Attitudes to older people

Time to make way

27 February 2014
Charles
10 Comments
Categories: Attitudes to death, Attitudes to older people, Death; Good death, End-of-life issues

A letter in last Thursday’s Times tells us something, perhaps, about the evolution of society’s thinking about dying, death, the competition for NHS resources, futile care and the declining value life holds for the ageing and the elderly both in the eyes of society and in their own eyes:

Sir, It makes sense to limit some expensive drug treatments to the people who can best benefit society as well as improving the quality of life for the patient. I am an old person (73) and an ex-nurse and I do not understand why so many oldies are obsessed with getting every treatment available, to prolong their lives.

My mental and physical health are deteriorating. This is a fact of life, not a complaint. If I should become ill I will gladly forgo any expensive cure to allow someone younger than me to improve their opportunity of a better quality of life, and the chance of being more use to society. I ask only for palliative care and the chance of a quick release from life when I feel ready to go. I am not alone in this attitude.

The fact is that many old people are a burden on society. Like all nurses I have cared for the elderly as well as I could, but there were many occasions when I wondered why we were doing it. People who cannot accept this argument should work for a few months in a care home where many patients are demented, incontinent, unable to care for themselves, and have no visitors.

Like many of my friends I have made a living will to express my wishes in the event of acute illness. I would like to be able to apply for a prescription which could be used if I ever feel like a quiet and peaceful exit before things get too bad.

Gill Pharaoh — Pinner, Middx

Matthew Parris made this contribution to the debate:

I’m 65 this year and I wouldn’t dream of expecting the taxpayer to divert scarce funds my way for expensive drugs that would do more good for a teenager. My conscience even troubled me over the cost to the NHS of an operation last December to stop my right hand clawing up, as I can manage perfectly well without a couple of fingers.

My late father (a retired electrical power engineer) told me after the Chernobyl disaster that they should use oldies like him to go in and secure the generators. He was serious. I never admired him more.

The way we were

15 August 2013
Charles
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Categories: Attitudes to older people

Elderly people reflect on their reflections of themselves when young. Entitled ‘Reflections’, it is the work of Tom Hussey. Hat-tip to Caitlin Doughty, who posted a link to this on her Facebook page the other day. 

Please note that here at the GFG we now post most of our stuff on Facebook these days. If you want to spice your day with newsy snippets from our web-harvesting team, make your way over to https://www.facebook.com/GoodFuneralGuide and Like us. 

The race grows sweeter

12 February 2013
Charles
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Categories: Attitudes to older people, End-of-life issues

Posted by Vale

Here on the blog we often rail against society’s thoughtless pursuit of longevity. Rightly so – it is cowardice not kindness that endorses the suffering that medicine – seemingly without reflection or conscience – prolongs.

But it’s important to remind ourselves that it isn’t always so; that old age can bring wisdom and unlooked for joys as well.

In the New York Times recently, in piece called The Race Grows Sweeter Near Its Final Lap, Eve Pell tells the story of the love she found. She writes:

Old love is different. In our 70s and 80s, we had been through enough of life’s ups and downs to know who we were, and we had learned to compromise. We knew something about death because we had seen loved ones die. The finish line was drawing closer. Why not have one last blossoming of the heart?

I was no longer so pretty, but I was not so neurotic either. I had survived loss and mistakes and ill-considered decisions; if this relationship failed, I’d survive that too. And unlike other men I’d been with, Sam was a grown-up, unafraid of intimacy, who joyfully explored what life had to offer. We followed our hearts and gambled, and for a few years we had a bit of heaven on earth.

Not only was I happy during my short years with Sam, I knew I was happy. I had one of the most precious blessings available to human beings — real love. I went for it and found it.

It’s a moving story of love and age and I defy you read to the end without a tear in your eye. Read it here

The biggest social issue coming down the pipe

31 January 2013
Charles
2 Comments
Categories: Attitudes to older people, Longevity

From an article in last Sunday’s Sunday Times: 

You may not be part of Britain’s 6.4m-strong army of carers yet, but if your parents are still alive, the dilemmas surrounding how to look after them as they get older will surely come.

