea in theory, though. :-)

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  5. Hi Karin,

    In an intentional community of mixed age ranges - I'm sure these issues must have been dealt with. If there's back up support from care agencies, elderly people could remain in their homes much longer - surrounded by neighbours & friends who are willing to help as much as they can.

    Our transition group has concerns about the elderly folks in our area, as we have more retired than working people. How will care be provided if care agencies are forced off the road by the rising fuel prices?

    We hope that our community will all pull together & care for each other...

    So far, there are 8 individuals who are trying to make changes here & there are over 600 households of people not interested!

    Kay :)

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  6. Interesting thread and one that has bought some concerns I have had in the past to the fore again.

    Our family have always in the past done for each other and individuals on their own at Christmas were always invited for company and a feed on Christmas day itself, so as a child I got to mix with all age ranges - it is of an enormous amount of benefit because I learnt at an early age how to treat people with respect and had friends in all age groups.

    Because families have to work now - they sort of don't always have the time to do the things that they would like to do especially if on a low income and firefighting with bills.

    People need not have to go into homes if they can be helped out within the community by say a neighbour involving them in their family life i.e. by inviting them to meals and interacting them with the young people. I remember this happening in my parent's household when I was a child and it helped socialise me.

    My Nan lived in Lincoln but every other week my Dad used to visit either on his own or with my mum and then I used to visit too and I always took a supply of home cooked meals for the freezer for her. She was paying out for meals on wheels whilst okay were not the quality of food she was used to, so mum and I sorted her out with meals. We used to cook plenty when doing a joint and cook extra veggies and then plate some meals up and freeze them for her. We also used to do casserol meals and portion them up. If people cannot have an older person in for a meal every night then this may well be an alternative for the evenings not attending a company based meal but still having a tasty meal to look forward to.

    Hospitals are not what they were - I was terribly disappointed with the care they gave my father at my local hospital. He didn't come out as he died unexpectedly. Staff were too rushed even to supply me with a commode for my father when he was desperate basically the attitude was because they were busy it was okay for him to mess himself which it was not.

    That same hopsital used to be just down at the end of the road from where I live. It has now moved to a new location one of these new super hospitals where everything is clean and new, but we have heard reports from the staff that they spend too long trying to negotiate through the hospital as it is too large and that they are not getting to spend time with the patients.

    I certainly would not like the care I have seen - there are some individuals angels out there but they are continually fighting the system and are few and far between. We need the matrons back on the wards to square up a lot of this tommy rot that is going on - they traditionally used to fight everyone off in the name of proper care of their patients and cleanliness. Now its all down to costings per head and achieving something at cheapest cost possible, which surely shoots itself in the foot.

    The 600 or so families are not thinking ahead and not seeing the full picture. As soon as something happens to them then its all hell let loose but whilst it is happening to someone else. No social conscience and an attitude of "I'm alright Jack" but what a selfish attitude.

    Good luck to those 8 individuals in getting the change needed so sorely to look after our older folk. My father subscribed to the view that if you kept the little grey cells occupied you wouldn't age quite so much. He was still lively to the end.

    Thank you for an interesting and thought provoking thread. I am afraid it is down to the few to make those changes, but the few will soon grow if like minded good people join the cause. I have always found that villagers traditionally always looked after their own or certainly in the villages where I grew up in Rutland and Lincolnshire.

    Pattypan

    xx

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  7. Hello and welcome, Pattypan. Thank you for dropping by. It's great that you and your family could visit your Nan and take her meals, but as you say many families would find doing something like that difficult for various reasons such as lack of time and money, and of course families are spreading further apart as people go further afield to find work.

    The Transition Initiative, which Kay mentioned, with it's emphasis on strengthening local community activity could provide an answer, but only if enough people join in - the same goes for David Cameron's Big Society, although personally I prefer the ethos of the Transition Movement but both are attempts to address big changes in the way we live, which we need to face up to.

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  8. Issues relating to care of the elderly will only increase as our population becomes proportionally older.

    In an ideal world elderly people would be cared for by their own families but, given the size of our houses, greater employment of women, and the independence of the nuclear family, this is rarely possible.

    My mum, who sufferered from alzheimer's, spent the last few years of her life in hospital. Fortunately for her my dad, who was able to visit twice a day, kept an eye on her and helped in her care. When he ended up in hospital himself my sister, who lived in the same city, was able to do the same for him. I regret that I was too far away to be of much practical use.

    We need to be able to trust the state and/or private agencies to take proper care of our elderly relatives. However this should not absolve us from our own responsibilities.

    Rather than waiting until people grow old, how much better it would be if inter-generational relationships could be forged earlier on, while friendships could be for their own sake, rather than seen as charity. We live in a society where most of our relationships are within our own age group and we are all the poorer for it.

    I don't do nearly as much as I should, but I do regularly visit an elderly couple down the road. I occasionally fetch them the paper or a pint of milk, but most of the time we just sit and chat. I like to think it does us all good.

    I applaud the Smiths' Transition initiative and Pattypan's ready meal service. It's thoughtful touches that make all the difference.

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