Archives for posts with tag: health

If we stop and take a look at ourselves it is not a pretty sight. We are in the midst of an unprecedented knowledge boom yet our world does not reflect this. Few parts of it have peace and real freedom yet we know that war only provides horror and intense suffering and sorrow and solves nothing. In the end the result only comes through peace talks. In a world in which we used the knowledge we have those talks would be at the beginning, not the end.

In countries not at war there is still unnecessary suffering and deprivation. We still haven’t learned to share and accept that having too much doesn’t bring happiness. Having too little inevitably brings misery and hardship. Over Xmas our Australian Prime Minister was photographed helping to serve lunch to some of our impoverished citizens. They already had too many helpers so that it’s only purpose was to rub in the fact that his many tax-deductible properties were keeping poor people in that situation. But that’s another story.

If we go back to the world scene, what should we do? Firstly I assume that there is no question that democracy is better than dictatorship. Free and fair elections for all should be the free and accepted norm for every country in the future. Secondly we need to ensure that every citizen has the opportunity to succeed according to their abilities, including physical ones. Thirdly, the leaders we choose should have these goals, not self fulfilment, self-gratification and enrichment which tend to be their current goals.

So where do we start? New knowledge seems to be the catalyst which is triggering the desire for a better world, and in particular the necessity for those in leadership roles and others to keep their knowledge updated. This would lead to better informed decision making. We can no longer expect one person to have the necessary qualifications to lead a country. We should look to electing a leadership team with a wide variety of skills and up-to-date knowledge. The days when someone with out dated knowledge of law can be treasurer, for example, should be long gone.

We need to move to an election criteria in which my final suggestion would be the first. We can no longer have a situation in which those who stand for election tell us, and partially listen to us, at election time then forget about us. We need to elect representatives who will represent us, not just themselves or their parties. We need to elect people who will represent us and have a well-established mechanism for doing so, with frequent opportunities to listen to their electorate, not just tell us after the event.

If our leaders are not prepared to keep up to date with their knowledge then they have no part in the 21st century world. Leaders who help to serve lunch to our poorest at Xmas need to be replaced by leaders who sit down and listen to all citizens so that they are aware of their needs, aspirations and ideas, including the poor. This is 21st century leadership. It needs to be a team with up-to-date appropriate knowledge.

 

 

 

 

 

 

The only mention made of death in our society is usually through the old saying that taxes and death are the only two certainties in life. The rest of the time it seems to be a taboo subject. The only certainty about it is that it will happen, yet for most of us the how, where and when are not only complete uncertainties but not discussed.

I’m trying to work out how long I will last, given my current age, life expectancy for my age group and restrictions such as chronic illness. This sounds really potent yet seems to be the medical name for diabetes and other common diseases which affect life expectancy. I felt really doomed when I first heard the expression, but life has gone back to normal since then!

For older people it probably makes life a bit easier if we can work out a rough, probably inaccurate time limit. It gives us a bit of a time-line for things we would like to achieve before then, such as tidying up and sorting through possessions (called rather cutely ‘downsizing’!). It doesn’t seem to work for me, having recently passed on a whole lot of books I knew I would never read to charity, then restocking with other books I thought I might read!

The other uncertainties we face are the how  and where. Most people say they would like to die at home but few do. I suspect that this could be caused by medicos trying to use their new devises and medications on us when we would prefer to just quietly leave this world.

The big problem is the current discussion we are currently having in Australia about being allowed to do have a hand in our death and allow us to advance it when medication is not currently available to so painlessly. Euthanasia has almost been a taboo topic and is often described as murder. There are quite a few countries intelligent enough to allow it under very strict conditions and it seems to work well, with the conditions imposed preventing abuse. The opponents to this practise seem to base their objections on reasoning which is not based on intelligence and knowledge. These are often the same people who oppose same-sex marriage and abortion. The problem is that although their ranks are being reduced because more people are applying reason and logic to arguments, based on modern knowledge, these groups still have a traditional influence which they inflict on all of us.

