The Media churn out another lazy rehash of the old familiar story, Mr Good trying to save money whilst Mr Bad wants to stop him firing all his workers, in this case all the London Underground Ticket Sales staff. If like me, you are an infrequent traveller to London, you always use the Underground as it is the only way to get about. As an aside, in fairness the Buses are getting better organised, (fantastic 'London Journey Planner' App) but still the dilemma of which Bus, where to get off and electronic display saying next due in 5 minutes whilst you wait for 25 minutes and still no Bus in sight. Back to my theme. A welter of overlapping tiers of travel options and an automatic ticket machine with an interface devised by the Devil himself, evil incarnate. I regard myself as reasonably technically competent, an average commuter, but my lack of routine familiarity with all the London travel options means I am defeated each and every time I attempt to use the automatic ticketing system. I need the human, even if scowling, face of the Ticket Sale Office to translate my simple travel plans into a sensible Ticket to Travel. Unless London has decided to commit suicide and turn its back on all those tourists that flood the Underground every day, what is it thinking.
Our Society is being driven top down by Accountant Rules. Sure, absolutely, the Money In has to exceed the Money Out, no argument. But Accountants do not have any formula to tell when Customers have had an unsatisfactory experience that they choose not to repeat. In the real commercial world out there, struggling to get by in the ongoing recession, they are highly tuned to the customer experience. They go out of their way to ensure the customer's residual recollection is favourable to them. Not that mistakes do not happen, of course they do, but it is someone's job to proactively respond with more than a smiley face and 'Have a Nice Day' to ensure any problem is fixed and they are left satisfied. Not so our quasi-private companies running our essential services. They are only in it for profit, customer, or consumer, satisfaction is of no account. Sure a stone-walling complaints procedure that at most logs the complaint then dead files it away. Their remit is not to provide a good quality service that meets the needs of the users, just to return a profit. Not just London Underground but a plethora of quasi-private service provider have all been hitting the news for failing to address their 'customers' needs. Take the water utility boards, responsible to safe discharge of sewerage, brushing aside one of several householders that have repeated (five times), raw sewerage flooding into their homes; or Environment Agency with responsibility to manage our natural resources, failing in their duty of care by allowing the Somerset Levels to be inundated for weeks on end; or our treasured NHS failing to provided basic care robbing their elderly patients of dignity; or Local Authorities not allocating sufficient Care Hours to enable carers provide a decent quality of assistance and so on, rail failings, postal failings and on and on. Staffed by dedicate people who joined to serve the public but in the end are undermined by administrations that can only see the profit line and have no motive to meet the needs.
As I argue elsewhere, (All Change)(Time to Stand Up) quasi-'competitive' private companies have no place in running essential services. The 'competition model' is an entirely false fabrication, no real viable alternate options exist, the customer is stuck and stuffed. Nothing wrong, in fact overwhelming reasons why, essential services should be State organised. Just a new leaner model of how to go about organising and arranging them and making them accountable. There is hope that we can get back to providing all the customers, that is us, with services that aim to at least meet the needs of its customers. Now that would be a refreshing change.
Showing posts with label carers. Show all posts
Showing posts with label carers. Show all posts
Thursday, 6 February 2014
Friday, 13 July 2012
Going On One Hundred
There was a charming TV programme, 'How to Live Beyond 100', all about people still able to live active lives when they were 100+. So good to have positive images rather than the usual downbeat doom and disaster ahead. Taken with other strands that are also running, it time to pause for thought, there are a lot of threads running behind this issue.
First off, for everyone that is still 'active' at 100+, there are manyfold others who are trapped, trapped in bodies or minds that do not permit them any active role. They have subsided into a total dependence on others for the daily chore of living, see also my post Waiting to Die.
Secondly as we 'baby-boomers' decline into old age the demographics rockets sky high. From being a rarity to survive until 100, now there are some 12,000 and shortly this will become 90,000 was we get into our stride. By the time our grandchildren grow to old age 100+ will have become the norm of life expectancy.
