Poor old folks

Shadylou

Well this sounds grim
https://www.rte.ie/news/health/2018/1003/1000721-saint-finbarrs/

Franz Von Peppercorn

Ugh. I’m booking into dignitas.

Atlantic Dawn

So will the report be used as nothing more than wallpaper for the place or will management actually lose their jobs for failure to run the place properly?

TheValeyard

Franz Von Peppercorn wrote: »

Ugh. I’m booking into dignitas.

Nah


Just book onto a cruiseship. It will be cheaper, go on round the world trips and die at sea

Shadylou

Atlantic Dawn wrote: »

So will the report be used as nothing more than wallpaper for the place or will management actually lose their jobs for failure to run the place properly?

I'd say they'll blame budgets and hse staff shortages

Roger Hassenforder

*Books non return flight to Switzerland for Jan 1st, 2050

TheValeyard

Roger Hassenforder wrote: »

*Books non return flight to Switzerland for Jan 1st, 2050

Bad idea. You're probably going to be hungover. Last thing you want to do is fly and die with a headache.

Sycamore Tree

Having worked in the HSE as a management consultant I can tell you that it's an absolutely money pit where nothing runs efficiently and never will. It was set up to fail and it will continue to fail in epic fashion. I now think that throwing money at the problem actually makes it worse. There is no value and it sends the wrong message. I don't ever see a day where a government is brave enough to sort it out. Too many vested interests that will block all reform and accept the status quo - Unions, bloated Management layers, Consultants, bloated Admin layers etc etc.

It needs to be abolished and re-created correctly next time with 1000s of non front line compulsory redundancies. Never happen of course.

fryup

^^^^^^^^^^^^^

yep, pass the parcel pass the blame

emo72

Like childcare, they want staff with level 6. And want to pay minimum wage.

When I get old I want to die so I don't give my children heartache or money problems.

But this country. Well, just cuntz basically.

Shadylou

We're unfortunately going to have to try to find residential care for my granny and this place was recommended to us as one of the best in cork ����

Graces7

some of the HIQA reports make hard reading.

OMM 0000

Serious:

In Asia, when your parents get old, they come live with you. The idea is they took care of you when you were young, so you can take care of them when they are old. They also help raise the grandchildren. There's also a strong concept of the family unit - the family look out for each other.

I know so many Irish people, including my own family, who put their parents in nursing homes, even though there were spare bedrooms, etc., where the parents could have lived.

Isn't there something kind of cold about the Irish (Western) way of doing things? It's as if we don't want to inconvenience ourselves with the old folk. I remember my grandfather's nursing home was over 1 grand a week. Surely it would have been cheaper (and nicer) to hire a helper to look after him in one of the family homes.

Shadylou

OMM 0000 wrote: »

Serious:

In Asia, when your parents get old, they come live with you. The idea is they took care of you when you were young, so you can take care of them when they are old. They also help raise the grandchildren. There's also a strong concept of the family unit - the family look out for each other.

I know so many Irish people, including my own family, who put their parents in nursing homes, even though there were spare bedrooms, etc., where the parents could have lived.

Isn't there something kind of cold about the Irish (Western) way of doing things? It's as if we don't want to inconvenience ourselves with the old folk. I remember my grandfather's nursing home was over 1 grand a week. Surely it would have been cheaper (and nicer) to hire a helper to look after him in one of the family homes.

My granny is at an advanced state of Alzheimer's and needs round the clock care, my mam and aunt have looked after her between them for the past 10 years but it's affecting all their health at the moment.
Its all very well to say bung them in the spare room and hire a helper ( which btw can cost up to €2000 a week if the person needs round the clock care) but not if youre compromising their care

Graces7

Met one old lady. She was incontinent. She had an hour a day home help. Her neighbours used to take her a dinner in but were leary of doing more in case she lost that hour a day. HSE also did laundry once a week....

She was got up, dressed and sat in a chair. Under the chair was a big bowl/bucket so the urine could run in. The stench in the room was ...

We asked if she would not be be tter off in a home but she wanted to stay home.

Not sure what help folk get to stay at home these days?

Fr_Dougal

Shadylou wrote: »

We're unfortunately going to have to try to find residential care for my granny and this place was recommended to us as one of the best in cork ����

After this report, there will be a lot of focus on this accommodation. You’d be better off staying with it.

badtoro

Shadylou wrote: »

OMM 0000 wrote: »

Serious:

In Asia, when your parents get old, they come live with you. The idea is they took care of you when you were young, so you can take care of them when they are old. They also help raise the grandchildren. There's also a strong concept of the family unit - the family look out for each other.

I know so many Irish people, including my own family, who put their parents in nursing homes, even though there were spare bedrooms, etc., where the parents could have lived.

Isn't there something kind of cold about the Irish (Western) way of doing things? It's as if we don't want to inconvenience ourselves with the old folk. I remember my grandfather's nursing home was over 1 grand a week. Surely it would have been cheaper (and nicer) to hire a helper to look after him in one of the family homes.