If people oppose those of us who want to be able to die to escape excruciating pain, why should this minority be allowed to dictate what we choose to do? If I still looked at the world through religious eyes I suspect I would think that if God hadn’t yet released to us the knowledge to reduce all pain to a bearable level, then why shouldn’t we use the God-given knowledge we already have to choose to end our suffering? How heartless are these people if they are prepared to force their own families to have to watch them suffer needlessly, often for weeks and months? Not my idea of a Christian, loving world in which we really care about those we love, as well as our neighbours, in its full definition.

Dying would be less of a worrying uncertainty if people didn’t have to face the possibility of unrelieved excruciating pain accompanying it. Lets at least make this a certainty.

I seem to have become involved in a jigsaw recently which I would rather not have participated in.

It started when I read an article about the importance of management in the success of a company. If management don’t appreciate their staff, and make them aware of how much they are valued, it has disastrous consequences. This shows in a high rate of ‘sickies’ among staff and high staff turnover rates. With the former it means carrying extra staff where their presence is necessary, such as in hospitals and nursing homes. For all businesses having to regularly replace staff who resign is expensive, thus raising operating costs.

The second part of the jigsaw was learning that our local public hospital has the highest sickie rate of any of the comparable facilities in the area. The person in charge blamed the nurses, apparently unaware that research shows that the blame in such situations lies with management. Worse still I have since been told that their figures have deteriorated further this year.

The third and final puzzle piece was when the safety officer of a major hospital in the U.S. was quoted as saying that the greatest threat to the safety of the patients was the relationship between the staff. Put these pieces together and I hope that neither I, my family or my friends have to be admitted to this local hospital.

The situation was brought home to me recently when a family member went into hospital, fortunately to another one, a private one. What struck me was the wonderful relationship between the staff, from the nurse in charge of the ward to the trainee nurse doing a university placement there. Both said how much they enjoyed their work. The older one said she had worked there for 17 years. What impressed me even more was that this was 21st century care as it wasn’t just the medical care that was done as a team but they also included patients and visitors who were given the impression that they were also part of the team. This is commendable as of course they all have a role to play in patient recovery.

This recognition of team work, rather than the hierarchical model which characterised the last century, is valuable knowledge to enable all organisations to reach the highest standards in all aspects of their work, leading to higher productivity. It is absolutely necessary in all businesses, but particularly where people’s lives and well-being are at risk.

 

 

This week I listened to a discussion about a new report on the adequacy of the pension in Australia. It is a very complex problem which is probably why it is a rarely tackled. The last attempt I am aware of was by a university researcher who ended up having to make so many assumptions the end result wasn’t really meaningful. This time the authors set themselves plenty of time and enlisted the help of a number of organisations involved with the elderly, such as the Council for the Ageing (COTA). The main value of the exercise to me was the inclusion of someone with many years of experience with ageing groups and is himself celebrating his 85th year this year. He was a member  of a three person panel speaking about the issue. It was a refreshing change to see a panel not just discussing an age related  topic but with one member actively, personally involved. They were not just studying the ageing but involved with us. It took away the weakness of so many discussions on ageing which talk about us, not with us.

So what emerged from the study? As expected it is a particularly complex issue but some problems cropped up frequently, particularly the topic of good dental health. Not having the money to pay for dental treatment leads to older people having to mash their food as their teeth are too painful for them to chew, or are none existent due to the expense of dentures. To me, this should be a separate issue. We have a free health system in Australia so I can’t see why this can’t be extended to dental health. The other issue which was not raised was the health costs of not taking action. If people are unable to eat properly for whatever reason, including inadequate money for food, then their general health will suffer, a situation which the health system will have to cover, particularly if they end up in the hospital system.

Another major issue was that of the family home not being included in a person’s assets. This problem arises when someone has lived in the family home for decades and its value has risen greatly. The person may not want to leave because, for example, it holds many memories. They also may feel that this is a legacy to leave their children who may be looking forward to it. The problem arises when maintenance costs rise and the older person is obliged to pay out of their pension. They may be left to live in poverty in a hugely valuable home.

These are among the many complex issues the study group looked at. There is obviously much discussion on the issue ahead. At least it is good to know that future talks will be held with older people. not just about us.

I liked the suggestion that the issue of the value of the pension be set by an independent body. The politicians’ response that the country couldn’t afford it was met by ‘but that’s how your salary’s are set”!

Those are just some of our problems in Australia.  What about those countries which don’t have any pension?