Future Identities, a government report published last week, drew attention to what one expert calls the biggest issue we face as a society. Because women are giving birth later in life, the baby-boomers’ time-poor children are increasingly being hit with a double whammy: they are having to care for their own offspring and their elderly parents simultaneously.

Christopher Lambert’s story is typical of this so-called Sandwich Generation. “My son was five, I was 58 and my dad was 87. I’d divorced my wife and was living back with Dad as his main carer,” he says. “My son would come at weekends, which was supposed to be our ‘special time’. It was bedlam. Dad would be screaming, ‘Breakfast! Breakfast!’ My son would be yelling, ‘Dad, Dad, you said you’d . . .’

“I felt trapped in the middle, the only grown-up. I remember being out in the garden and Dad collapsing on the ground and my son wanting to play football and me saying, ‘Let’s play looking after Grandpa,’ and he’d say, ‘No, that’s boring and he’s smelly.’ I was at my wits’ end.”

The feelings of conflicted loyalties, divided between the parents who raised you and the children who need you to raise them, are so common that more than 4 in 10 Sandwich Generation carers are struggling to cope or at breaking point, according to a recent survey by Carers UK.

The problem will only intensify as the postwar baby-boomers enter their seventies — by 2022 there will be a 20% rise in over-75s (up from 5.1m to 6.6m). “People live longer now with severe disabilities who would have died years ago,” says Helena Herklots, chief executive of Carers UK. “A revolution is required in family care akin to the new understanding we have around working parents, as in the future so many of us will be juggling work around elder care and children.”

The forecast is also for the number of children aged under 16 to increase from 11.8m now to 13.2m in 2022, exacerbating the Sandwich Generation squeeze.

Source (£)

The unintended consequence of promoting longevity

8 January 2013
Charles
14 Comments
Categories: Assisted dying, Attitudes to death, Attitudes to older people, Death; Good death, End-of-life issues

Michael Wolff describes caring for his eldery, dementing mother in New York magazine. It’s a long piece and it will concentrate your mind. You’ll brood on it.  Warning: once you start, you won’t be able to put it down. 

…what I feel most intensely when I sit by my mother’s bed is a crushing sense of guilt for keeping her alive. Who can accept such suffering—who can so conscientiously facilitate it? 

“Why do we want to cure cancer? Why do we want everybody to stop smoking? For this?” wailed a friend of mine with two long-ailing and yet tenacious in-laws. 

Age is one of the great modern adventures, a technological marvel—we’re given several more youthful-ish decades if we take care of ourselves. Almost nobody, at least openly, sees this for its ultimate, dismaying, unintended consequence: By promoting longevity and technologically inhibiting death, we have created a new biological status held by an ever-growing part of the nation, a no-exit state that persists longer and longer, one that is nearly as remote from life as death, but which, unlike death, requires vast service, indentured servitude really, and resources. 

This is not anomalous; this is the norm. 

The traditional exits, of a sudden heart attack, of dying in one’s sleep, of unreasonably dropping dead in the street, of even a terminal illness, are now exotic ways of going. The longer you live the longer it will take to die. The better you have lived the worse you may die. The healthier you are—through careful diet, diligent exercise, and attentive medical scrutiny—the harder it is to die. Part of the advance in life expectancy is that we have technologically inhibited the ultimate event. We have fought natural causes to almost a draw. If you eliminate smokers, drinkers, other substance abusers, the obese, and the fatally ill, you are left with a rapidly growing demographic segment peculiarly resistant to death’s appointment—though far, far, far from healthy.

Read it all here. 

Oldies in Need

16 November 2012
Charles
1 Comment
Categories: Attitudes to older people

The British are some of the most charitable people on Earth — if you measure their charitableness according to how much money they fork out for good causes.

Today marks BBC Children in Need Day. There will be the customary telethon, razzmatazz, fevered fundraising, spinning figures and, if all goes to carefully-laid plan, ta-da, a record sum of money amassed. 