My granny is at an advanced state of Alzheimer's and needs round the clock care, my mam and aunt have looked after her between them for the past 10 years but it's affecting all their health at the moment.
Its all very well to say bung them in the spare room and hire a helper ( which btw can cost up to €2000 a week if the person needs round the clock care) but not if youre compromising their care

Yup, this.

People who don't directly provide care for their own elderly relations (for whatever reason) are not able to grasp the enormity of the task and it's affect on the care givers.

EdgeCase

What I never understood is why what amounts to “hostel like” accommodation in multi bed rooms is deemed to be acceptable for the old and the sick here.

I would absolutely hate to have to share space with a bunch of strangers and go from having my own home, dignity and privacy to living in some kind of weird Victorian hospital 5 to a room with bad and depressing facilities.

How is this ever acceptable?!

My mum died recently (and quite young) in a big, relatively modern public hospital and what shocked me was the lack of privacy. It was a multibed neurology ward and at one stage I was at the bedside and a man across the room was clearly being given use of a bed pan. I nearly got sick with the smell. The only ventilation was the open windows.

That and there were people who were clearly likely to die (my mum for example) sitting in beds opposite people who were very likely to recover.

When my mum died we didn’t really know what to do.
I went for a bite to eat and when I walked in and found she was dead and went rushing out to the nurse who nurse who already seemed to be vaguely aware of it.

Then a priest came in and did some kind of blessing thing.

Then we were just left there and had no idea what to do next.
Do you just stand there?

Nobody took us anywhere. There was no space to bring her. We had no idea where her body was going. We ended up kinda sitting in a corridor hugging and crying until we went home and the was still nowhere to go with the body.

You'd kind of expect maybe they'd wheel her out into a quiet space where the family could get their heads around what just happened, but no such place seemed to exist.

I had to ask staff what to do next and nobody seemed to know.

She went from totally normal breakfast to dead in 24 hours.

I have no idea what you're supposed to do. My dad was in actual shock and I was on autopilot and we ended up just going home. It felt awful as there was such a weird lack of respect to the whole thing. The hospital just went on as a big acute hospital and we felt like we were in the way.

The whole system here is a mess.

I can't pin blame on individual staff. they were all nice and friendly but there were no systems.

I’m still in shock about it tbh a few weeks later. I still get nightmares.

Hector Savage

I think ill just do away with myself when I reach 70 ... providing im still healthy.

CruelCoin

Shadylou wrote: »

Well this sounds grim
https://www.rte.ie/news/health/2018/1003/1000721-saint-finbarrs/

I'm just back from visiting a dying relative in Holland and I cannot believe the disparity between that article and what I saw over there.

The Hospice she's in had 7 rooms, I was greeted at the door and asked for coffee, and it was more a quasi-hotel than anything else.
Staffed by volunteers, part-funded by the state and charity driven the rest.
And that apparently is the norm.
Providing dignity for your final days is a driving theme there and people are active with their fund-raising efforts to provide it, where the state cannot.


Such a difference. We need to stop with the Trocaire/Concern crap and fund-raise for those who need it at home instead.

EdgeCase

Had the experience of visiting an Irish hospice and if was similar to what you're describing.

St Finbarrs is an old, old former workhouse that contains the HSE Geriatric and long term care services for some of the HSE facilities in Cork City.
It's not a hospice.

It's like a blast from the part of a bygone era of the HSE.

I encountered a vast contrast when my granny was dying. She was briefly in St Mary's HSE facility in the Phoenix Park and it was like the area she was in was last decorated in the mid 50s. I don't know if it's improved over the past few years but it was grim at that stage. We felt absolutely awful when leaving her there overnight but that was where she was to be "assessed". We got her very quickly back to home care packages.

Then she went to a hospice in Raheeny which was phenomenally good. it felt more like a hotel than a hospital.

CruelCoin

Hector Savage wrote: »

I think ill just do away with myself when I reach 70 ... providing im still healthy.

Nah dude,

Sky-diving, scuba trips, bungee jumping, all the good and exciting stuff.
What's the worst that could happen?

wexie

Graces7 wrote: »

Not sure what help folk get to stay at home these days?

Very little and it's very hard to get. The crazy thing is that providing (more) adequate homecare usually is cheaper than long term hospital care. But there isn't enough funding for the homecare so many people end up staying in hospitals far longer than they should, even though that's costing much more and they (and the family) want to go home....

EdgeCase wrote: »

I can't pin blame on individual staff. they were all nice and friendly but there were no systems.

I'm sorry to hear about your loss and the circumstances . It's really not good enough for people and their families to be treated like that in times like those.

But you're right you can't blame individual staff (certainly not the ones you might have seen on the hospital floors) in my experience they are doing the best they can and the ones that seem like they don't are just worn down by trying so hard to do good and being hampered by a completely broken and inefficient system.

EdgeCase

It’s not the staff. Individually they were doing their best and were extremely busy doing medical things. It’s an extremely busy neurological ward and people were arriving with head injuries, strokes, seizures and they were dealing with people recovering from brain surgery in other areas of the same floor.

