GrumbleSmiles

“Bolt from the Blue”

Posted on September 16, 2014 by john graham

I do hope Scotland does not go independent, otherwise we may be deprived of some of the pearls of wisdom being released at the moment about the virtues of exercise, which no doubt were timed to coincide with the Commonwealth Games in Glasgow.

Researchers at the University of Dundee did high intensity training (HIT) with older people – six second sprints on an exercise bike only twice a week. With this short burst of exercise they found that pensioners significantly improved their physical fitness and lowered their blood pressure.

Helpfully, one of the researchers explained that “you do not have to go at the speed of Usain Bolt”. I guess that is just as well, since running 100 yards in less than 10 seconds is probably quite challenging for someone over 70.

The Catch 22 in this new advice is that they recommend that you consult your doctor before HIT training. Perhaps you could run on the spot while waiting to queue for an appointment.

Posted in HEALTH | Tagged research | 1 Comment

“Take Less Pills”

Posted on September 14, 2014 by john graham

Another presentation at the Age UK Later Life Conference this year was a senior doctor giving some surprising, unusual and rather contradictory advice.

Dr Charles Alessi is Public Health England’s Lead Advisor for preventable diseases and also Chairman of the National Association of Primary Care. Here is the gist of his argument:-

Modern medicine treats patients as conditions rather than people;
Doctors should stop practicing medicine by body part which leads to over-prescribing of many drugs;
Older patients need to be more resilient and take control of their illnesses by leading more active lives;

I would agree strongly with all of this but there is a big BUT:-

It is surprising when you think that all his colleagues spend all their time giving out millions of go-away pills in ten minute consultations every day (except weekends and nights and some afternoons, that is);
It is unusual to suggest that patients should take control when you should be able to trust your doctor to know best and not prescribe you things you do not need;
It is contradictory to tell doctors not to treat body parts individually when they tell you in prominent notices in their surgeries “only one condition per consultation”.

The lady pictured in the cartoon is my friend “Pilly Galore” who I first commented on in a blog with that title on the 19 December 2010. Click in the Archive on that date to see the blog or click “PILLS” in the TAG CLOUD to see other blogs on this subject.

Dr Alessi is a rare voice of sanity in a health system of mixed messages but will anybody have time to listen?

Without more focus in the NHS on prevention rather than cure, patients will continue to live their ill-healthy lives.

Posted in HEALTH | Tagged "Pills" | 1 Comment

“Fruitless Effort”

Posted on September 11, 2014 by john graham

I have spent a lot of blogging time over the summer extolling the virtues of eating more fruit and vegetables. (See all these blogs by clicking on “EMFV” in the TAG CLOUD).

All of my efforts were based on Government advice given out in April this year that five a day was just not enough and you needed to eat seven portions of fruit and vegetables every day to stay at peak dietary health levels.

Goodness knows five was hard enough but seven took a lot of eating. Plus the persistence to find all those choke berries that no-one had ever heard of in the village corner shop. Then there was all the miles walking up and down the aisles at Tesco and Sainbury’s and Morrisons and Asda and Waitrose and Aldi and Lidl. Thank goodness for the wife – she’s a treasure and two stone lighter after all that exercise.

What a pity then that a researcher studying all the other researchers studying fruit and veg has now concluded that seven a day may be going a bit too far because the benefits of extra fruit and veg level off with higher consumption.

Mind you this later study was based on data from 833,000 people and was collected over 26 years. So those people probably explain why so many supermarket shelves are empty of all but the bruised fruit at the end of the day.

The study of studies was done by the nutty Professor Hu of Harvard School of Public Health. He still recommends eating lots of nuts. So as I will not be eating so much fruit and veg in future, I have asked the wife to stock up on family size bars of Cadbury’s whole nut chocolate which as the jingle goes ……………..

“Nuts, whole hazelnuts, Cadbury make them and they cover them with chocolate”

So now I’m totally confused with all this Government advice and have no idea whether I will be more or less healthy without all the rabbit food. But I am fairly confident that I will be happier with all the chocolate.

Posted in HEALTH | Tagged "EMFV" | 3 Comments

“Early Dementia Signs”

Posted on September 9, 2014 by john graham

Promoting an active lifestyle for older people has always been the central theme of my working career over the last thirty years.