Children in Need is the perfect good cause. It has all the attributes. Brits are sentimental — they can’t resist a tug at the heartstrings. They’re suckers for sensation (expect lots of oohs and aahs). They buy cialis germany succumb to celebrity endorsement. They are bedazzled by glamour. It’s actually not all that difficult to whip up a lot of heightened emotion where sick children are concerned. Who could possibly doubt that this is an excellent cause?

Fundraising is a highly professionalised business. But fundraisers can only work their magic if a cause has all the magic ingredients: sentiment, sensation, celebrity and star quality. Compassion has its no-go areas. Where cancer is concerned, boobs will always trump balls. 

What price, then, Oldies in Need Day? 

Hinterlands between the living and the dead

5 November 2012
Charles
1 Comment
Categories: Assisted suicide, Attitudes to death, Attitudes to older people, self-deliverance

We didn’t cover the Dia de los Muertos, the Day of the Dead celebrations on 1 & 2 November. Perhaps that was an oversight. It’s a colourful and intriguing festival of great interest to Westerners. Those from cultures influenced by Protestantism tend to be a bit tongue-tied in their relationships with their dead.

The Dia de los Muertos is much envied by those who feel that their own culture has forgotten how to commemorate the departed. But is it culturally informative, or is it no more than a cultural curiosity?

Held to coincide with the Feast of All Souls, the Dia de los Muertos is the result of the incomplete colonising of a pagan festival by militant Catholics. Its origins are Aztec and it possesses a quality of incoherence which seems not to bother anyone very much. In its original Aztec incarnation the Dia expressed the belief that the living and the dead co-exist. Christian teaching, on the contrary, tells us that our dead go far, far away.

Our own Hallowe’en is, of course, the product of another such marriage of incompatibles, in this case between Christian All Souls and the pagan Samhain, held at that time of the year when the door to the Otherworld opens wide enough to allow the souls of the dead to return for a brief time. Again, not at all Christian.

In an increasingly secular society, where the spectrum of spiritual beliefs is very great, it is useful to have the examples of other cultures to plagiarise and adapt – repurpose, to use the modern idiom. We can probably expect to see a growth in the variety of commemorative observances as people increasingly find the courage to do whatever it is they feel they need to do no matter what anyone else might think.

Maurice Saatchi, for example, breakfasts every day with his dead wife, Josephine Hart, at her grave. He’s not a fan of the moving-on/closure school of grieving. He says, “In my view, to move on is a monstrous act of betrayal and to come to terms with — I think I’d call that an act of selfishness.”

Saatchi’s wifes’s death has even enabled him to redefine his own identity: “The reality of it is that she is me, I am her, we are one . . . I am Josephine Hart, I can put it no stronger than that. It is no different now from what it has always been; we have always been one person.”

The on-trend hinterland between the living and the dead is currently that occupied by zombies. Of ancient African origin, contemporary portrayals of zombies are derived from the slave culture of Haiti, where, according the Amy Willentz, ‘the only escape from the sugar plantations was death, which was seen as a return to Africa, or lan guinée (literally Guinea, or West Africa) … The zombie is a dead person who cannot get across to lan guinea,’ and is thereby condemned to an eternity of backbreaking toil in the sugar plantations under the rule of cruel overseers.

Wilentz goes on: ‘There are many reasons the zombie, sprung from the colonial slave economy, is returning now to haunt us. Of course, the zombie is scary in a primordial way, but in a modern way, too. He’s the living dead, but he’s also the inanimate animated, the robot of industrial dystopias.’

Leaving aside industrial dystopias (together with ghosts and angels), let’s finish by considering the living dead – those kept alive by modern medicine; those who inspire all the debates we’re having these days about assisted dying.

The Liverpool Care Pathway has come under fire in recent months. Doctors have been prescribing it without consulting some families. Hospitals have been incentivised to apply it to living dead people in order to effect economies in healthcare.

The Liverpool Women’s NHS Foundation Trust received £1.03m for doing just that in the last financial year.

