“New Vision of Later Life” 1

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.


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17 Responses to “New Vision of Later Life” 1

  1. John a very interesting blog, and as always with deep insight. Iit has taken me years to understand openess and freedom of thought about ones health (Wealth) and well being. As I am now in my golden years I appriciate that I would like to be aware of my health problems and how to cure them. I do have to be realistic and may not like the diagnosis, but this will help me understand what I have to face.
    With or should I say in my working life in my early 20’s, newly married and with a young family, an insurance policy or assurance policy was my means of provision for my family. You state that with a little money one is able to be aware of ones health problems? If I refelct back to my younger days I was very worried if I became ill and could not work: It was not the fact of becoming ill one had to face but society did not encourage those of limited ability to seek a worthwhile return in the work place to help feed and keep clothed and housed a young family. The employers attitude which I am proporting to was one maybe of ignorance then, but of washing their hands of you, and leaving you to the state and private means. As for another meanful way of employment it was very difficult once one had failed health wise. Hence I was cynical of health checks while younger.
    I do not think this is the case today, but just in case one falls between the gaps through no fault of their own: Then I suggest we need the NHS and the Welfare State benifits of a reasonable level for all, without out bias. I do appricaite those with money may determine to their own satisfaction what help they may need so NHS and Welfare State should at least have an upper level at which an Income is not subsidised by the state! for health care and welfare benifits.!
    As you so rightly point out for me my parents told myself and my siblings and our own families if possible work hard, with loyalty and again if you can buy bricks and mortar and use this property as an assurance in old age> This is fine so long as your health holds out: If you have problems the mortgae of 25 years and your own security left you to the devices of the state! Here I think while I was fortunate health wise i do reflect that the state/Society needs to provide some assistance for the more unfortunates of life. I do not mean the work shy, or wasters but those whose misfortunes are made by god and not man.
    I am very dubious for the reasons of cyisiism that the health records of all are being web based. Great for the health service and the employer and insurance/finance industry, but what about the individual. I suspect it is a tactic to have central statistics of the general health of the UKplc, and the future investment needed to have a meaningful health and welfare system.
    Modern medical science has enable more persons of less health ability to enter the workplace,May be?? and if the income is not available by employment to sustain a meaningful life? Then where does the moneies come from.
    My soap box endeth.

  2. Maureen o'Neill says:

    Talking to my brother who lives in a pre-war semi-detached in a suburb of Bristol he said that neither he nor his wife would like to live anywhere else. All the neighbours seem to look out for each other, they shepherded in an old lady who regularly came out with no clothes and called her son to help, They do shop for each other and when my sister in law was ill she received on two occasions flowers from the Neighbourhood watch. If one is away the neighbours put the bins out and return them afterwards. They shop for each other if one is ill and always let you know when they are going away. They are not all old or young. A man and his wife have gone to Mexico for a fortnight and left the sons at home. Like all young people the bins did not get put out as they forgot. The neighbours have just put the holidaymakers bins out which should remind the sons when they have to put them away.

    .My brother has a very caring doctor and although he is not a well man he walks as far as he can every day. Usually 3 miles. His doctor is caring and bothers to listen and note and gets in touch with him.
    Along the road is a secondary school and the students returning home along the way drop quite a lot of various litter, One of the neighbours goes along and picks up the litter most days and he now has a special bin in which to collect this litter

    This put me in mind of being a child , c1942, when the greengrocer delivered on a horse and cart, the milk was delivered via a churn the groceries were delivered in a cardboard box from the list and the ration book you had sent in earlier

    I recently received this e.mail – It comes from the days when we cared but didn’t realise we did.

