“Living in the Present”

The growing number of older people with dementia is making societies all over the world reach for straws of solutions   —–    in health care services that are drowning under the pressure of struggling to cope with ageing populations.

Over the past two years, I have written about the pills and potions that lay claim to helping slow down the relentless advance of the disease (click on dementia under TOPICS for previous posts).

The NHS has almost completely given up on long-term care of dementia patients and by default handed the task over to the private sector.   Residential care homes have become the out of sight, out of mind warehouses for the majority of elderly people with the later stages of dementia.   Numerous reports testify to the low quality of care that is provided to most residents by a largely untrained and low paid workforce (click on “NEGLECT SHAMES BRITAIN” in the TAG CLOUD).

As a society, we have a  ‘hopeless’  view of dementia.   This desolate outlook  negatively colours our whole view of the ageing population.

                 It is essential that we turn this unspoken grumble into a smile.

Therefore, any attempt to do so should be looked on positively.    That is why when I recently wrote about a new project in Switzerland, which is a planned village for people with dementia, I wished them well.  (See “Living in the Past” in the ARCHIVE 16 February 2012).

Collectively we need all the help we can get to find better ways of providing for the challenge this difficult disease presents to ageing societies.    Therefore it was particularly interesting to read in The Times,  31st March 2012, of a village in Holland which inspired the Swiss project.   The project is in Hogeweg, which was opened in 2009 and accommodates 152 residents with dementia, who live communally in small group homes.   It has a range of facilities which include a restaurant, a shop and traffic free village streets.   More importantly they have a host of trained staff and volunteers.   The village cost £16m of mainly state funded money to build and it then  around £50,000 a year to look after each resident.   So this option is certainly not cheap and probably therefore cannot be easily replicated.    However, the most important question is “does it improve the lives of the residents?”   To this the answer would seem to be yes – certainly if you judge it by the demand for places – although this may well come from relatives looking for respite for themselves as much as for the residents.

The reported response from Jeremy Hughes, the Chief Executive of the UK Alzheimer’s Society, was understandably cautious and disapointingly sceptical.   He focussed on the need not to deceive dementia patients.    I think that is a somewhat simplistic view.   We subject dementia sufferers to huge indignities in the care we currently provide for them, which go well beyond a few little white lies.

Perhaps the lesson to be drawn out of all of this is that for residents with dementia and their relatives to have better lives, they need more support from properly trained staff and an active life in familiar surroundings.

To this end, taking residents to an artificial environment and grouping them with other confused residents may not be the most obvious thing to do.    Though it may be the only answer for some residents who live alone or are in in the later stages of dementia.

I wonder are we confusing dementia sufferers by taking them away from a world in which they had anchor points in an earlier life ?    Is that is why they so easily lapse back into the past ?    Surely it is better to continue to look forward, by building on a lifetime of their own experience and skills.

Then allow people with dementia to live in the present.

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“Move to the Country” 3

Two years ago I wrote a blog recommending you move to Dorset if you want to live longer.    See May 28 2010, in the Archive.

I must apologise to anyone who took me seriously and moved.   A more upto date study by actuaries Towers Watson has now suggested that Hinton St. George in Somerset is the best place to live if you want the longest life expectancy.  A man of  65 could expect to live until 88.7 and his wife of the same age will live on until she is 91.6.

The downside is that you will be living among lots of barristers, teachers and vicars, who all seem to enjoy long lives.  Still the pub quizes should be good.

Isn’t it amazing how statistics can be so useful in helping us live our lives.  I am sorry though if you have to move again, but it may give you a few more years.

For anyone reading this who lives in Bootle, you are predicted to live 5.5 years less.   So if you can afford the move to Somerset and are good at pub quizes, I should get on with it without delay.

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“A Shopping Experience”

This is one of a series of blogs which describe my trip to Japan in April 2012.  To see earlier blogs in the series, click on “Japan Odyssey” in the Tag Cloud.

Takashimaya is an upmarket department store in Kyoto.   We went there to see a Marc Chagall exhibition.   Not exactly the normal way to use valuable retail floor space !    Since we were directed to the “exhibition hall” it is evidently in frequent use for this cultural purpose.   The gallery was well attended and not full of shopping bag carrying temporarily diverted customers.

