The British Liverpool Care Pathway was created in the 1990s as a guide to medical staff dealing with elderly people near to death. It’s intention was to ensure people had a dignified and comfortable death. Unfortunately, it has been used by some as a “tick-box” checklist , and in such a way that some patients have deprived of water and food. This can come as no surprise. Where human beings have a set of rules you can bet some will always cut corners, misunderstand, or get irritated and impatient.
In response, new guidelines focus on providing personalised care, good communication and shared decision-making between staff, relatives and patients. Staff are advised to undertake daily reviews of medication and hydration and checks to see if the patient has improved. If there is any uncertainty about the best course of action, staff must seek help from more experienced colleagues.
Dare I say that with so many foreign nursing staff in Britain, both their English and their medical training can raise legitimate questions. It’s wonderful that there are people who are dedicated to helping the old, sometime grumpy, monosyllabic, ungrateful or even violent elderly people. I have personal experience of the excruciating frustration one can feel, trying to do your best. But if you are going to recruit inexpensive and inexperienced people, you also need to train them properly to ensure they behave competently on a ward.
If you’ve ever been to an institution occupied by elderly people near death or with dementia you know all too well what I mean. Everybody, however old and gaga, deserves to be treated with skill, kindness and respect. Hidden away behind the blank faces and hopelessness are real people with senses of humour, wisdom and often extraordinary stories. Epicureans should try to be gentle, patient and kind. One day that old person could be you.
The Nursing and Midwifery Council control the employment of nurses in the UK. They act precisely like a medieval guild, apparently trying to keep the supply of qualified nurses low by sheer inertia in order, presumably, to force up wages. They have a reputation for being astonishingly inefficient, keeping applicants waiting for weeks for simple acknowledgements, and making all sorts of difficulties about the qualifications of foreign nurses who have been well trained, are experienced and have nursing degrees. They understandably give precedence to British, then EU applicants, but, given the chronic lack of nurses, seem to deliberately discourage other trained nurses from Western countries. If you are, for instance, from the US they are sniffy about all American nursing qualifications, but even if you overcome this hurdle you have the additional hurdle of getting a Home Office work permit, even if you are married to a British citizen. Meanwhile, the wards of British hospitals fill with nurses from countries like the Phillippines – nothing wrong with them personally, but my own visits to a local London hospital suggest that in terms of English comprehension and nursing training, patients are being short- changed for financial reasons.
An insightful post infused with Epicurean values. Institutionalizing the elderly is a mark of how every aspect of Western civilization has devolved into commercialization or militarization of every aspect of human life.
A mentally, emotionally, and physically healthy life is rooted in a community of people at all stages of life, not segregated by accidents such as age or wealth. And there is another mark of the West’s decline–our institutions are seldom driven by human needs but rather by the enshrinement of profit as an absolute good.