Thirdly it is incontrovertible that as we age beyond the 60's to 70's our bodies and minds are no longer able to perform as they once did, see also my post Retire at 70+!. All past excesses and poor gene choices come to haunt and rack a frail body or mind. Maybe science, medicine or better life choices might stave off the day, but mechanical or mental failure is the inevitable and inescapable consequence of ageing. We will each need support in some form or other to get by. Logistically large numbers of frail old people will have to benefit from support.
In the meantime our Government considers it appropriate and fitting that the retirement age for all is deferred to the 70's or even later. As a blunt answer to the economics of funding an ageing population it is unchallengeable but the social consequences are horrendous. The physical and mental deterioration that occurs with advancing age means you simply cannot compete with younger work colleagues. The end result is you have to step down, accept to be sidelined, reduced to taking on menial roles, pushed aside whilst watching others more productively undertake what was once your domain. That is a big ask, to carry on pushing a increasing frail body to do work but being surrounded by evidence of your failure to undertake it. Does this reflect a caring society with a compassion for its elderly? Or a society that is only looking at balance it books, to hell with the personal consequences?
I had hoped the programme would open the window of how these centenarians saw and viewed the changing society around them. Not to be. There is no ducking it, this ageing poses two crucial dilemmas. Why live to 100+ and what do we do when 100+. We live to 100+ because our skills have made it possible and there is no other alternative. Medical interventions ensure all the easily curable diseases are cured. There are no knock out illnesses or diseases left, other than the ones beyond the reach of medicine, that used to mean death by the 70's was the norm. All we are left with are causes of death beyond cure, such as the cancers, or parkinson, alziemers or dementia. Not for everyone, but what is left for the large majority who do not succumb to these killers, what is left to bring their long lives to an end?
In the meantime they face the inevitable, inescapable increasing dependency on other to support and provide the means you can no longer cope to provide for yourself. Surrender yourself into the hands of salaried carers. Now our Government has decided that this should not be a charge on the State, if you have independent financial means. You should pay for your own care first off. Apart from weasely caveats, this begs several questions. Where is a line to be drawn between say a terminal bedridden cancer patient or confused wanderer with no conscious recollection putting themselves and society at larger at risk, both clearly in need of constant medical support. As against an impaired person, mentally sound, but physically unable to carry out day to day tasks of feeding cleaning and dressing. Sound like a Solomon's judgement to me. Inherently unfair.
We as a Society, through our Government, have decided that the family home, invested in, harbouring precious memories, a depository for all the family hopes and expectations must be sold to pay off a russian lottery outcome. You are decreed insufficiently incapacitated and it has been decided you have the means, so you shall pay. How outrageously unfair and inequitable. Never mind that with the Governments connivance house values have gone beyond the reach of youth and their only hope to claim a home of their own is a share in their parents inheritance. It tastes exceedingly bad to me. Society is so much more than economic book balancing. It has to be about respect, compassion and a rough but overal even equity.
The final part I want to raise is why would anyone choose to live upto 100, let alone beyond a 100. If life has a meaning, it is about being able to contribute. Plenty of avenues to agree or disagree on the significance of contribute and to what. The ageing are no longer able to physically or mentally compete. They now require support and assistance just to get from day to day. We as a Society have chosen to turn our backs on the one significant contribution the aged can still offer. They have accumulated experience, wisdoms and a longer perspective having seen many iterations of events and peoples reactions to those events. In a youth centric world, these views from a past are brushed aside, marginalised even laughed at for being quaint and so irrelevant. The arrogance of youth. With their one gift trounced our aged are left nothing to contribute but their memories. Instead of being revered for being pillars of wisdom with a canny understanding of how life works, they are dismissed as a costly drain taking up precious and unaffordable human resources better spent elsewhere.