As lunchtime was approaching, we went to the food department with counter after counter of unrecognisable delicacies.   As you pass by each section, the assistants shout a high-pitched “welcome” at you, like fruit and veg market stall holders in the UK.   Walking by the fresh delicatessen counter which had about ten assistants, set them all off in unison.  Clucking like a coup of squawking chickens.

We finally found the Sushi bar and expected to go in and be able to select one or two samples of food for a light lunch.   First problem was the door again – we could not see in, so when we entered we were surprised to find ourselves in a tiny room with a counter only big enough for a dozen seats —  with a white aproned chef and only one waitress.   Next problem – the menu was all in Japanese – no pictures and no English speakers.    So we pointed at the mid priced set meal and hoped for the best.    We were not disappointed – individual bowl after bowl of food was placed before us.

It was all interesting, although we had no idea what most of it was.    After about an hour and ten courses, we were presented with a plate with one real chilled strawberry and a quarter of grapefruit which turned out to be delicious jelly.    This looked like the last course, but we were only certain when the people at the end of the counter got up and left.

Another surprise experience behind a closed-door.

Next some gift shopping.    I went to browse in the homeware department.    I obviously looked lost after ten minutes of aimless wandering and an assistant approached and offered to help.     When it was apparent I could not speak Japanese, she apologised and fetched someone who spoke fluent English and proceeded to be my personal shopper.  Each time I selected something, she picked up the plastic label off the display and someone else came and took it them away.    When I had finished my selection, she ushered me to sit down at a table.   All my selections were already waiting neatly laid out in front of me.    I was asked to check these were the correct items and then to choose a wrapping paper and colour of ribbon.    I was just wondering how I would keep track of what was in each box, when I was asked to put the name of the intended recipient on a strip of paper.  Then all the presents were taken away.    Within five minutes they were all returned wrapped, ribboned and protected with bubble wrap with the small paper name-tag labels attached.

  A brilliant lesson in customer service !

As I left, I passed another exhibition in the store.   This time a big room sparsely filled with displays of ikebana flower arrangements.   The attendants were all ladies in Kimonos.

I could even get to like shopping if it was all done in this way 🙂

                                    THANKFULLY IT WON’T BE

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“Royokan Garden”

This is one of a series of blogs which describe my trip to Japan in April 2012.  To see further blogs in the series, click on “Japan Odyssey” in the Tag Cloud.

The highlight of our trip to Japan was, without doubt, our stay in a traditional Japanese family hotel called a Royokan.  I will write about our experience in a separate blog but the one thing that stands out most in my mind, is the memory of the garden.

The interior of a Royokan is one of stark simplicity – sliding walls and doors.  Standard size tatame floor mats.  Uncarved tables and chairs and no other furniture.  The only interior decoration comes from a few Japanese prints on the wall, and carefully placed Origami flower arrangements.  Colours are straw, wood browns, white wall panels and ebony black furniture – all illuminated with subdued low-level lights.

The small internal garden is a complete contrast.  It contains a host of elements knitted into an intricate tableau of natural and man-made features.  Water meandering in a small stream – contrived into a waterfall, splashing over green moss on rocks, trickling through hollow bamboo shoots.  Rocks and stones of all shapes and sizes – a few rugged boulders, flat stepping-stones, round river pebbles on the banks of the stream.  Man-made stone pagodas and lanterns.  Verdant plants adding a green pallet – moss on the wet rocks.

 

Tussled uncut grass, ferns on the boundary between the waters’ edge and the rock scree.  Camelias not flowering any longer.  Just one flowering cherry clipped to leave a thin cloud of pink flowers.

A few large trees rising out of and above this small piece of heaven, all bounded by bamboo and plain off-white walls.

In the early morning after doing my Tai Chi exercise in the quiet slumber of a sleeping house – silent footsteps on a forgiving straw mat floor – I sat and watched the dawn break over this garden haven.  The babbling stream is the dawn chorus.  White, golden and speckled Koi Carp adding colour to the dark water.

Black silhouetted tree branches against the lightening, colourless sky.  Light splashes on the already moist rocks and wet leaves.  As the garden wakes, the sun breaks.  Just a slow sleepy-eyed dawn.  The cherry blossom not yet awake for a new day given the courtesy of a late awaking for her daytime glory.