The consultant did their absolute best to be there and talk to us when she was being treated but when she died it was like there was just nobody.

You literally need bereavement counselors on site who can immediately just step in and make sure the whole sad exit from hospital is done with dignity. It’s not even a religious thing. It’s just you need someone to be able to take you and your recently departed loved one to a calm, quiet room and coordinate making arrangements.

The undertaker was actually far, far, far more helpful than the hospital.

What I always feel in Irish hospitals is that there’s nobody coordinating anything. I’ve found this even in expensive private Irish hospitals and public hospitals. You arrive in and you’re assigned to a consultant and the hospital is just sort of working around you without anyone as a point of contact. You’d think each specialty would have a team of hospital doctors and that every patient would be assigned a GP-like person who can interface between the hospital and the patient and manage and facilitate their care, but nope - instead you’re basically left to your own devices in semi organized chaos.

It’s almost as if instead of it being a hospital, it’s one of those coworking spaces where a whole load of self employed people use facilities to work on totally independent projects. There’s never anyone to interface between the patient and the hospital. You often can’t seem to get information or find your consultant or have to resort to ringing their office on your mobile to get information.

The other big issue is the patchy nature of quality of facilities. Brand new wards are usually “ok” but anything from older eras is usually diabolical. How the hell we are still building expensive new facilities with multibed wards, over hot radiators, no HVAC systems and so on is beyond me.

There’s something very wrong with the specifications of these facilities.

Wibbs

badtoro wrote: »

Yup, this.

People who don't directly provide care for their own elderly relations (for whatever reason) are not able to grasp the enormity of the task and it's affect on the care givers.

+1000. Having done it myself for ten years, mostly on my own for five of those years and with only decent help in the last two it takes a huge toll on your life. When you're in it you tend to either not notice because you're too involved in other stuff, or you get used to it(or think you do). You only notice when the person dies and the aftermath hits and the realisation that years of your life are gone passed in limbo. My advice? As harsh as this sounds, if you find yourself in the position of primary carer, especially in the case of dementia and it could potentially go on for more than say a year or two; don't do it. If I had a time machine, I wouldn't and my life would have been very different today.

Kivaro

EdgeCase wrote: »

.....

When my mum died we didn’t really know what to do.
I went for a bite to eat and when I walked in and found she was dead and went rushing out to the nurse who nurse who already seemed to be vaguely aware of it.

Then a priest came in and did some kind of blessing thing.

Then we were just left there and had no idea what to do next.
Do you just stand there?

Nobody took us anywhere. There was no space to bring her. We had no idea where her body was going. We ended up kinda sitting in a corridor hugging and crying until we went home and the was still nowhere to go with the body.

You'd kind of expect maybe they'd wheel her out into a quiet space where the family could get their heads around what just happened, but no such place seemed to exist.

I had to ask staff what to do next and nobody seemed to know.

She went from totally normal breakfast to dead in 24 hours.

I have no idea what you're supposed to do. My dad was in actual shock and I was on autopilot and we ended up just going home. It felt awful as there was such a weird lack of respect to the whole thing. The hospital just went on as a big acutely hospital and we felt like we were in the way.

The whole system here is a mess.

I can't pin blame on individual staff. they were all nice and friendly but there were no systems.

I’m still in shock about it tbh a few weeks later. I still get nightmares.

I am very sorry for what you and your family went through.

We had a similar experience. And while most of the staff in the ICU were very nice to our family, we were treated with contempt by the head nurse and the doctor doing the rounds. As our elderly father lay dying and had hours to live, we had to deal with confrontational staff, as more of my siblings arrived from far flung areas of the world. We were extremely respectful of the environment and the requirements of the ICU unit, but there was a complete lack of respect and dignity for my father's last hours on this earth. I have to point out again though that many of the ICU unit nurses were truly inspirational and understanding.

The HSE is a mess; it needs to be torn down and re-built again, but this time from the bottom up.

OMM 0000

badtoro wrote: »

Yup, this.

People who don't directly provide care for their own elderly relations (for whatever reason) are not able to grasp the enormity of the task and it's affect on the care givers.

How are they able to do it in Asia?

wexie

EdgeCase wrote: »

The other big issue is the patchy nature of quality of facilities. Brand new wards are usually “ok” but anything from older eras is usually diabolical. How the hell we are still building expensive new facilities with multibed wards, over hot radiators, no HVAC systems and so on is beyond me.

Have you ever heard the story of the 5 monkeys?

Start with a cage containing five monkeys. Inside the cage, hang a banana on a string and place a set of stairs under the banana. Before long, a monkey will go to the stairs and climb toward the banana.

As soon as he touches the stairs, researchers spray all the other monkeys with cold water.

After a while, another monkey makes an attempt with the same result... all the other monkeys are sprayed with cold water. Pretty soon, when another monkey tries to climb the stairs, the other monkeys will try to prevent it.

Now, put the cold water away.

Remove one monkey from the cage and replace it with a new one.

The new monkey sees the banana and attempts to climb the stairs. To his shock, all the other monkeys assault him. After another attempt and attack, he knows that if he tries to climb the stairs he will be assaulted.