 

It is about 10 years now since I first became interested in ageing yet I still come across areas I haven’t yet investigated. Recently I was invited to join a group of people investigating homelessness in the city where I live. It was the first time I had considered the plight of older people for whom everything has collapsed.

I had previously heard a talk by someone from a large city in Australia who was describing his involvement in building a group of units for homeless older people. The units were fairly small but big enough to satisfy the needs of those living there and were extremely sensitive to the needs of their new inhabitants. For example, each unit had a balcony attached to it. The balconies overlooked a walkway which enabled the residents to choose to sit outside and chat to people out for a walk (and get some beneficial fresh air), or stay inside if they wanted to be alone. One lady commented that it was the first time in her life she had a key to her own place. She was thrilled! It occurred to me that what she was actually saying was  that this was the first time in her life that she, and her possessions, were safe. A sobering reminder of the constant danger the homeless are faced with.

The group’s research of course will involve those who don’t have that security. It must be a frightening situation for anyone but for older people, aware of their frailty and their vulnerability to illness or violence, it must be even more difficult. The problem is that homeless people tend to hide themselves away from public view for safety so that the only way we can be aware of them is through the wonderful people who go looking for them. These people are among the angels of this world. Those they look for are most likely to be dirty and smelly, out of necessity, yet these angels look beyond that and offer them help. I assume that this is a problem which exists throughout the world, with the size of the problem depending very much on the number of people who go looking for them and are enabled to offer them help. This help currently cannot always be in the form of shelter, food and necessary medications, due to financial restrictions.

So what is this new group I recently joined hoping to do about it? Firstly we need to know how big the problem is and we need to contact those with knowledge in this field to get this information. The next step is to make people living in our city  aware of the problem. I suspect that many, hopefully most, will be prepared to lobby their politicians to provide the money to address the problem. With an election a few months away this is an ideal time to be highlighting the problem.

Will a solution to this problem through provision of low cost shelter and access to health professionals be the answer to the problem and nothing more? I suspect not. It is easy to dismiss the homeless as no hopers but I suspect that this is not always the case. I suspect that we will find that many of them will be in this situation through no fault of their own, bowed down by numerous disasters in their lives. We could end up as the beneficiaries of solving the problem if those assisted are enabled to lead useful and rewarding lives. At least those who are assisted will have the opportunity to live better lives. Well worth researching the problem and solving it.

 

I have recently joined a group which is interested in this topic so I am on a sharp learning curve. Being older has its restrictions but not having a place you can call home must make the problems even harder.

I now realise that the topic ‘Homeless’ actually covers two different groups of people. One group have no specific place which they can label ‘home’ but can usually find a place of shelter, the other group are what we normally regard as homeless and literally sleep wherever they can find some shelter from the elements, such as under bridges. This latter group is of real concern, particularly when we mix it with the ageing process.

The sad part is that what I suspect is a very small minority actually prefer this way of life. Some years ago I saw a documentary about one such young man with a respectable job who suddenly got tired of what he felt was a controlling life and took to the roads. His family never knew where he was but every few months he would turn up at the family home, clean himself up, eat well for a few days, and then set off again, living off whatever he could find beside the road. We have to respect people who find fitting in with modern life oppressive but our concern must be with those who don’t have a place to live, not out of choice.

The homeless group includes all ages, including young people who live by surfing couches at friends homes but a homeless life is particularly hard for vulnerable older people who, among other problems, are more at risk of health complications. In the next few weeks I also hope to interview someone who has specialised in the beginning of this problem, recognising impending homelessness and trying to prevent it.

Our winter nights here are particularly cold, with below freezing temperatures the norm. Some of the homeless are likely to find shelter in accommodation provided usually by charities who specialise in this work. If there is enough of this the problem is partially solved, although I also hope to interview the providers and find out what the situation is in my own rather wealthy city. My main concern is with those who can’t find even this type of accommodation and have to sleep in their cars, if they have one, or rough on the streets, particularly if children are involved.

If a city or town has managed to solve the problem for its own residents then another problem arises. The homeless in surrounding areas hear that if they go to that particular centre they will find accommodation of some sort and it becomes a bottomless problem. I’m not sure what the answer to this is.