The designer who put this together was a genius.  Nothing and everything new each day – timeless beauty.

A CALM PLACE TO CONTEMPLATE

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“Tidy Japanese Style”

This is one of a series of blogs which describe my trip to Japan in April 2012.  To see further blogs in the series, click on “Japan Odyssey” in the Tag Cloud.

When I leave my hotel room each day I try to leave it tidy, but my idea of tidy falls a long way short of tidy by most people’s standards.  Certainly my wife tells me frequently enough.  That said by Japanese hotel standards I am not even close.  They do all the things that any hotel housekeeper does – replace the used towels, clean around everywhere, make the bed and put clothes back into wardrobes and draws.  Nothing unusual about any of that.

However, there are noticeable differences that go beyond that in Japan.  Immediately you walk back into your room the curtains haven’t just been drawn back, the lace shear has been evenly pleated so precisely that you assume it must have been done with a ruled template.  Similarly, in the bathroom, they haven’t just replaced all the soaps and lotions you have used, but a new variety of bath salt – “herbal” has replaced yesterday’s “citrus” – to bring you health and happiness.

Towels have been refolded and placed long on the high rail and short on the low rail.  Used dressing gown, not just hung up but expertly folded and tied with the belt as it was when we first arrived.

Tissues are all triangle tidy, as are the toilet rolls.

Even my toothbrush, toothpaste and razor have been repositioned with all the other items to match the alignment of the sink basin.

It makes you want to keep the room tidy yourself.

MAYBE THAT’S THE LESSON

P.S.

It does not stop there  —-  all hotel corridors are spotless and clutter-free  — except for the occasional decorative item.  Here are some examples :-

This last one is something really special 🙂

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“A Guided Tokyo Tour”

This is one of a series of blogs which describe my trip to Japan in April 2012.  To see further blogs in the series, click on “Japan Odyssey” in the Tag Cloud.

Like our hotel door to 16th floor lobby experience, we emerge from the underground into the light of a Shinto Shrine.

Our Meewa guide turns out to have an encyclopedic knowledge of the Meiji Shrine.   The park was built near the beginning of the 20th century with trees planted by 10,000 volunteers.    90 years on it is one of the three largest man-made forests in the world.    The others being the Bois du Boulogne in Paris and Central Park in New York.    We enter through a massive wooden gate constructed with two single cedar tree posts brought from Hong Kong.

One of the first things we saw on the pathway leading up to the Shrine, were offerings to the many Gods.  There are 180 Shinto Gods and judging by the wall of Saki barrels that were left for them, they must have been heavy drinkers.

As we walk up the wide paths through the wonderland of specimen trees, we occasionally pass a be-masked fellow wanderer, surely missing the point of this fresh air lung in the city.    On the approach to the Shrine, the path widens and is framed by an advertising hording sized gallery depicting the history of the park.    Even the people with masks stop to admire them, but they still don’t take their masks off.

At the next turn in the path, a man with a rake has a Forth Bridge job of raking flat the loose gravel scuffed up by all the visitors.    He shows no sign of concern about new visitors approaching his freshly levelled work, more like pride that they can walk on a smooth leafless path.    His job is to keep the path looking today as it did on the day he first started in the job.    Change is in the hands of the God of the Seasons.

Before we were able to enter the Shrine, we had to cleanse ourselves of any impure thoughts.  There is a small washing place and Meewa shows us the ritual of washing our left hand first, then our right hand, then cupping water into our cleaned right hand and swilling our mouth.  I don’t know if it worked but we tried.

After this, there are no more photographs as you weren’t allowed to film inside the Shrine.

The Japan Odyssey continues as we emerge into the more commercial world of Tokyo again but with one final surprise just outside the entrance.  I saw in the distance a familiar building which was locked way back in my mind from my early architectural training.  A building designed by Kenzo Tange for the 1964 Olympic Games in Tokyo.  This swimming pool design was so outstanding that it instantly brought back the impression it had made on me all those 38 years ago.

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“Grumble Day or Smile Day”

How you feel when you wake up in the morning can often determine your outlook for the rest of the day.  Today I am in London for a meeting, staying in a modest no-frills backstreet hotel.

As usual, in my slow start early morning daze, I stumble and fumble my way through shaving, showering and dressing.  Too early yet to form an impression of the day.

