Innovation in caring for the elderly

 Most of the developed world is faced with difficult decisions on how to care for the rapidly growing population of elderly people who can no longer care for themselves. In my own country, the UK, there are 800,000 dementia sufferers. Globally the figure is 35 million, projected to reach 115 million by 2050.

 The most difficult ones to help are those who not only cannot help themselves but, through mental frailty are unable to ask what help they need or do not even know. I recently read in The Times (31 March, 2012, article by David Charter, p.46) of an imaginative new scheme to make the lives of severe dementia sufferers as normal as possible.

Hogeweg is a specially designed village near Amsterdam. It is a community of 152 living in 23 separate houses. To get to the shops, restaurant and hairdressers they have to go through open spaces, exposed to sun, rain and wind, not covered walkways. There is no traffic and although the whole perimeter is secure they can walk around in complete safety without feeling like prisoners, even though it could be argued that in fact they are prisoners. But such people need protection from a world full of hazards as well as to be within reach of medical or psychological help. The ethos is to allow them to live as normal a life as possible.

The design and interior of each house is based on detailed research of Dutch society and is on one of seven themes: Christian, Indonesian, urban, rustic, homely, cultural or upper class. There is an individual room for each person, a large shared sitting/dining room and a kitchen. The 6 residents meet for an evening meal cooked in their own kitchen.

Less medication is needed and residents are in general calmer than their counterparts in conventional nursing homes.

A natural question comes to mind. Is it ethical to deceive the residents into thinking they are free agents in the real world?

As an ordinary Christian layman I see it like this. If you believe in a loving Creator who wants to bring all people of all races, cultures and creeds together in peace and ultimately to eternal life and you want to help God do this your aim must be to serve God by serving his people, as commanded by Jesus Christ. A dementia patient is one of God’s children and one must help that person in any way within your power to feel less frightened, less anxious, more bold, more caring, more aware of God’s holy presence in all of life and death. What is more truthful? The act of loving care that goes into creating a reassuring environment and helping someone feel secure and comfortable inside their ailing mind-body system, someone whose essence is I believe beyond the mind-body system and is learning from the experiences of love and suffering. Or is it pumping them full of drugs and minimising all human contact because it is time consuming and expensive? Which is more true to God? And which causes the greater spiritual growth and learning in the carer?

Hogeweg, which will no doubt further improve with experience, should give carers, visitors, pastors, chaplains, psychologists and counsellors time to interact with the residents in a relaxed way and in a supportive environment.

There may be another strategem to make richer the lives of dementia sufferers: give them as much contact as possible with mainstream society. I know from experience that many older people failing in mind and body get great pleasure from seeing people go about their business the way they once did themselves, and interacting with young people, especially children, and being entertained in simple ways.

How this might be done? I think there is great scope for further innovation here. Here are some examples which come to mind for a place like Hogeweg.

• a cafe in the midst of the development open to the general public and to residents (clients from outside would be issued with a pass on entry for security purposes).

• a theatre for both residents and the public (again, passes would be issued for security).

• arrange with schools, colleges, drama groups, musicians and choirs to perform in the theatre.

• a race-track passing through an area where residents can see the contestants. It could be for people, bikes or horses subject to certain safety precautions.

Such measures would, I believe, enrich the lives of dementia sufferers in their last years while friends and relatives would find their visits more meaningful and enjoyable as they shared experiences with the residents and staff. 

See also Reversing dementia in honybees

John

cosmik.jo@gmail.com

Better restaurants, less food

It is well established that in the USA, UK and other parts of the well-fed world that a large proportion of people eat too much, often of the wrong type of food, so that they can be undernourished and overfed at the same time. People eating too much is not only obscene when set against famines and malnourishment on a large scale but is a sign of neurosis, media obsession with food and enslavement to the stomach.

My impression, living in the UK, is that there is a growing awareness of this. I also think that there is a business opportunity here which could help accelerate society towards a lower consumption per person.