Next, remove another of the original five monkeys and replace it with a new one.

The newcomer goes to the stairs and is attacked. The previous newcomer takes part in the punishment with enthusiasm, because he is now part of the "team" and has learned the rules.

Now, the monkeys that are beating him up have no idea why they were not permitted to climb the stairs. Neither do they know why they are participating in the beating of the newest monkey.

Finally, having replaced all of the original monkeys, none of the remaining monkeys will have ever been sprayed with cold water. Nevertheless, not one of the monkeys will try to climb the stairs for the banana. If they could talk, they would simply say, “We’ve always done it that way.”

So realistically, in the case of the HSE (and many others) we should just start with all new monkeys

EdgeCase

I think though to get back to the original topic. Every facility in the HSE should be evaluated from the point of view of a secret shopper.

Having facilities as poor as what’s being described in St Finbars is unacceptable. There’s money. There are staff. There’s public and political support for doing this right. What’s missing is the organisational ability to implement services.

However well intentioned and well funded it may be, it doesn’t work. The services are awful and nobody seems to be prepared to just call it out for what it is: chaos dressed up as an organisation. I just see a whole load of frustrated and well intentioned staff running around in circles in a system that is completely dysfunctional.

Even calling it a “system” is probably not a valid term. It’s a bunch of medical staff and buildings.

I also think the staff are largely institutionalised to accept that this is normal. It’s not and shouldn’t be. Chaos and low standards are accepted and normalised and staff who want to work in better systems leave and find jobs elsewhere and the HSE just chomps down on a new intake of canon fodder who will mostly become discontent and leave to go to better systems elsewhere and the cycle repeats.

I don’t think we can realistically just go on with a system that is basically destroying both patients’ and staffs’ lives! It’s doing “stuff” but achieving nothing.

Wibbs

OMM 0000 wrote: »

How are they able to do it in Asia?

They're not. Sure, if someone is just old, but is not suffering from a degenerative condition and has all their marbles intact. IMHO people like that should be with their families. If anything they're a positive in family life. However if someone needs 24 hour care such as in the case of stroke victims or dementia that's a very different situation.

If there is just one carer which is often the case(and often an equally aged spouse) the level of work and attention required is extremely high. If you've not done it or know someone who has done it, you just don't realise the effort required. Funny enough I got far more sympathy and help when the parent I was caring for ended up bed bound and helpless, yet when they were profoundly mentally compromised and mobile it was of a magnitude harder to cope. Put it another way, when they were admitted by ambulance to hospital and their treatment was looking like at least a week's stay, they were so troublesome I was called the second night to come in and stay and watch them(with a security guy in tow). When I returned the next day they were ready for discharge. They weren't, but the district nurse and me were left with that aftermath.

EdgeCase

I think people have very unrealistic notions of what caring for someone in that kind of condition actually involves.

My grandmother died of cancer and was as sharp as a tack until the very end. She just needed physical assistance with doing things but was very much her normal self otherwise. She had big physical issues but she didn’t need “looking after” and was able to function very well with just an odd visit from a home carer and family looking out for her.

I’ve seen other relatives who’ve died of deterioration of brain function and it is very, very, very challenging to cope with that and many families may not even be able to do so.

You can very easily get into scenarios where a spouse, child or sibling is left in totally untenable situations as a full time carer. There are plenty of cases where people have sacrificed their own happiness, health and young and middle age tirelessly looking after relatives. You do need facilities for some people but they should be properly setup and run.

We have a lot of badly broken services.

up for anything

OMM 0000 wrote: »

Isn't there something kind of cold about the Irish (Western) way of doing things? It's as if we don't want to inconvenience ourselves with the old folk. I remember my grandfather's nursing home was over 1 grand a week. Surely it would have been cheaper (and nicer) to hire a helper to look after him in one of the family homes.

Who usually gets the lion share of looking after the old folk when they live with family? You are condemning one member of a family to what will become round the clock 24-hour care without help. Which member of the family will you nominate for that? Looking after an old person can be in many instances exactly like looking after a baby or child - doing what feels like constant feeding, changing, medicine rounds, exercise, jollying along, entertaining, talking endlessly about the old days until the day that stops and you wish that it would begin again because anything is better than that constant staring into space.

The routine of installing glasses, hearing aids, teeth and then uninstalling them for an afternoon nap and then installing them again. Getting over the ickiness of touching someone's false teeth or the putting on/changing an adult nappy and wiping crap and knowing you'll be doing it again in an hour and an hour after that. Whether dementia is present or not there can be verbal or physical abuse and certainly a helping of emotional abuse. There's the constant grind of semi-sleepless nights and very early mornings. There's the physicality of the care... it's hard work putting on a pair of compression stockings especially when you're old enough to have arthritic fingers yourself, never mind the dodgy knees that make getting up off the floor after putting on someone else's shoes a job of work on its own - just dressing/undressing someone can be a bit of a marathon.

