IT WAS IN THE PAPERS
Export trade of people with dementia
It is shocking to read that some older people with dementia are being placed for their last months of life in care homes at the other side of the world: https://www.theguardian.com/society/2020/jan/12/families-sending-relatives-with-dementia-to-thailand-for-care This revelation comes from a study by researchers from Newcastle upon Tyne and the University of British Columbia. They found older people from the UK living in care homes in Thailand. The reasoning behind individual placements no doubt varies with their specifics, but common themes seem to be the cost of care in the UK and its unsatisfactory profile – not enough staff to make people safe and comfortable, stories of rough handling and worse.
Correspondence in response to the initial article has been mostly positive https://www.theguardian.com/society/2020/jan/14/can-thailand-provide-better-dementia-care-than-the-uk It comes from people who are well travelled and often have personal and continuing family involvement with Thailand. Even so one lady was able to visit her husband three times within a year. There are potentially serious and complex ethical and practical issues: freezing of pension and benefits, need to pay for all medical care, not to mention the matter of lost mental capacity and informed consent.
I have a memory of being involved in a Panorama ‘expose’ in the 1980s when old people from the South of England were being transferred to cheaper care in the North. It was suggested that the patients knew no difference because they were demented. We countered this by observing that people with dementia are more sensitive than ever to the nuances of shared language, culture, food, dress and ways of moving. The idea of moving people out of their natural territory at the end of their lives, like passive animals simply because this will be less expensive for them, their family or social services, is unpalatable. But it is happening everyday within towns and cities of the UK: the extension of the practice to an international scale is arguably a logical extrapolation of this.
As one of the correspondents says – we must make the system of care in this country comply to humane standards and make it possible for individuals and families feel safe near home. A few will still chose more exotic placements, but for uncontaminated reasons
The same letters column includes several missives in support of Home-share communities which engineer old and young living within one complex. Some are writing from the perspective of a special interest (Shared Lives plus, Associated Retirement Community Operators – we met them via their comments to the House of Lords on the future of eldercare). I am not comfortable with such self-conscious departures in the name of mutual good, aiming to right a problem (Intergenerational Conflict) which I doubt exists for most people.
Confirmation of being past your sell-by date: making marmalade, buying long-playing records: www.theguardian.com/food/2020/jan/14/never-too-old-to-be-making-marmalade
Interest in what it is like to be old: Birmingham, Ikon Gallery has a VR (Virtual Reality) installation February 15 – 23 which ‘immerses viewers in the mind of an older person who has fallen in a home’ www.theguardian.com/food/2020/jan/14/never-too-old-to-be-making-marmalade
The state of the nation, most especially relating to older people
The last McDonald-free County gave in to the modern way of providing food quickly: www.dailymail.co.uk/news/article-7889353/Rutland-locals-react-fury-McDonalds-confirmed.html
From the wealth of facts collated by the Office of National Statistics we have confirmation that well-off people have nine years extra of pain-free life: https://www.theguardian.com/society/2020/jan/15/being-wealthy-adds-nine-years-to-life-expectancy-says-study The bald fact must hide a complex of causalities from genetics via life-style, luck, education and more. The encouragement is to believe that there are lessons to be learned: More people can gain advantages from analysis of what it is to be wealthy – and action to make them more widely available
Roughly ten patients with a diagnosed terminal illness die every day in England, Scotland and Wales before receiving benefit payments for which they qualify: https://www.independent.co.uk/news/health/benefits-terminally-ill-deaths-personal-independence-payment-government-dwp-a9279481.html
Pressure on hospitals because of insufficient beds leads to their arranging risky discharges: https://www.dauk.org/news/2020/1/17/BMJDAUKslamsunacceptablemovetodishcargeearly
Professor David Nutt again draws attention to the dangers of alcohol – ‘by for the leading cause of drug harm, outstripping even heroin and cocaine’. Yet alcoholic drinks remain highly regarded features of social life throughout many countries, and are widely used, sometimes to excess by older people. Share a pint or glass of wine between three to drink safely, says expert