Somehow I navigate my way down the lift and through unsigned corridors to the restaurant for breakfast.  A smile from the waitress, seated and tea-ordered, my new day begins.

     NO SAUCER  😦 my cup on a not-quite formica table.  American style economy without American style bountiful breakfasts, and make-my-day smily service.

My more modest two poached eggs on brown toast arrives,  — with extra toast that will be cold when I get to eat it   😦

Then the background music plays Roxette’s “It must have been love”  🙂   That rescues a smile and evokes memories of great times in the early 1990 days of ExtraCare.  Driving around the Midlands opening shiny new nursing homes and recruiting lots of fresh-faced, eyes wide-open, new-job staff.  Singing to the car stereo as I went.  As the song says, “It must have been love, but it’s over now”.

                                HAPPY MEMORIES   🙂   🙂   🙂

Maybe this hotel is not so bad after all.  Ten flavours of yoghurt, a variety of French croissants, ham and other cold meats, and fresh fruit from all over the world – apples, oranges, bananas, pineapple and strawberries in February 🙂

Now to finish with my cold toast and little jars of jam – raspberry jam, apricot jam, strawberry jam, blueberry jam……….BUT

                NO MARMALADE  😦  😦  😦

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“Underground Tokyo”

This is one of a series of blogs which describe my trip to Japan in April 2012.  To see further blogs in the series, click on “Japan Odyssey” in the Tag Cloud.

Greeted in the hotel’s 16th floor lobby by our guide for the day, Miwako — call me “Meewa”; nice lady, very good English.   How did she spot us?   Maybe we were the most casually dressed —- or just taller than most around us  —– or the most obviously bewildered ?

After a brief introduction, we headed off to the underground station.   All 5′ 2″ of Meewa leading the way at a fast pace, with her two black clad minders strolling along behind her like obedient camp followers.   When we get to the subway station, our obedience becomes ever more attentive as Meewa weaves in and out of the crowds of morning commuters.   Getting lost down here is not an option.   The Japanese signs are all indecipherable and the English translations are unpronounceable.   Meewa’s suggestion to follow the green symbols would be ok if we could spot them, but in this melee there is no chance.    So we hang on to the sight of Meewa’s fast disappearing white coat.

When we get to the platform, its narrow and full; every inch of the side wall has a body pressed against it like wallpaper.   We find an alcove where there is a little room to form a queue behind our leader.   As the train arrives the doors open on an already full train.    No-one gets out, and with a big slurp the train sucks the wallpapered bodies off the tunnel walls and into the even fuller train.    We squeeze in behind.    Sardines couldn’t do any better!

Once inside, its standing room only, with handles drooping from the ceiling for people to steady themselves, although there is no chance of falling over.    The handles are just at the right height for Tom and I to bang our heads on them as we pass each one.    Maybe now we can see a reason for masks — one sneeze and hundreds of people will catch a cold !

After several stops and a change of train to a slightly fuller one.   We reach our destination and the escape from the underground burrow begins as Tom and I chase the rabbit in the white coat.

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“First Steps in the Ginza”

This is one of a series of blogs which describe my trip to Japan in April 2012.  To see further blogs in the series, click on “Japan Odyssey” in the Tag Cloud.

The first day in Japan is still not over and at 3pm we venture out onto the streets outside our hotel in the Ginza area of Tokyo.

A bewildering mixture of people, unreadable signs,

luxury designer label glitzy shops,

restaurants with windows full of plastic plates of food, sushi everywhere, lots of noodles.

Bars with stairs leading up to the first floor or down to the cellar, but if they are on the ground floor, they have solid doors so either way you can’t see what you might be walking into.  It is similar to the hotel entrance but you’re less confident of the outcome.

A queue out of nowhere, at least a hundred yards along the pavement outside some big shops.  Must be a sale – but no, when we reach the front of the queue – NOTHING.

Walking by on the pavements are lots of small people – men average around 5′ 6″ – women more around 5′ 0″ and most women do not have high heels. Most of the men are in suits and ties.  The women are much more varied – most with coats (it’s a cold, spring day) topped with scarves or shawls/throws, nearly all with boots either knee or angle length.  Many of the ankle boots are topped with frilly lace or animal fur.  Younger girls often wear socks to the knees.  Overall there is a smartness about the place – jeans and open neck shirts don’t seem to have blessed Japan yet.  Very occasionally you see a kimono which looks very elegant.  Just once I caught a glimpse of an elderly couple both in kimonos.