In life we make, or have made for us, choices which set up a flow of consequences. We have chosen to intervene and use our medical skills to take away natures calling card. There is no longer a natural end game for most. We have chosen to marginalise our elderly so they can longer contribute meaningfully into society. We have chosen to regard them as a cost liability to be born by society rather than a debt of honour. We must now face the consequences of those choices and we have to replace natures calling card with a calling card of our devising so that our tired elderly can say, in their own time, enough is enough, and then let them go peacefully, without financial harassment. In peace and in dignity. Tough call. Get it right because in due time you too will incur the consequences.
First off, for everyone that is still 'active' at 100+, there are manyfold others who are trapped, trapped in bodies or minds that do not permit them any active role. They have subsided into a total dependence on others for the daily chore of living, see also my post Waiting to Die.
Secondly as we 'baby-boomers' decline into old age the demographics rockets sky high. From being a rarity to survive until 100, now there are some 12,000 and shortly this will become 90,000 was we get into our stride. By the time our grandchildren grow to old age 100+ will have become the norm of life expectancy.
Thirdly it is incontrovertible that as we age beyond the 60's to 70's our bodies and minds are no longer able to perform as they once did, see also my post Retire at 70+!. All past excesses and poor gene choices come to haunt and rack a frail body or mind. Maybe science, medicine or better life choices might stave off the day, but mechanical or mental failure is the inevitable and inescapable consequence of ageing. We will each need support in some form or other to get by. Logistically large numbers of frail old people will have to benefit from support.
In the meantime our Government considers it appropriate and fitting that the retirement age for all is deferred to the 70's or even later. As a blunt answer to the economics of funding an ageing population it is unchallengeable but the social consequences are horrendous. The physical and mental deterioration that occurs with advancing age means you simply cannot compete with younger work colleagues. The end result is you have to step down, accept to be sidelined, reduced to taking on menial roles, pushed aside whilst watching others more productively undertake what was once your domain. That is a big ask, to carry on pushing a increasing frail body to do work but being surrounded by evidence of your failure to undertake it. Does this reflect a caring society with a compassion for its elderly? Or a society that is only looking at balance it books, to hell with the personal consequences?
I had hoped the programme would open the window of how these centenarians saw and viewed the changing society around them. Not to be. There is no ducking it, this ageing poses two crucial dilemmas. Why live to 100+ and what do we do when 100+. We live to 100+ because our skills have made it possible and there is no other alternative. Medical interventions ensure all the easily curable diseases are cured. There are no knock out illnesses or diseases left, other than the ones beyond the reach of medicine, that used to mean death by the 70's was the norm. All we are left with are causes of death beyond cure, such as the cancers, or parkinson, alziemers or dementia. Not for everyone, but what is left for the large majority who do not succumb to these killers, what is left to bring their long lives to an end?
In the meantime they face the inevitable, inescapable increasing dependency on other to support and provide the means you can no longer cope to provide for yourself. Surrender yourself into the hands of salaried carers. Now our Government has decided that this should not be a charge on the State, if you have independent financial means. You should pay for your own care first off. Apart from weasely caveats, this begs several questions. Where is a line to be drawn between say a terminal bedridden cancer patient or confused wanderer with no conscious recollection putting themselves and society at larger at risk, both clearly in need of constant medical support. As against an impaired person, mentally sound, but physically unable to carry out day to day tasks of feeding cleaning and dressing. Sound like a Solomon's judgement to me. Inherently unfair.
We as a Society, through our Government, have decided that the family home, invested in, harbouring precious memories, a depository for all the family hopes and expectations must be sold to pay off a russian lottery outcome. You are decreed insufficiently incapacitated and it has been decided you have the means, so you shall pay. How outrageously unfair and inequitable. Never mind that with the Governments connivance house values have gone beyond the reach of youth and their only hope to claim a home of their own is a share in their parents inheritance. It tastes exceedingly bad to me. Society is so much more than economic book balancing. It has to be about respect, compassion and a rough but overal even equity.