In your working life, it is your job that drives you to get up early in the morning, rain or shine. When you retire, the loss of this strong motivation needs to be filled. Initially most people have a backlog of chores around the house to do, in between the holidays and trips that were put off while you were at work. This immediate post-retirement period has its own momentum while you enjoy the new found freedom from workday responsibility, but then what’s next ?

The transition into long-term retirement has no road map – you have to find your own way. Family, volunteering, hobbies or a new interest all offer answers that fill the early years after work.

An interesting piece of research at The Institute of Health at Maryland in the USA studied older peoples’ lives in retirement. They gave MRI scans to over 4,000 people with an average age of 76 who specifically did not have dementia or depression. They studied levels of apathy amongst the group by asking them questions about their current lifestyle. Indications of apathy were – lack of interest; lack of emotion; dropping activities and interests, preferring to stay at home and having lack of energy.

They found a correlation between those people with a high number of indications of apathy and accelerated brain disease.

The moral of the story:-

Posted in Dementia | Tagged research | 2 Comments

“Be a Jitterbug”

Posted on September 7, 2014 by john graham

A small piece of research by cardiologists at the University of Texas has profound implications for the care of the elderly, although probably no-one, including older people themselves, will jump up and take notice.

The research found that getting up and moving around can stop your fitness from dropping and keep your heart healthy. The study concluded that sitting down for two hours can be just as harmful as 20 minutes of exercise is beneficial.

The reality for many elderly people, especially those in residential care homes, is that there is nothing to do but sit around all day. So while we are supposedly caring for people, we are actually doing them more harm.

Care needs to be focussed on maintaining an active life. The good news is that it does not have to mean joining the gym or walking 5 miles a day. Great if you can do that but just taking a few small steps frequently can at least maintain your current level of fitness and keep the grim reaper away for a little longer.

This implies a radically different approach to residential care, where currently the focus has become safety first. Where care plans concentrate on ensuring you take your pills and where bowel movements have become more important than getting out and about.

Active care plans challenge residents and also staff. Residents deserve more out of life than a rocking chair that no longer rocks.

Posted in HEALTH | Tagged "A Health Ladder" | 1 Comment

“It Pays to Die”

Posted on September 4, 2014 by john graham

Inheritance tax is your final tax bill, easy to put out of your mind because it is only paid after you are dead. At one time it was only paid by the very wealthy, but as home ownership has become more widespread and as property prices have escalated, more and more people are drawn into it.

Currently you need to leave a legacy greater than £325,000 to pay it. In 2012-13 it is estimated that 15,976 estates paid inheritance tax, which is only 3% of all deaths in the year. Nonetheless, this totalled up to £3.4 billion.

By 2018-19 the Office of Budget Responsibility expects this to rise to £5.8 billion.

If you are a Government hell bent on austerity, this is a powerful incentive for a much more aggressive policy on euthanasia (oops ! ….. assisted suicide). And as a collateral benefit, we will save a lot more money spent on the NHS, if there are less old people around.

Posted in ELDERLY UK POLICY | Tagged assisted suicide | 2 Comments

“Greasing the Slippery Slope”

Posted on September 2, 2014 by john graham

Lord Faulkener’s Bill only passed its second reading in the House of Lords in July this year. This Pandora’s coffin has been opened and now the elderly must face the consequences. Furthermore they may not even have to wait until the Bill reaches the legislation stage.

The subject of assisted dying is no longer taboo. A cardiologist in Heart of England Hospital in Birmingham has been widely reported as advocating allowing more elderly people to die, particularly if they have a heart attack, they should not be resuscitated. This may sound reasonable, especially when his experience is that only 5% of elderly people leave hospital after being resuscitated.

The problem is where does it stop? If resuscitation is denied to older people, why not withhold Cancer treatment? Why give any life prolonging drugs to older people? It is potentially, even probably, a waste of money?

Withholding treatment is the unspoken simple way of allowing assisted suicide. No second doctor needed. No patient consent. Not even a Bill in the House of Lords.

Posted in HEALTH | Tagged assisted suicide | 1 Comment

“Switched on Granny”

Posted on September 1, 2014 by john graham

More and more pensioners are using the internet, at least according to retirement housing developer McCarthy and Stone.

Amongst 600 older people they studied, half own tablets of the computer kind, rather than those given out by their doctor. Three quarters had a laptop or a desktop computer. 47% of the study group had a Smart Phone.

