I have written a lot about the neglect of older people in the NHS, in residential care homes and in their own homes. My blogs have been stimulated by the many reports over the last twelve months of malnutrition and dehydration in our hospitals; poor quality care and downright neglect in both hospitals and residential care homes. Recently another report by the Equal Opportunities and Human Rights Commission confirms that care of the elderly in their own homes is abysmal too.
It’s depressing, shaming and overwhelming. Where do we begin to put it right? Especially at a time when the Government tells us there is no more money.
Firstly, let’s start by accepting that it’s all our fault and all our responsibility. Care of the elderly starts with us.
When we are really young, we should cherish our grandparents – they are a font of knowledge, wisdom and experience, if we only take the time to listen. They are free life experience. Mentoring consultants whose successes and mistakes we can learn from and grow. For those who no longer have grandparents, there are plenty of older people alone out there we can adopt. A little support offered – a lift to the doctors, assistance with shopping or just a chat over the garden gate, are the first steps of a more engaged society.
We have to also start with ourselves, because delegation or abnegation of responsibility to the State / Government clearly doesn’t work well and is destined to only get worse if we carry on as we are. Particularly given the numbers of older, older people is set to grow exponentially in the next twenty years.
As we reach working age we need to start saving much more for our own old age, now that we know we can expect to live much longer in retirement. Maybe 30-40% of our income needs to be squirreled away for our later life years. OK, some of that may be used to buy a family house, provided that later on we accept that downsizing to a smaller home or even renting in retirement is a necessary means to liquidate our savings to pay for care and support if and when we need it.
None of us know how healthy we will be in later life. The working age implication of this is that we need to insure ourselves, particularly to cover the cost of long-term care. We also need to take a more preventative approach to our own health. There are established and accepted links between issues like smoking and cancer, obesity and diabetes which we could heed and save ourselves a lot of pain and expense in later life. The prompt to take notice might be the cost of long-term care if in future we can no longer rely on the State. Long term care insurance companies could take a more proactive and holistic view of health insurance and focus on well-being rather than ill-health.
How much better our health care system would be if GPs, instead of just responding to ill-health issues, were also charged with promoting health and well-being. Providing annual health checks for everyone and developing a personal health plan. A good place to start would be with the older population who are more likely to be susceptible to health problems. Certainly those who can afford to pay for regular check ups are more likely to have a positive attitude to looking after themselves. They are also more likely to discover problems at an early stage.
This new vision of health care in the community starts with a Health Care Practice, ideally located inside a fitness centre so the elderly are part of an all age healthy life style. There is a friendly and welcoming, smiling receptionist who makes you feel like a customer and not a nuisance to the busy doctor. Tea, coffee, fruit juice while you wait – and today’s newspapers rather than long out of date magazines. A well-being nurse to see you first and routinely measure your weight, blood pressure and take blood tests. Then an on time and unrushed appointment with your personal GP – the one who deals with all your family and has done for years. Someone who is familiar with your health history and doesn’t spend all of the consultation looking at a computer. A friend who is aware of the importance of motivating you to look after your health by communicating effectively and ensuring you understand what you can do to improve your well-being. You then leave with a health plan supported by helpful and easy to read literature. The plan will be followed up with you by the well-being nurse at least twice before you see the doctor again in a years’ time – all being well.
So that is the beginning of my new vision for later life – an annual health check up and a monitored health plan funded by those who can afford it or by their private insurance companies in exchange for lower health care premiums.
I will come back to how we deal with those who can’t afford it later.