None of that takes into account the fact that you also then probably have a family to take care of and a house and meals to cook and shopping to do. Even with the best behaved old person, they are still demanding and hard work - not because they intend to be but they have wants that need to be met. Try balancing all that with meeting the needs and challenges of teenagers and a husband/wife who may be fed up of you not wanting mad passionate sex because you're so physically ****ed by the time you fall into bed and you know that at any moment you might hear your elderly charge calling for you on the baby monitor which you've had to rescue from the attic. Not another bloody nappy change when all you want to do is sleep and it doesn't seem so long ago that you lived under the same demanding sleep-deprived militant regime.

Try adding the fact that your parent and you may not have had a wonderful relationship up till that point or it's a pesky in-law who made your life miserable and still does. Add in the fact that although all the people in the house who made a commitment to help you with the care doesn't translate into reality...there's homework, soccer/hurling practice, school, social life and the other adult in the house is in a stressful job with long hours and flakes out arriving home. Depending on where you live there may be hours of taxiing kids around and deciding whether you can live the old boy/old girl on their own for a couple of hours or do you need to put them in the car and ensure that you're able to deal with toilet accidents parked at the local hurling pitch on a dark wet afternoon in the dead of winter.

Life was very different when it was customary to take in your parents or you were already living in their house so it was your job to look after him. Resenting your siblings because you were doing the lion's share and they moaned about an odd weekend and let you down on the weekly couple of hours they were supposed to do...not just once but constantly and you know it's because of their spouses/partners or because they have to meet their children's needs (while you can't your own) or because they're ****ing off on a foreign two-week holiday or collecting their new car which they can afford because they're both working in their house while you're lucky to get away on a mid-week break and hope that your car doesn't break down on the way because you don't have €150 for the tow charge.

It really is not as easy as bringing them to live with you and it being cheaper and nicer. Someone has to lose part of their life in order to keep an old and infirm person at home.

I worked in a private old-folks home for two weeks. Although it was modern and well run with no abuse that I could see, the problem for me was no one gave a fuck about the people inside those bodies and who they were or who they had been. I didn't last longer than two weeks because I could not bear to work somewhere where profit meant more than people. Where I was instructed to walk away from someone who just wanted to tell you who she was, what she could remember of it. To tell some Grandpa Simpson stories because in the telling of them she was that person again and not trapped in bed waiting for strangers to come and get her up and wheel her to a day room where she could stare out a window/look at the tv or wait for the exciting activity for the day to begin.

I could go on and on. I already have.

I know that if I don't die suddenly then before I lose too much physical or mental function, I'm going to have a huge family party and celebrate my life and bore them to death one more time with stories that they've all heard umpteen times and then make a speech about how I'll be doing what I'm going to do for my sake and not theirs and if any of them try and keep me in a semi-vegetative state they'd better hope there's no after-life. Then a few weeks later I'll take a massive amount of tablets (don't ask) and pop my clogs nicely and tidily and there'll be a DNR just in case things go wrong. It's probably easier said than done because the will to cling to life is very strong and I've seen old people I love go from saying what I say to looking to make their 100th birthday. Is it a fear of dying? So the trick must be in the timing.

OMM 0000

Wibbs wrote: »

They're not. Sure, if someone is just old, but is not suffering from a degenerative condition and has all their marbles intact. IMHO people like that should be with their families. If anything they're a positive in family life. However if someone needs 24 hour care such as in the case of stroke victims or dementia that's a very different situation.

I've lived in 6 Asian countries and I can tell you it's normal to have a very sick grandmother or grandfather living with their family.

We can tell ourselves whatever we want to make ourselves feel better, but the reality is Asian families, in general, take care of their old people, and don't put them in homes.

For example, the guy sitting beside me right now, his grandmother wears a nappy and can't walk, and his grandfather can barely walk. But they all live together as one family. That's totally normal here (Hong Kong).

I'm not saying it's easy. I'm just saying it's a bit sad how we're so quick to put old people in homes in Ireland, especially when they're not that sick.

Graces7

EdgeCase wrote: »

I think though to get back to the original topic. Every facility in the HSE should be evaluated from the point of view of a secret shopper.



Having facilities as poor as what’s being described in St Finbars is unacceptable. There’s money. There are staff. There’s public and political support for doing this right. What’s missing is the organisational ability to implement services.


Basically this is what HIQA does, They arrive without warning. In depth assessment. Detaillled report of faults and a set time given to set things right. If not,. they have the power to close the place

Have a look at some of the reports. All online

https://www.hiqa.ie/reports-and-publications/inspection-reports

EdgeCase

That's what they do but they're clearly not having enough impact. It's a system that's unwilling to change.

EdgeCase

OMM 0000 wrote: »

I've lived in 6 Asian countries and I can tell you it's normal to have a very sick grandmother or grandfather living with their family.

We can tell ourselves whatever we want to make ourselves feel better, but the reality is Asian families, in general, take care of their old people, and don't put them in homes.

For example, the guy sitting beside me right now, his grandmother wears a nappy and can't walk, and his grandfather can barely walk. But they all live together as one family. That's totally normal here (Hong Kong).