So I am suggesting a new approach to catering where the customer pays according to quantity, i.e. the amount of food on his or her plate. Many clients of self-service restaurants, cafes, fast food outlets and takeaways would prefer not to be given huge portions as standard but to be charged according to the amounts and types of food they choose to have placed on their plate – either by themselves or by the person serving them. In the past this was not a practicable proposition but with modern camera-cum-computer technology the situation could change quickly. All one needs is a camera to register how much food is piled onto your plate and a weighing device, and to feed these two parameters into a program to calculate the appropriate charge, an amount approximately proportional to the type and weight of food chosen by the customer.

No more leaving an eating or serving establishment with a bloated feeling or guilt or embarrassment at having wasted a good proportion of the food when so many in the world are starving. Not only would this improve the customer experience it would mean, globally

• less energy wasted on food production and transport as well as lower fossil fuel emissions and less use of water

• reduced greenhouse emissions from food production and rotting waste

• customer trends towards smaller portions would be reinforced by price penalties for larger ones

• the habit of smaller helpings from caterers would spread to home eating habits

• food retailers would need to reflect the trend e.g. customers could have food dispensed in variable amounts by machines matched to reusable packaging

• farmers, retailers and caterers would have to concentrate on quality and customer demands to get the necessary profit margins

• less obesity in the developed world

• lower expenditure by health services on diabetes, hip replacement and heart problems

I invite someone to try this.  If you do please email me and I might be your first customer. Or perhaps someone else somewhere in the world has already done this

http://www.who.int/nutrition/topics/3_foodconsumption/en/index.html

John, author 2077 AD
reach me at cosmik.jo@gmail.com

Syria: the chemical weapons factor

How will the Syrian fighting end?

At the time of writing, the Kofi Annan UN plan seems to have been accepted by Bashar al Assad and two powerful sympathising nations – China and Russia.

The disparate forces trying to depose him are so disorganised that despite UN support and universal horror at the bluntly applied brutality shown by Assad’s forces there seems little chance of the plan coming to fruition, except possibly on a long term basis.

Only recently I became aware of his chemical weapons stockpile and this could be a large factor if he decides either to go down fighting or to negotiate a safe passage and immunity. Even if he does not use them they could fall into the hands of jihad groups hostile not only to the western world but to each other and to Coptic Christians who, prior to the uprising, had been protected by Assad’s security forces. Given the relative technological illiteracy of many of the fighting groups involved the death and injury from chemcal weapons are more likely be the result of tragic accidents than targeted mayhem.



Image from Amazon site

However there may be a very significant factor which I had almost forgotten about.

 Not long after Saddam Hussein’s defeat a senior defector who was the no.2 official in Sadam’s air force, General Georges Sada, wrote a book (c.2005) about his time in Saddam’s high command. In this book Saddam’s Secrets  it was claimed that shortly before (6 weeks or so) the ill-considered 2002 invasion of Iraq Saddam had dispatched all his weapons of mass destruction (WMD) to a secret location in Syria. A senior Israeli figure confirmed the report but the media did not pick up on this at the time so I mentally put it to one side.

 Recently more stories about this hitherto largely ignored divulgence have begun to appear on the Internet and there seems to be increasing acceptance that Syria does have a large stockpile of chemical weapons, although it is still an open question whether this includes Saddam’s former arsenal. Here is a fairly random selection of recent links:

http://www.maggiesnotebook.com/2012/02/saddams-mustard-gas-in-syria-israel-warned-us-iraq-warned-us/

 http://www.thedailybeast.com/articles/2011/08/26/assad-holds-lethal-arsenal-of-weapons-of-mass-destruction-in-syria.html

http://cnsnews.com/node/13384

If Assad has been storing Sadam’s WMDs it might be used by him as a bargaining point in negotiations. Although Democrats and Republicans have obvious party political motives in accepting or rejecting the rumours it would probably be better for the USA as a nation to have its invasion of Iraq at least partially vindicated. Whatever truth emerges concerning the presence or otherwise of WMDs in Syria, there can be no justification for the political leaders of the time riding rough-shod over the US military commanders as they questioned the wisdom of trying to occupy a country with such a small army and without intensive planning.

This blog is about peace and unfortunately, human nature being what it is, one has to recognise that until we get the kind of world portrayed in 2077 AD it may sometimes be necessary to fight towards it. All we can do is fight in as humane a way as possible and try to hasten the day when it is not necessary.

John

cosmik.jo@gmail.com