Sassies (single sexy and sixty or over): plan for the future as well as pulling the men

Trying to sort out my Clipboard site (where I post the odd comments on news of the day) I was reminded of this old Daily Mail article on Sassies: that is single, sexy and sixty (or over). Apparently, in 2010, women of this age were seeking lots of sexy fun.

My comment: I wonder what plans they're making for their possibly less active late-seventies and eighties. I don't want to pour cold water on the Daily Mail's opportunity to publish loads of attractive photos of beautiful women in their sixties, but this is a period when you can be zapping life and also planning for your future.

I recommend lasting powers of attorney, a funeral plan, a will and settling into an adaptable home where you can live well with a greater degree of disability. You can still go on pulling the men for a lot longer than your sixties, as any care home owner knows.

Link to my Clipboard site.

How to steal someone's identity: read the widely available care home reports at your local hospital

My wife fell down the stairs, so we went to the Urgent Care Centre (what used to be called Accident and Emergency) at our local hospital. 

While waiting by her trolley, I read with interest a report left on the counter. It was from a care home, sent in with a previous patient, giving full details of his and his nearest relative’s name, address, date of birth and information that would allow me steal his identity. It included his medical details and symptoms of dementia, so you could probably steal his identity without his knowing.

I thought about mentioning this to the computer-users studiously avoiding any eye-contact with the rest of us in the room, but I didn’t because my wife and I have a policy of being nice to everyone involved in caring for us. This is the most likely tactic for getting good service from harassed professionals in the NHS. So they had no opportunity to cease revealing the personal details of one of their patients to all and sundry arriving at the counter because our ‘be nice’ policy prevented my handing the report back.

It’s an example, though, of how easy it is to be careless about making sure that patient information is not routinely left around for anyone to gawp at. It’s lucky I am a registered social worker who keeps things confidential and carefully forgot the things I saw; they might not be so lucky next time.

Your medical information from your GP for commercial interests? - Lexology reblog

A post from a lawyer with severe doubts about the confidentiality of patient information, now that the government is proposing to collect GP information, aimed to be with the aim of evaluating GPs. But the information will identify patients, and the government has made a big thing about using NHS information to help commercial companies to compete in the international marketplace.

So who will rally be using your information and why? And will they ask you for permission and tell you how they are going to use it? Seems not.

This is the link to the legal commentary.

Link to the government proposals.

Children's community services should always include grandparents and the older generation

Ofsted (the people who inspect children's facilities) has published a good practice example of a community and children's centre in Lancashire. No mention of grandparents though - a whole lot of stuff about building community networks.

My view is that it should be a matter of principle that children's lives should include older people. And a good practice example should show how the community and family resource of the odler generation is being involved in the lives of the young. It's good for the children, the parnetal generation and the older generation.

Think about it, Ofsted.

Link to the Good practice example.

Department of Health needs a broader non-health view on older people's needs

One of the good things about the Department of Health's new Director General for Social Care and blah blah (Jon Rouse) is that he has good experience of social housing - this is a really important link for the Department of Health to make for services for older people. The DH is far to health-oriented - it needs to have a broader view about what is important for older people in the whole range of public services.

Link to Department of Health announcement.

Care for older people is everywhere - but paid for, not a social service

I thought it was just another pizza delivery leaflet through the door, but this was something I haven’t seen before, a leaflet offering ‘Care visits at home’ assuring me that this organisation cares passionately and explains all the services that they might offer.

When a grandparent had difficulty living at home in the 1970s, it was really quite hard to find an independent service for her, or a care home that was not public sector. Even ten years ago, door-to-door publicity for care services could not have conceivably been worthwhile. Yet now, a publicity leaflet has been pushed through the door, presumably of every house in the district, so widespread is the presumed need.

Another sign of this is these pictures that I took locally recently of the offices of just such a care service. Its name and advertising emphasise how it meets what the need is assumed to be: CareFirst24 indicates a 24 hour service and the advert says 'putting people before profit', an implied criticism of other services. Having this on the average high street is a mark of how the care world has changed in the last few years. Care is assumed to be like any other paid for service; the result is that care provided by local social services is for those who cannot pay, rather than the normal service for everyone.

 

Just because you can make gadgets do complicated things is no reason why you should

Having recently bought a new telly, I can only endorse my son's view, expressed in his blog, that the plethora of information about technical products that you don't really understand makes it hard to make decisions about what to buy. I'm not surprised that older people feel they just don't want to know about all the new gadgets they might buy. My wife said we should get this telly with all the things it can do that make it so much more than a telly, because in a few years' time our grandchildren will not want to come to see us if our equipment will not meet their assumptions about the world. Already, our grandchildren are unable to comprehend why our telly can't just show everything they might want to see just when they want to see it.

Stuart Payne's blog on logistics.

It's a feature of old age that one's children's professional activity in completely incomprehensible worlds begins to eclipse one's own feeling of general social competence; I was never sure what logistics (you see it on the sides of lorries) was in general before my son got a job doing it, and I'm still not sure what he actually does; my mother had the same problem about social work. But I see from the blog that the old Sony telly that we used to watch a quarter of a century ago has formed his retail decision-making, so obviously parental behaviour does have long-term implications. It seems that modern domestic equipment, marvellous though it is in so may ways, is just too complicated even for younger people nowadays to keep up with. This is a sign of the rigidities of old age strike ever younger because today's world is so unnecessarily complicated.