These ownership figures are very high compared the UK elderly population as a whole, which no doubt reflects the fact that people who buy McCarthy and Stone homes have downsized to buy a new home and probably have more disposable income.

So, although it is not representative of all older people, this small survey is an indication of how retirement housing and the internet can open up a new life. Talking to friends with a live video link on Skype for free; watching the world go by on YouTube video as an escape from daytime TV; chatting to family / friends and sharing photos on Facebook.

It can be a more connected world out there if you switch on.

(For other posts on this subject, click on “Technology Gap” in the Topics list).

Posted in SMILES | Tagged "Technology Gap" | 3 Comments

“More Food for Thought”

Posted on August 31, 2014 by john graham

I have written a lot about the way elderly people are malnourished in hospital but it seems like senior officials at the NHS were out to lunch at the time.

See the previous blog – Food for Thought – by clicking on June 2012 in the ARCHIVE.

Dr Liz Jones is Head of Patient Experience at the Department of Health and is responsible for policy on hospital food. Anyone with that title must risk being sacked every day. At the Age UK Later Life Conference this year, she shared some pearls of wisdom which tell you why the Department of Health is so starved of ideas on this vital issue. She said:-

“If we give them nice food, it will make them feel better” – I wonder how long it took for her reach that revelation? Judging by all the reports of malnutrition in hospitals, perhaps she should have said “If we give them any food it will make them feel better”.
“Patients need better nutritional care because if they do not eat enough they will get sicker quicker and better slower” – that’s a nice sound bite!
“Many uneaten dishes are recipes that elderly patients would not normally eat” – 30 million uneaten meals are thrown away annually. You think that would tell Dr Jones something rather more strategic than just taking Tai Curry off the menu.
“Older people are at risk of not eating enough because they had become terrified by anti-obesity campaigns” – what planet is this woman on?

Her recommendations:-

“Give elderly people unhealthy treats such as doughnuts, ice cream and chips” – presumably not all at once.
“Encourage them to eat as part of an overhaul of hospital foods” – after all the efforts of Lloyd Grossman, Hester Blumenthal and Jamie Oliver, nothing seems to have changed.

Finally the key word:-

What is missing from Dr Jones’ recipe is the nursing staff making mealtimes a priority not an interruption in their form-filling days.

Bring relatives and visitors in at lunchtimes and make mealtimes enjoyable, instead of serving up patronising platitudes.

Posted in N.H.S. | Leave a comment

“Longer House”

Posted on August 28, 2014 by john graham

Only a few days ago I was advocating a new form of house which could provide for the extended family; a several generation household instead of the fragmented family option of Granny in the downsized flat and the grown up kids in a rented waiting room, in housing limbo until the family house is sold by the parents to put deposits down on homes for the children. (See previous blog by clicking on “RETIREMENT HOUSING” in the Topics List).

I had forgotten another housing option, one which was quite common in equally austere and housing-shortaged Britain after the Second World War. The lodger was a common addition to many households as a way of supplementing income and filling a spare room. No need for a bedroom tax in those days, people automatically thought of using under-occupied rooms.

We had a succession of managers from Woolworths (Woollies) Department Store who I remember brought me sweets home. Then there were the shoe shop managers, all stepping up the shoe shop management ladder, one shop at a time. No free shoes that I can remember, but I did get to play in the Clarks shoe shop and see my feet in the X-ray machine. I remember Uncle Glyn who was a great cartoonist who drew lots of Disney characters for my bedroom wall. Then there was big David Rowlands – a Rugby player who had to duck to get through the doors in the house. I am sure he was 7’ 6” with feet as big as dinner plates.

Lodgers bring back lots of happy childhood memories. So maybe the multi-generation family long house could be extended to provide for a few lodgers.

A recent survey by LV=, the home insurer, found that twice as many homeowners are taking in lodgers to make ends meet, compared to 5 years ago. The average rent for a spare room in the Midlands was £201 for a month, in London it was £345.

P.s. My Dad used to collect insurance door to door every fortnight for the Liverpool Victoria before it became posh and unrecognisable as LV=. Now, it is all online and no friendly face calls at the door any more. Progress of a sort, but insurance is not cheaper. Nonetheless. I’ll bet LV= has a glossy, glassy, swanky HQ office and I don’t suppose their managers lodge in people’s houses anymore.

Posted in RETIREMENT HOUSING | 2 Comments