I look forward to being part of this group as all the members either work in this field or are keen to try to find a solution to the problem. Some years ago one charitable organisation in another city, Melbourne, had provided small housing units for the elderly homeless. I will never forget one resident saying it was the first time in her life she had had a key to her own place. In other words a place where she and her belongings were safe. If only we could make this a world-wide goal.

Come with me on my journey.

The last couple of decades in particular have seen us make huge advances in communication and other areas of technology which seem to have affected the lives of many people in the world. The ones who have missed out are those who seem to miss out on everything- food, clothing, shelter and medical expertise. And we don’t seem to care.

Does humanity have to be like this? Is there one country in the world which is going against the trend and reducing the gap between the top rich 1% and the bottom poor 1%? If there is such a country I would guess that its leaders are not rich, as are currently the leaders, and potential leaders, in the most influential countries in the world.

Citizens in the USA seem to be heading in the direction of having to choose between two rich citizens for their next leader even though I am sure that there are many, many, people who would make better leaders because they have more knowledge and ability and are not tainted by being money addicts.

So many countries in the world have this problem of admiring the rich, presumably because they wish they were in that position themselves. In Australia the media is listing the top people on our rich list presumably lauding them for having this particular trait, which in the field of medicine would be labelled an addiction. In the past so many rich people have used their wealth to honour their names and families by putting their money into charitable trusts or noteworthy buildings, both of which honoured their memories for generations to come. Today’s rich seem more intent on spending as much of their wealth on themselves and leaving their offspring in the same situation rather than leaving a lasting memory. Is this because the Christian church, which encouraged the former behaviour, is no longer as influential as it was?

Is there no one today with the power and influence to encourage a fairer sharing of resources? Could I be right in feeling that if we did have fewer rich people and fewer poor people the world would be a much better place? We can’t just assume that those at the bottom leg of the ladder are brainless and untalented. Many of those who have reached the top today have done so because they got a leg up and opportunities from their rich families, rarely just from their own abilities.

Could we measure the degree of success of today’s world by the extent to which the basic necessities are available to all, and all have access to a good education and the opportunity to make use of it to the best of their ability? If we could make such a measurement I suspect today’s world  would end up with a big ‘FAIL’.

This isn’t good enough. In the past the plague affected everyone, rich and poor, and today’s superbugs are threatening to do the same. We need to pull together to make this world a happier successful place which we all share. Technology and other modern advances can’t do this on their own- it needs a caring human race to facilitate it.

This week, for the second week in a row, I have visited a small country town in Australia. This time it was Dubbo, a small inland town with about 36622 residents and a catchment area of 130000. It is a farming community although currently they are in the midst of a prolonged drought. The drive there makes you aware of why it is currently called a dust bowl- the landscape has a cloud of dust above it.

At one point I was trying to find the local shopping centre and asked directions of a lady who turned out to be a leading light in the town. She was going to the same place and we chatted as we walked there. Before we parted company she gave me an 8 page pamphlet, published by the local people, of all the events in town they were organising. There were about 30 listed, from gardening groups to writers, musicians, a historical society, arts and crafts, theatre, dining, to cooperation with the Sydney Opera House. What a vibrant community.

This made me realise how important local communities are and that this is the major problem with our cities. I am not sure what city planners are concerned with, I can only assume it is with roads and transport and housing siting and other non-human items. This lack of acknowledgement of the human needs of city dwellers is what makes them the disastrous places they usually are, particularly for older people.

My suggestion is that we design cities, and renovate them, in terms of smaller designated areas round a central hub, probably with local shops and some form of meeting place. It would be an area which allowed, and encouraged, all the activities currently Dubbo makes available to its citizens. It would be designed around humans, not merely convenient areas for the provision of water, electricity and other local governance responsibilities. If we put people first we will have much healthier and happier communities.

This is not a dream world idea although it will be difficult to implement initially, simply because it has always been a neglected area of city life and planning. When cities first developed they were created in the interests of the manufacturers who needed a large supply of workers for their factories. Workers were merely commodities. We have now evolved to the stage where workers are recognised as people who will work better and more creatively if they are treated properly. They will also be healthier and happier. We have centuries of catching up to do in our cities.