I'm not saying it's easy. I'm just saying it's a bit sad how we're so quick to put old people in homes in Ireland, especially when they're not that sick.

To be honest I don't think we're quick to put people into homes.

My grandfather was looked after at home by my grandmother with support from my uncles and mom.

My great grandmother and great grandfather were looked after at home. My dad's parents were both looked after at home until it got to the stage where one of them needed 24/7 nursing care and even then it was only as an absolute last resort.

My other grandmother was at home other than for 3 weeks when she was in the very final stages of cancer and needed hospice care.

My great aunt is in her 80s and has no immediate family and it's been made clear to her on many, many occasions that's she's very welcome to come live with us if she needs to.

Actually, thinking about it, the vast majority of the old people I know lived at home for as long as possible.

Wibbs

OMM 0000 wrote: »

We can tell ourselves whatever we want to make ourselves feel better, but the reality is Asian families, in general, take care of their old people, and don't put them in homes.

I agree that too many people end up in homes and too many Irish families have gone the way of much of the West when it comes to pushing otherwise fairly healthy old people into homes, or leaving them in hospital taking up beds when they could be at home with minimum enough care and the district nurse dropping by to keep on top of things. In my childhood I had two grandparents living with us. One had some issues, but these were manageable and the end came within weeks. The other was as fit as a butcher's dog, until he keeled over one day, gone in seconds. I grew up with that, as many of my generation did.

However...

For example, the guy sitting beside me right now, his grandmother wears a nappy and can't walk, and his grandfather can barely walk. But they all live together as one family. That's totally normal here (Hong Kong).

And by the sounds of things both have their mental faculties intact and don't require 24 hour specialised care. As I pointed out that's a very different scenario. Try dealing with a paralysed stroke victim for years, or someone completely disabled by something like arthritis, or someone suffering with profound and progressive dementia that towards the end, an end that could last for years. Try dealing with that in increasingly nuclear non extended families more common today, or worse dealing with that as just one person.

I don't have to "tell myself whatever I want to make me feel better". I did it for over a decade. I know the costs, financial, physical and mental involved. Never mind the aftermath. Get back to me when you have even one year of that kind of experience under your belt.

EdgeCase

I'd also point out St Finbarr's the hospital being cited in this thread isn't a retirement home. It's a specialist, long term residential hospital for people with very high dependency nursing and medical requirements.

It's worrying me that a facility of that type isn't absolutely top notch in terms of infrastructure.

Sycamore Tree

Sycamore Tree wrote: »

Having worked in the HSE as a management consultant I can tell you that it's an absolutely money pit where nothing runs efficiently and never will. It was set up to fail and it will continue to fail in epic fashion. I now think that throwing money at the problem actually makes it worse. There is no value and it sends the wrong message. I don't ever see a day where a government is brave enough to sort it out. Too many vested interests that will block all reform and accept the status quo - Unions, bloated Management layers, Consultants, bloated Admin layers etc etc.

It needs to be abolished and re-created correctly next time with 1000s of non front line compulsory redundancies. Never happen of course.

I had the misfortune of attending Hollar Street with my wife, who had miscarried. In the waiting room was a young women who was in agony and as far as i could see, was in the process of miscarrying.

The queues were huge and when we were finally seen, the doctor (Who was the only one on duty) had four people stood around her with clipboards. When they asked for my comment (which i doubt was ever recorded) it was "How about we have four Doctors and one person with a clip board and make the whole thing work a lot quicker?".

Wibbs wrote: »

+1000. Having done it myself for ten years, mostly on my own for five of those years and with only decent help in the last two it takes a huge toll on your life. When you're in it you tend to either not notice because you're too involved in other stuff, or you get used to it(or think you do). You only notice when the person dies and the aftermath hits and the realisation that years of your life are gone passed in limbo. My advice? As harsh as this sounds, if you find yourself in the position of primary carer, especially in the case of dementia and it could potentially go on for more than say a year or two; don't do it. If I had a time machine, I wouldn't and my life would have been very different today.

My mother nursed my grandmother for about three years and I am sure she has a large collection of sleeping tablets in her bedside drawer to prevent her children doing the same thing. She is quite open about ending her own life, on her terms and I have no doubt she will do it. She knows the hurt it will cause, but forty years on, she still remembers the pain and struggle she went through nursing someone with severe dementia. She didn't once regret it, but does not want to put anyone else through what she went through.

OMM 0000

Wibbs wrote: »

I agree that too many people end up in homes and too many Irish families have gone the way of much of the West when it comes to pushing otherwise fairly healthy old people into homes, or leaving them in hospital taking up beds when they could be at home with minimum enough care and the district nurse dropping by to keep on top of things. In my childhood I had two grandparents living with us. One had some issues, but these were manageable and the end came within weeks. The other was as fit as a butcher's dog, until he keeled over one day, gone in seconds. I grew up with that, as many of my generation did.

However...
And by the sounds of things both have their mental faculties intact and don't require 24 hour specialised care. As I pointed out that's a very different scenario. Try dealing with a paralysed stroke victim for years, or someone completely disabled by something like arthritis, or someone suffering with profound and progressive dementia that towards the end, an end that could last for years. Try dealing with that in increasingly nuclear non extended families more common today, or worse dealing with that as just one person.