Time’s up, take yourself out

16 July 2012
Charles
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Categories: Attitudes to older people, dying, End-of-life issues, euthanasia, Good death, medical interventions in dying, self-deliverance

A theme that we like to explore on this blog is the way in which longevity has reconfigured the landscape of dying. The blessing of long life has its downside: protracted decline. We are likely to linger longer, much longer, than our forebears. There’s a physical cost in chronic illness and possibly, also, mental enfeeblement. There’s the emotional cost to the elderly and their families. And then there’s the financial cost, which the government has wrestled with and now kicked deftly into the long grass.

In the Sunday Times Minette Marrin wrestled with it, too. I’ll have to quote a lot of it because the ST website is paywalled. She suggests some interesting solutions:

Last Thursday the Office for Budget Responsibility (OBR) announced in a chilling report that the escalating costs of an ageing population will mean yet more national austerity. Pointing out that the proportion of people over 65, who now make up 17% of the population, will rise to 26% by 2061, it estimates many increased costs, in care of the elderly, health and pensions, amounting to an added £80 billion a year in today’s money.

In the next 20 years, the number of people over 70 is set to rise by 50%, reaching nearly 10m, according to the Office for National Statistics.

The OBR states that Britain’s public spending will be “clearly unsustainable” over the next 50 years, despite the spending cuts. So, far from care for the elderly rising above today’s inadequate standards, it is almost certain to fall further below them. There’s no money now and in future there’s going to be even less. 

Universal bus passes (which cost £1 billion a year), winter fuel allowances (£2 billion) and free television licences must go. 

Everyone must accept that their savings, including their homes, may have to be spent on paying for care in old age. There’s no universal right to leave one’s property to one’s children.

Taxes of all kinds must rise hugely, or else there will have to be a large hypothecated tax upon people reaching old age. Services to old people must be reduced … Health service care must be rationed for the very old. Palliative care of every kind should be available, but not ambitious treatments.

There should be fewer old people. I’ve often felt the best thing one can do for one’s children is to die before real infirmity sets in. The taboo against deliberately shuffling off this mortal coil, as people did in other cultures in the interests of younger people, is wrong. Most people say they never want to be a burden to others in old age; it would be good if more of us felt able to prove we mean it, by taking a timely and pleasant walk up the snowy mountain. Especially since there’s no money left. [Our bold]

Source

Dead wrong

5 April 2012
Charles
2 Comments
Categories: Attitudes to death, Attitudes to older people

It was the nineteenth-century Liberal politician and prime minister Willim Ewart Gladstone who famously said “Show me the manner in which a nation or community cares for its dead, and I will measure with mathematical exactness the tender sympathies of its peoples, their respect for the laws of the land and their loyalty to high ideals.” His words are largely forgotten in the UK but they are often quoted by American undertakers seeking to big up their role and get inside their clients’ wallets. Care = spend. 

Were Gladstone living today he would probably have broadened his message to take in the elderly and exclude US undertakers. 

The Oldie magazine recently received an appeal from Ward 23, a care of the elderly ward at Bristol Royal Infirmary. The writer, Sue Nicholls, Ward Clerk, asked for money to buy basic toiletry items. She said, “Even the smallest of items such as a bar of soap would benefit our patients … we get single sachets of shower gel and shampoo, but they are unscented and don’t lather. Vile stuff.” Ward 23 hopes also to raise enough money to buy special chairs and footstools for the patients. 

Vile treatment of the elderly is normal in our country. Punitive legislation has altered attitudes to black and minority ethnic people and all sorts of other people, but no one has thought it worthwhile to extend attitude-altering legislation to include old people. Nor are there any current plans for an Old People In Need telly-jamboree fundraising festival. 

The manner in which a nation or community cares for its elderly is a measure of its attitude to its dead. We shan’t get death right until we change the way we treat our elders. 

If you are inclined to send a donation or a little parcel to Ward 23, the address is: Ward 23, Uppwer Maudlin Street, Bristol BS2 8HW