    “In the line at the store, the cashier told the older woman that she should bring her own grocery bag because plastic bags weren’t good for the environment. The woman apologized to him and explained, We didn’t have the green thing back in my day.
    The clerk responded, “That’s our problem today. The former generation did not care enough to save our environment.”
    He was right, that generation didn’t have the green thing in Its day.
    Back then, they returned their milk bottles, soda bottles and beer bottles to the store. The store sent them back to the plant to be washed and sterilized and refilled, so it could use the same bottles over and over. So they really were recycled.
    But they didn’t have the green thing back in that customer’s day.
    In her day, they walked up stairs, because they didn’t have an escalator in every store and office building. They walked to the grocery store and didn’t climb into a 300-horsepower machine every time they had to go two blocks.
    But she was right. They didn’t have the green thing in her day.
    Back then, they washed the baby’s diapers because they didn’t have the throw-away kind. They dried clothes on a line, not in an energy gobbling machine burning up 220 volts. Wind and solar power really did dry the clothes. Kids got hand-me-down clothes from their brothers or sisters, not always brand-new clothing.
    But that old lady is right, they didn’t have the green thing back in her day.
    Back then, they had one TV, or radio, in the house not a TV in every room. And the TV had a small screen the size of a hankerchief, not a screen the size of the state of Montana . In the kitchen, they blended and stirred by hand because they didn’t have electric machines to do everything for you. When they packaged a fragile item to send in the mail, they used a wadded up old newspaper to cushion it, not styrofoam or plastic bubble wrap.
    Back then, they didn’t fire up an engine and burn gasoline just to cut the lawn. They used a push mower that ran on human power. They exercised by working so they didn’t need to go to a health club to run on treadmills that operate on electricity.
    But she’s right, they didn’t have the green thing back then.
    They drank from a fountain when they were thirsty instead of using a cup or a plastic bottle every time they had a drink of water. They refilled their writing pens with ink instead of buying a new pen, and they replaced the razor blades in a razor instead of throwing away the whole razor just because the blade got dull.
    But they didn’t have the green thing back then.
    Back then, people took the streetcar or a bus and kids rode their bikes to school or rode the school bus instead of turning their moms into a 24-hour taxi service. They had one electrical outlet in a room, not an entire bank of sockets to power a dozen appliances. And they didn’t need a computerized gadget to receive a signal beamed from satellites 2,000 miles out in space in order to find the nearest pizza joint.
    But isn’t it sad the current generation laments how wasteful the old folks were just because they didn’t have the green thing back then?”

    I remember all of that.

    Maybe John we need a return to the good old days. My brothers small area obviously has care as important in their lives.

  3. In todays Daily Mail Page 61 -Femail Section- (Tuesday 30 June 2011), is a piece on care for the elderly. To me it made interesting reading. It alledges poor ‘extracare’ by Hanover Housing in a village near Bristol.
    I am concerned they use the wording ‘extracare’
    I believe a generic term used for ‘care in the home’ under a government scheme. Hanover Housing get an earful of trouble, and by enuenduo of the wording ‘The EXTRACARE CHARITABLE TRUST’ must be aware of the allegation.
    In the case of the ‘THE EXTRACARE CHARITABLE TRUST, I am a resident and while the charity has its faults, I belive all of its villagers and residents in its schemes would be the first to protest if standard where unacceptable, as shown at the lack of care alledged by the Daily Mail Newspaper article.
    For Hanover housing I cannot speak, and they must make their own protestations to the press.
    I am not aware of residential homes, only retirement homes By Hanover Housing in Milton Keynes? Other districts may differ! I remain to be corrected.
    Extracare or ‘CARE IN THE HOMes’ managed by the government are schemes which I believed where provided by the private sector, and not the NHS or Public Sector??? Here again I remain to be corrected.
    Care for the elderly one as one grows elderly has to fight it appears on an individual basis, there appears no central or common point of contact?
    At my mothers residential home in Leeds they have a petition for the local MP to have parliament adpot a minister for the elderly, who could specialise in such issues as care and welfare for the elderly. I agreed with the petition and signed. Pen to paper, but will it only cultivate hot air and a lot of wind??? I hope not.

  4. pS One cannot start a new subject blog if one wishes? Is this deliberate?.