I don't have to "tell myself whatever I want to make me feel better". I did it for over a decade. I know the costs, financial, physical and mental involved. Never mind the aftermath. Get back to me when you have even one year of that kind of experience under your belt.

I'm not going to argue with you. You are wrong on this topic. I can sense you won't give an inch so I'll leave it here.

Paddy Cow

CruelCoin wrote: »

I'm just back from visiting a dying relative in Holland and I cannot believe the disparity between that article and what I saw over there.

The Hospice she's in had 7 rooms, I was greeted at the door and asked for coffee, and it was more a quasi-hotel than anything else.
Staffed by volunteers, part-funded by the state and charity driven the rest.
And that apparently is the norm.
Providing dignity for your final days is a driving theme there and people are active with their fund-raising efforts to provide it, where the state cannot.


Such a difference. We need to stop with the Trocaire/Concern crap and fund-raise for those who need it at home instead.

A hospice is very different to a hospital. My mother was in the Hospice in Galway and like you say, it was more like a friendly hotel. We were even allowed to bring her dog in to visit her! The staff were lovely and would try to accommodate us staying over to keep her company.

Paddy Cow

OMM 0000 wrote: »

I'm not going to argue with you. You are wrong on this topic. I can sense you won't give an inch so I'll leave it here.

So the guy with ten years experience as a carer is wrong and the guy with anecdotal evidence is right? :rolleyes:

El_Duderino 09

Atlantic Dawn wrote: »

So will the report be used as nothing more than wallpaper for the place or will management actually lose their jobs for failure to run the place properly?

That’s harsh. We don’t know whether the budget is being spent efficiently or not. The money required for elderly care is a much bigger problem than anyone wants to face.

There needs to be a huge rebalancing of resources to make sure old people are taken care of with dignity. There also needs to be a rebalancing of understanding that young people pay the tax for old people’s care. And young people deserve a bit of bloody credit for the burden they inherited.

Old people fad their fun and wrecked the environment and the economy. Now they need young people to clean up the environment, fix the economy and find money for the old folks care while they can’t afford basic things like houses or to start a family for themselves.

I’ve no problem paying for old folks care because it’s the right thing to do. But I’d like a bit of acknowledgment that this duty of care will be carried by the young people.

Wibbs

OMM 0000 wrote: »

I'm not going to argue with you. You are wrong on this topic. I can sense you won't give an inch so I'll leave it here.

How the hell am I "wrong"? I clearly stated that I agree we put too many people into homes. I would add that there is an increasingly profit driven industrialisation of the elderly and massive profits are made on it and those profits are driving this cultural change. The cost of care homes even for otherwise relatively independent older people is a bloody scandal.

I also stated that there is a big difference between someone living in the family who happens to be old and someone who needs constant care(of any age really). And you lumping the two together with zero personal experience of the difference and the human costs involved in the latter. But even though I actually fcuking lived through it apparently I'm wrong?

wexie

El_Duderino 09 wrote: »

That’s harsh. We don’t know whether the budget is being spent efficiently or not. The money required for elderly care is a much bigger problem than anyone wants to face.

There needs to be a huge rebalancing of resources to make sure old people are taken care of with dignity. There also needs to be a rebalancing of understanding that young people pay the tax for old people’s care. And young people deserve a bit of bloody credit for the burden they inherited.

While I wouldn't necessarily disagree with you straightaway I think if we can believe the many voices and experiences coming out of the HSE then we could do an awful lot better with the money there already is.

I wouldn't say it's only a political/management problem but they're not making things much better by dogged insistence on sticking to polices and procedures that the staff on the floor is telling them simply don't work/are inefficient/wasteful

Graces7

[QUOTE=Wibbs;108255178]I agree that too many people end up in homes and too many Irish families have gone the way of much of the West when it comes to pushing otherwise fairly healthy old people into homes, or leaving them in hospital taking up beds when they could be at home with minimum enough care and the district nurse dropping by to keep on top of things. In my childhood I had two grandparents living with us. One had some issues, but these were manageable and the end came within weeks. The other was as fit as a butcher's dog, until he keeled over one day, gone in seconds. I grew up with that, as many of my generation did.

A few years ago I was in an acute surgical ward for emergency surgery after a fall.

There were 6 beds. I and a man who had had his appendx out were the only surgical cases.

The other 4 beds were old folk needing care but not surgery. and waiting lists for non emergency surgery are long.

Wibbs

El_Duderino 09 wrote: »

That’s harsh. We don’t know whether the budget is being spent efficiently or not. The money required for elderly care is a much bigger problem than anyone wants to face.

There needs to be a huge rebalancing of resources to make sure old people are taken care of with dignity. There also needs to be a rebalancing of understanding that young people pay the tax for old people’s care. And young people deserve a bit of bloody credit for the burden they inherited.

Old people fad their fun and wrecked the environment and the economy. Now they need young people to clean up the environment, fix the economy and find money for the old folks care while they can’t afford basic things like houses or to start a family for themselves.