My final morning in Dubbo was surrounded by a cloud of female motorcyclists (and their partners). They were meeting at the local showground. If they could get 900 of them together it would be a world record. Apparently they held it 2 years ago but the Brits took it off them! What struck me was what a happy group they were, pleased to be together joining up with other bikies from across Australia. Needless to say this good news event didn’t hit the national news. After all, they were regarded merely females and bikies, not young women harmlessly enjoying themselves, passing on their pleasure and enjoyment of life to others.

 

I have attended 2 functions this week which were dealing with the way older people are treated, in very different ways. One was  research from two universities, the other by people researching care both in the community and in residential care. The different contributors showed very different approaches.

The two University studies were about intergenerational interaction. The first proudly described a project in which children’s play areas are built near aged care facilities. I got the impression that the older people had not even been consulted. Given that some older people, particularly the fragile, do not like boisterous children around them, I felt that this is very much a ‘client’ program.

The second study was from the University of Queensland. It linked older native foreign language speakers, in this case Chinese, with students in years 11 and 12 who are learning this language. It meant that the students heard the language from native speakers and also learned about their culture. For their part the older people felt that their lives were suddenly more meaningful. They had an important purpose in their lives. A win/win for both groups.

The second function united researchers looking at assistance for older people, with older people using these services, particularly those living in the community. It provides a link between the bureaucrats and the customers or clients. One person in the group objected to these words, pointing out that we are actually ‘people’.

The main problem in Australia seems to be the ability of older people to access information, finding out what help is available. Given that home care is much cheaper than nursing home care it is a major problem. There were complaints about telephones not being answered, and web sites that were hard to use. This is easily blamed on the lack of computer knowledge on the part of older people, not considering that it may actually be a problem. From my own limited experience the fault lies with the on-line programmes which are usually very badly written, making them inaccessible. As long as older people, not the programmes, are being blamed little is likely to change.

Some of the comments described older people who needed help showering at home having to wait long hours, in one case until 5pm, for the provider to arrive. Another was of a newly arrived resident in a nursing home being told to go to bed at 7.30pm. She protested that this was not her custom. She was told she had to because they all had to be in bed before the carer could end her shift and go home. The carer settled the impasse by turning the light off. This was appallingly dangerous. Let’s not rush to blame the carer. The fault is with management which created this rule. There are so many stories of inadequately trained, uncaring management it is time such problems were addressed. Where management in any workforce situation does have the necessary knowledge and attitude, sick days and staff turnover are greatly reduced. It is more profitable!

Meanwhile the voices of older people must be heard in any situation in which we are involved. We are people! Such an attitude creates a better, more efficient, happier  and cost-effective world for all involved.

 

The other day I was reminded of an incident when I was teaching College students in their last couple of years of school. One of the students came up to me to tell me she was quitting. When I asked why she said that everyone was picking on her and she couldn’t take it any more. Today we would recognise it as bullying but fortunately we weren’t using that word then otherwise there would have been a standard response. Instead I told her to take a good look at herself. Her head was down and her shoulders scrunched over; I imitated her. I told her to hold her head up high, hold her shoulders back and look people straight in the eye. About a month later she bounced up to me with a big grin on her face to tell me that it had worked! She was enjoying life again.

I was reminded of this the other day when I heard a comment that as we age our spines can take on a new configuration, referred to as stooping. My own back was starting to hurt so I remembered some exercises I had been given a few years ago and started doing them again. It certainly helped.

I began to wonder if, as we age and begin to stoop, we become like my student, feeling that people are looking down on us. If the rest of our bones lose their strength then it makes sense that our spines are likely to do the same. Worse still, our early ancestors moved with a horizontal spine!

I have long advocated that there should be clinics for older people so that we know what to expect as the years take their toll, and do something about it if possible. Almost 10% of patients over 65 in hospital are there because of falls so why aren’t fall prevention measures available to all in this age group, just to mention one aspect of ageing. Preventative medical care would appear to be much cheaper among older people than the current system of dealing with a problem when it happens but those responsible for our health don’t seem to be able to work this out. Meanwhile is stooping as a result of ageing, and the public reaction to it, just another contributor to ageism?

It reminds me of a lovely story I heard some time ago. A young lady was out with her mother who was muttering “hold your shoulders back” at which the irritated daughter said “Mum, I’m an adult now”. The mother’s reply was “I’m talking to me, not you”.