  5. Dear John, I believe you have the concept of a virtual village, with the possibility of becoming reality. This idea is intriguing and if it can work on a small scale-Geographically- locality-, can it be made to work in general within any society irespective of physical distance?
    This afternnon it is tennis on the telly-mens final:Great? I am rather cheesed off and need my brain to be engaged other than watching a yellow ball being hit backwards and forwards.
    My mind fluters like a butterfly, and with no reason or logic as to direction, except when it is home time I need that taste of nectar to sustain me.
    In a virtual Village I suppose one can use the web for almost anything to obtain information, and place instructions such as:
    Shopping, banking, travel, appointments at the dentist, doctor,chiropodist, opticians and other health requirements? That one may think of.
    With respect to clincs and doctors, hopitals and the like, then unless you are deaf or blind of impaired in such a way that you cannot handle a telephone, then the voice comes into its own, maybe with SKPE to the local health service? Has this too come?
    So far I have pushed my computer buttons and talked on the phone (Most likely to a machine-answer phone), so no real people yet!!
    What the ideal virtual village lacks is a population by people, and here we come distinctly to locality, and will my community listern to me, or consider offering practical assistance in arranging, talking, transport to and from the local shops, post office and bus or railway station? I may need help if I am wheelchair bound, restricted in mobility, or have a partner or dependent at home who requires company or supervision while I conduct my business outside my virtual village, in the realms of reality.
    Day to day life for all of us as we progress into our golden years require freedom of some sort whether it is of the mind or body or spirit of the soul, and it is good to bounce out of our habit/surrounds if only for a couple of hours!
    The virtual village can sustain life, and with the contact of people it can make life enjoyable. It is only the will to make it work that it lacks, so John carry on the good work, and maybe we can all enjoy the fruits of your labour, with a little imput here and there.
    Your concept of life in a village of the EXTRACARE CHARITABLE TRUST I feel is a good starting point, with a mixed age group and ability group of the over 55’s is very rewarding. Like the curate egg it is not all good but 350 people in a village all viving for life, not an existance is reward enough.
    I must go back to the tennis now 16.59 I suspect they are in the 4th and maybe playing the 5th set. Oh dear!!!

  6. PS I do talk and I do have hairs growing on the palms of my hands. Molly Loves me and Maureen thinks I am a sweetie, so I am happy, I have people to talk too? and many other villagers at Lovat.

  7. At the weekend I visited a fete of a residential complex that was for some 80+ people/residents in some50+ residencies. The event was well attended by family and friends.
    The complex did not have the facilities as I know of them in a village built run and by the management of ‘The Extracare Charitable Trust’
    In ‘The Extracare Charitable Trust’ the villages I am aware of have the following facilities in varying degrees:
    Restaurant, Village Hall, a General store/shop, a Hairdressers and beauty saloon, It Suite, Craft room, Bar, Cafe ,Fully equipped gym, meeting rooms, Alzheimer’s suite for recreation pursuits, Reception, keyed entry, reception, gardens and a greenhouse, Bowling mats out door- long mat Indoor- short mat Laundrette all for use by a resident of the village, and the social and wellbeing facilities such as the Bar/Restaurant/cafe/hall/gym and bowling mats by ’ friends of the village’ who pay a nominal fee.
    What intrigues me is the ‘Virtual Village’ as a concept being discussed by John Graham.
    What are missing from the Residential complex are the facilities listed: Which are a given provision by being a resident of a village belonging to ‘The Extracare Charitable Trust’?
    The residents are the same people in both cases, individuals and friendly souls at that.
    I believe the Virtual Village is a concept to bring into line those residences/schemes to which people belong but do not have the total facilities of a Village by ‘The Extracare Charitable Trust’?
    The virtual village has some plus points even for a village of ‘The Extracare Charitable Trust’ type to consider.
    Points to consider.
    In the village of Extracare Charitable Trust, you have persons on care, or of limited mobility, where care is provided in the home, and on occasion the individual resident may wish to be stimulated by fellow villagers and conversation, other than by care workers or friends who pop in and out on occasions.
    I am thinking of an idea where the ’ It ‘ suite is used as the transport mechanism for communications and ideas, to all those on the ‘Net’, and then maybe for the future we can have?
    Computer terminals in resident’s apartments friendly to the older aged resident, with simple keyboards, and maybe complex programmes but with simple operational instructions.
    The Computers with audio links or even skpe that can be locally net worked to one village or all villages and schemes run by ‘The Extracare Charitable Trust’ or a similar body of a virtual Village. Fitted with games programmes that stimulate the mind such as can be played with a standard 52 pack of cards (Hearts, Clubs , diamonds Spades,) and offer such games as can be conceived such as snap, patience, whist, bridge, cribbage, or other sociable card games such as Maj Jong or Rubicon, and scrabble.
    What I am dreaming about is that all players can be simultaneously connected, play the same game, and interact with audio or skpe, and that for residents of restricted mobility they may have a common time to play these games, and that the computers and programmes are rented out by the organiser (Here ‘The Extracare Charitable Trust’ or another Housing or residents association).
    This would or may provide stimulation for those less able at times when the person being cared for is not tied by meals or bedtimes.
    It is not as good as human contact and the interaction of conversation. However In some cases it may provide a solution, which one may consider? Just a thought?
    David Freeman

  8. Brandywine says:

    Great thinking! That really breaks the mould!

  9. Addrienne says:

    Smack-dab what I was looking for—- thank you!

  10. cevon says:

    Thank you for a great post.

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