I’ve no problem paying for old folks care because it’s the right thing to do. But I’d like a bit of acknowledgment that this duty of care will be carried by the young people.

This is in many ways what the economics behind the care of the elderly wants us to believe. The care home and ancillary industry make huge profits. Turkey's aren't gonna vote for Christmas and suggest more families look after even healthy older family members. They want to push the American model that older family members go into retirement homes as an expectation. A couple of generations ago American families looked after their elderly, but now the general expectation is they'll feck off to Florida to supervised housing or end up in homes a la Grandpa Simpson. Again which generates more cash?

Secondly the grind and costs of modern consumerism necessitate more people working more hours within a family, which means fewer hours to be an "old style" family unit, which also adds more cash flow at the other end of life with childcare.

As for "wrecking the environment"? How many of our grandparents and great grandparents were going through expensive consumer items on an annual basis? How many were buying a new car every three years? How many were throwing clothes out after year's wear? How many under 40 even know how to darn a sock? Previous generations consumed far less and filled far fewer landfills than today's. Hell, they even ate less and ate more locally sourced foods with it. They certainly weren't eating strawberries in January flown in from Israel. It is beyond a nonsense to seriously believe that the average adult in say 1960 was more harmful to the environment than the average adult in 2018. Next time you buy a carton of milk as one does, consider that if you were around in 1960 you'd have bought it in a bottle, one that would have been returned and reused, rather than go into landfill or packed off for "recycling" somewhere else.

"Had their fun"? Again, how many of our grandparents and great grandparents were having biannual continental holidays? How many went to college? How many had the concept of "leisure time" we have today? Hell, plenty of average folks on tinder and the like have had more sexual partners by the time they're 30 than Casanova had in his life and far more than their recent ancestors ever had.

"The economy"? While the most recent generation of the Celtic Tiger™ certainly shoulder some blame for being idiots, the average Irish 70 and 80 year olds are most certainly not in this mix. The vast majority lived frugal lives, very few had access to credit the way we do and they quite simply couldn't afford to be profligate. The average Irish 70 and 80 year olds lived through mostly crappy times in Ireland. They helped build the Irish economy. Never mind that a large number of them had to leave the country. About the only large assets they have are their houses they bought and paid for decades ago at prices that were doable for single wage earning families. They didn't drive the housing market to the silly levels they are today(even after the crash). Now you can certainly point to a succession of an older political caste for screwups, but not the average older person today.

EdgeCase

My granny was probably one of the most environmentally friendly people I know and she wouldn’t have considered herself radical by doing so. She just hated waste of resources or money.

Things like plastic packaging were mind boggling waste to her. She went to the supermarket with a “trundle” (wheely trolley) on foot and refused all plastic bags. She was doing that in the 80s when everyone else was getting extra bags to go inside the bags.

She thought teabags were the height of laziness.
Clothes lasted years and years and we’re repaired.
She heated the rooms whe was in and even that was probably a bit “excessive” and they wasn’t due to lack of money. She just couldn’t stand the notion of gas being wasted.
Cooked really good meals but always seemed to focus on making economies of scale when she was cooking.
Owned a car but walked or took public transport where possible.

They were a FAR more frugal generation than my parents or mine.

PlaneSpeeking

Sounds horrific, my dad has his own room but lots of contact with other residents.

wexie

Graces7 wrote: »

The other 4 beds were old folk needing care but not surgery. and waiting lists for non emergency surgery are long.

My wife deals with this on a regular basis, she'll be told there's no money for the home package, to which she'll argue that keeping these people in the hospital is far more expensive and the beds are needed.

But they can't be sent home until suitable homecare has been arranged, but because that comes out of a different budget than the general hospital one that can't be done even though it would represent an overall saving to the HSE AND free up a bed AND allow a person who wants to go home to go home.

Of course then every so often there's enough of a hooha in the media about beds crisis etc. etc. and money magically appears from somewhere and those poor people are expected to be gone today.

It's a constant pattern of fighting crises rather than actually addressing the sources of the crises (underfunding, understaffing and many many faulty policies and procedures)

Graces7

wexie wrote: »

My wife deals with this on a regular basis, she'll be told there's no money for the home package, to which she'll argue that keeping these people in the hospital is far more expensive and the beds are needed.

But they can't be sent home until suitable homecare has been arranged, but because that comes out of a different budget than the general hospital one that can't be done even though it would represent an overall saving to the HSE AND free up a bed AND allow a person who wants to go home to go home.

Of course then every so often there's enough of a hooha in the media about beds crisis etc. etc. and money magically appears from somewhere and those poor people are expected to be gone today.

It's a constant pattern of fighting crises rather than actually addressing the sources of the crises (underfunding, understaffing and many many faulty policies and procedures)

Sums it up well. The need is for what they call "step down care" ie the smaller local hospitals. Was only in an Irish hospital briefly and the time before was an acute medical ward.. same scenario but the patients were fitter. They whisked three off to step down care, ie two small local hospitals within reach