There seems to be very few tourists, certainly not European or American.

The biggest surprise was to see lots of people walking towards you wearing a large white surgical style face mask.  I had already heard about it before I came, but it is still a shock to see so many people with them.  You see them outside and inside shops and offices.

Explanations given to me include:-

  • Protection against pollution
  • Protection against getting infections
  • Protection against giving infections
  • Protection from pollen
  • Providing modesty for girls

None seems very convincing for such a dramatic appearance.  Yet at least 30% of people seem to wear them.  Strange!

I did see one green mask on a man who I suppose could have been a travelling surgeon.  I also saw one girl with a very fetching leopard skin mask who must have been a model I guess.

End of a very tiring first day in Japan.  Brain scrambled and befuddled.

MAYBE I IMAGINED IT ALL ?

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Japan — Stranger First Impressions

This is one of a series of blogs which describe my trip to Japan in April 2012.  To see further blogs in the series, click on “Japan Odyssey” in the Tag Cloud.

Our Tokyo hotel is the Mitsui Garden Hotel in the Ginza district.  You enter through an uninviting closed solid panel door at the bottom of a 24 storey office block.  It opens automatically when you approach, but no concierge is at the door to greet you , just a starkly bare and small lift lobby.  One “up” button on the outside of the lift and inside just one button with “16” on it.   A controlled and controlling entry.

The lift opens onto a spatious lobby on the sixteenth floor, with a panoramic view of the city and Tokyo bay.   A brilliantly set up piece of design !   The reception counter is minimalist  —  a brown topped counter, with no clutter to be seen anywhere.    Three reception staff who must be related to the taxi driver — black trousers, white shirt, black jacket, black ties  — no white gloves.   Check-in only takes a few minutes, then with a smile and a bow of the head, you are presented with a plastic card and shown to a second lift.

The second lift lobby is as stark as the first, except the lift has more buttons and there are three lifts.   Only problem is none of them work 😦 not until you realise that you have to use your plastic card to summon the lift 🙂  Tommy San, who is practically Japanese by now, quickly realises this is a proximity card.   (We are both jet-lagged after 20 hours of travelling and a nine hour time change.)    Then the lift doors open  — in we get — more buttons 16 to 24.    We press 19, but the lift is broken again  😦   the button lights up but the lift does not move  😦   The lift does speak to us, but it is not helpfull as it is in Japanese  😦    Then Tommy San realises that we have to use the proximity card again  🙂    I’ll bet no-one breaks into Japanese banks.

Up on the 19th floor we arrive at our rooms.   Tommy San is into his straight away.   I take a while to understand that swiping the card doesn’t work.   Inside the room the magic card becomes a light switch.   I have seen this before, so it wasn’t a surprise.    Except that there are no other light switches  ?????    Eventually I find one for the bathroom, but once inside that’s a whole new technological adventure.    The loo has a control panel like I imagine the cockpit of the space shuttle.   Only the instructions are all in Japanese —  an inconvenient convenience.    A simple chain with a pull handle would have been good enough for me.   The control panel also has pictures, but I don’t know what they mean either  😦     I decide to press the one with a capital W.    This turns out to be a bad idea, because a fountain of water spurts out of the toilet.    Thank goodness I wasn’t sitting on it at the time !   I only manage to  stop the fountain by pressing another  W.    By now the toilet is fully illuminated and the seat is getting hot.    It is only a matter of time before we go into orbit.   I don’t figure out how to flush the loo until I accidently lean on the control panel, at which point there is a loud  WOOSH.   This must be the take off.    Several days later I am still learning how to drive the loo.

One more surprise came with another anonymous button, with a clue in English  —        ” Press this switch to enjoy the view” — curosity got the better of me.  With one touch I am standing in the bathroom as the opaque glass window becomes transparant and I have a view onto the world outside my bedroom window.   Fortunately there is no-one looking in from outside the 19th floor !   Although I do wonder if there are lots of telescopes in the distant office tower blocks ?

And this is still the first day !

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