I might worry that this why I've had to take so much stuff back after Christmas. But no, as I said to the young man who said he could help me with my wife's new gadget, it's not that I don't know how to make it work, because I can make my own work. It's just that because modern technology can, modern technology does and then it's made itself too complicated to work

Fuel poverty kills vulnerable people, including older people

I came across an intriguing report about fuel poverty among older people (and other vulnerable people), written in 2011 for Friends of the Earth, the environmental charity, by Sir Michael Marmot. You may wonder why FoE are doing stuff on fuel poverty: their website connects this with energy efficiency contributing to a good relationship between humanity and the environment. You may also wonder how Marmot (a public health medic) comes to be writing all this stuff: of course he doesn’t, he has a team paid for by sucking up research grants from organisations which very broadly fit within his main research theme that tackling health inequalities is a crucial part of improving health nationally and internationally. Presumably, he looks at what they are doing and so his signature on the report gives it added credibility.

Link to the FoE report by Sir Michael Marmot’s team. 

Link to the FoE website on fuel poverty and energy efficiency. 

It’s mainly a literature review, and it collects up some very interesting figures. Among them, is this graph, which shows the excess deaths in different years from 1999 to 2010 due to cold. The point is that, particularly for older and other vulnerable people, cold is a real health hazard, and therefore fuel poverty is an important issue. The NHS spends a lot of money treating people for disease caused by poor heating in private sector housing, according the a quotation from the Chief Medical Officer of the Department of Health in the FoE report.

You are in fuel poverty if you spend more than 10% of your disposable income on heating and lighting. There are three reasons for getting into fuel poverty. Obviously one is how rich your household is; the rich can afford their fuel. The other two are the cost of fuel and how well-insulated your house is.

Life story work and care mapping for people with dementia: creative work is human, form-filling is not

I looked at the projects approved for funding by the government’s dementia research programme. Most of the things are about stepwise improvement in how various bits of the NHS manage dementia care.

Link to the government's list of projects they are funding here. They are many (21) and various.

I picked out two that interested me. One is about the use of life story work; this is a technique for getting people to look at the different stages of their life and producing a written account, or increasingly video and other kinds of product. I imagine that they are interested in it because it might improve or use the memory of the person whose dementia is worsening. But what I think is much more important about these sorts of techniques is that way it encourages people to work on projects, and be creative in what they are doing., So much health and social care focuses on managing a care setting, and keeping people alive in what are fundamentally boring environments. Creative activity is a really important way of combating this.

The other thing I think is important about this is that it is a form of activity which involves the person with dementia taking part in human interaction with the person working on their life story with them; so much conversation in care settings is humdrum management stuff rather than personal, it also involves the person with dementia leading the conversation with their life story, rather than answering questions that are mainly of interest to the professional.

I also picked out the project on something called dementia care mapping. The starting point for doing this study is that people with dementia in care settings become agitated or difficult in ways that the staff can’t cope with. As a result, such people with dementia are more like to be admitted to hospital, and given anti-psychotic drugs to cool them out, making them easier to manage. This is worrying in itself: years ago, social work developed a professional policy that it was neither useful nor ethical to cool people out; better to understand and work with their difficult behaviour. I wish other professions thought the same way.

But I would have wished that they’d come up with something better to research than another ‘tool’. You may be misled by the word ‘tool’ into thinking that this will be some concrete and practical way of helping people in this position, but tools in the care world are usually forms for staff to fill in. I’m always very interested in the interpersonal content of the conversation when forms are being filled in, and then what is done with them. Forms being filled in is often done in a routinised way by staff who don’t really understand what they are about, and then don’t know how to use them.

The project information says this is about staff development: but how are they going to help staff develop using the material they are working with? The education process that results is far more important than getting them to fill in the form. I’ll wait for the research results before believing this is going to be widely useful. I suspect it may turn out to seem wonderful to the people who are piloting it and have research money spent on helping them to develop their understanding. For the people who follow on after it is declared a success, I suspect it’s going to be just another form to fill in. 

These are the accounts of the projects in the Department of Health's list:

HS&DR 11/2000/11 Improving care for people with dementia: development and initial feasibility study for evaluation of Life Story work in dementia care.

People with dementia sometimes need help to communicate their histories and identities. This study will investigate how 'Life Story work' can help people living with dementia to do this, and whether this work can enable services to more effectively meet their needs. It will do this by speaking to people with dementia, their carers, and health care professionals about their experiences of Life Story work, and identifying areas of good practice.

HTA 11/15/13 Evaluating the effectiveness and cost effectiveness of Dementia Care Mapping (DCM) to enable person-centred Care for people with dementia and their carers: A UK cluster randomised controlled trial in care homes (DCM EPIC trial).

At least two-thirds of people living in care homes have dementia and many become agitated or show other behaviours staff find challenging.

These behaviours are often linked to poor quality care and people with these behaviours are more likely to be admitted to hospital and are often prescribed antipsychotic drugs, which can cause harmful side effects. This study will involve 750 people with dementia and care staff in 50 care homes. 30 care homes will be randomly allocated to have staff trained to use Dementia Care Mapping; a practice development tool and process. The success of Dementia Care Mapping will be measured according to changes in behaviours staff find challenging, resident quality of life, the drugs residents are prescribed, the number of NHS services needed for residents, changes in the numbers and types of negative events residents experience (for example admission to hospital, falls), how staff feel about their job and staff resignations and sickness.

Older person too brisk for the young and their mobile phones

Returning failed Christmas  gifts (a Kobo ereader, which acquaintance with their website tells me have a lot of people are experiencing problems with) I am caused to revise my ageist assumptions about how old people are slow in malls and shopping street, always chuntering along without a thought for the busy.

As a older person myself, I'm obviously still too brisk, but this time for the young. I’ve come (I recognise this is equally ageist, but this time against the younger) to be irritated by younger people, halted wherever they have decided they need to adjust their mobile phones, without a thought for the passing flow of pedestrians.