The final part I want to raise is why would anyone choose to live upto 100, let alone beyond a 100. If life has a meaning, it is about being able to contribute. Plenty of avenues to agree or disagree on the significance of contribute and to what. The ageing are no longer able to physically or mentally compete. They now require support and assistance just to get from day to day. We as a Society have chosen to turn our backs on the one significant contribution the aged can still offer. They have accumulated experience, wisdoms and a longer perspective having seen many iterations of events and peoples reactions to those events. In a youth centric world, these views from a past are brushed aside, marginalised even laughed at for being quaint and so irrelevant. The arrogance of youth. With their one gift trounced our aged are left nothing to contribute but their memories. Instead of being revered for being pillars of wisdom with a canny understanding of how life works, they are dismissed as a costly drain taking up precious and unaffordable human resources better spent elsewhere.
In life we make, or have made for us, choices which set up a flow of consequences. We have chosen to intervene and use our medical skills to take away natures calling card. There is no longer a natural end game for most. We have chosen to marginalise our elderly so they can longer contribute meaningfully into society. We have chosen to regard them as a cost liability to be born by society rather than a debt of honour. We must now face the consequences of those choices and we have to replace natures calling card with a calling card of our devising so that our tired elderly can say, in their own time, enough is enough, and then let them go peacefully, without financial harassment. In peace and in dignity. Tough call. Get it right because in due time you too will incur the consequences.
Sunday, 10 April 2011
Waiting to Die
We are just too good at keeping people alive. Our baby boomer generation is now approaching those critical final years as the body systems begin to shut down or wear out. Gradually as the body systems weaken then fail so the support needs increase. As we approach the nineties we become increasingly dependant on support carers to make all those necessary daily living tasks possible, of sleeping, washing, dressing, eating, defecating and waiting for the day to end. Each further intervention requires giving up precious independence and loss of privacy whilst having to accept and rely on the goodwill and timing of others. Medication struggles to offset contradictory systems failures, weak hearts, water retention and a general inability to mobilise. Relieve one symptom at the direct jeopardy to the other. By the time we are well into our nineties, if we are lucky, we are housebound, physically and mentally confined to an ever shrinking world, scarcely able to break out of the containing walls, drained by the effort to manage those few physical task not yet delegated to others. If we are lucky. If not, we may be drifting in an out of mental confusion unable to make sense of what little conscious thought we retain or hooked upto to machines with every function monitored and controlled with no escape routes left open to the mind.
The elderly have no natural place left in our society. For many reasons their families cannot accommodate or give daily support for them. Their views and experiences are old worldly and not only are seen as having no relevance but actually derided for being so out of touch. The best the state can offer is to offer low paid carers from the bottom of the employment market. Even then the rising costs of supporting all these elderly mean that budgets are constantly strained with more limitations placed on what can be provide under which ever meaner circumstances. The medical profession is harassed and time constrained without the tools to ease their elderly patients and lacking time to empathise with their patients deteriorating condition. We as a society, having made some provisions, refuse to recognise the enormous indignity we subject our old to nor have sufficient generous hearts, in recognition for all the sacrifices they made, to allocate time, with costs, to help them enjoy their last years.
So our grand elderly, who have led extraordinary lives with so many rich and varied experiences are left trapped within their weak and feeble bodies and minds, trapped in an ever closing in world. Waiting to die.
The elderly have no natural place left in our society. For many reasons their families cannot accommodate or give daily support for them. Their views and experiences are old worldly and not only are seen as having no relevance but actually derided for being so out of touch. The best the state can offer is to offer low paid carers from the bottom of the employment market. Even then the rising costs of supporting all these elderly mean that budgets are constantly strained with more limitations placed on what can be provide under which ever meaner circumstances. The medical profession is harassed and time constrained without the tools to ease their elderly patients and lacking time to empathise with their patients deteriorating condition. We as a society, having made some provisions, refuse to recognise the enormous indignity we subject our old to nor have sufficient generous hearts, in recognition for all the sacrifices they made, to allocate time, with costs, to help them enjoy their last years.
So our grand elderly, who have led extraordinary lives with so many rich and varied experiences are left trapped within their weak and feeble bodies and minds, trapped in an ever closing in world. Waiting to die.
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