The Closing Down of Care Homes: An Inevitability (a reply to @lloydy, sorta)

in #health7 years ago (edited)

In Ten facts everyone needs to know about Care Homes (Before They All Close Down!)., @lloydy calls for a fight against the closing of care homes in the UK.

I wanted to comment, but got into rambling and the comments should not be slided with a WoT like this, especially since I finally landed somewhere completely different.

This is not my opinion of course:

I have worked in a nursing/care home, and I served in a university hospital, both in a rich, "Western" and "social" nation, so I sort of have a comparison between how the terminally ill and the terminally old are treated.

But I lack the words even in my own language to describe the disgust every human being with a heart in his chest must feel at the way old people, "deprecated humans", are treated even in the best of these institutions.

The way they are treated by staff, which is underqualified, underpaid, overworked, burnt-out, and unfit to be trusted with the care of a house plant -- let alone the care for practically helpless humans beings.

This is not the place for anecdotes, but telling an elderly lady, who - the gods be praised - still posesses enough mental capacity to announce she has to go to he loo before her visit to the doctor, to just pee into her diapers, that is low. Telling a volunteer, who just took a minute, maybe one of the last, to listen to an old lady's story about her flight from the Red Army over the frozen Baltic and how the horses broke in and drowned and the bombers made low-altitude fly-overs, to hurry up collecting the dishes, that is despicable. Preventing another old lady to join maybe the last christmas festivity of her life in the home's aula because nobody had time to put her into her church dress (as the nurses were busy (as always) doing the "documentation" of when and how often which resident shat, pissed, sneezed or coughed) should make you want to punch things.

The way they are treated by their children, who are now parents and grandparents themselves and simply don't have the time to visit every week, and skip sometimes even the second week or the whole month (do you really think grandpa wouldn't notice, despite his advanced dementia?), and pacify their nagging consciousness with all the money such a home costs and the nurse's reassurance how well grandma is doing... that is low.

And so these places are becoming landfills for all the undesirable, used-up family members, boxes to stuff and forget them in, out of the eyes, out of the mind - only to switch on the great weeping and regret and lamentation upon receiving the news that finally, finally!, they have withered away, taken their last breath and closed their eyes forever, Jesus thanks, it was better for her after all, wasn't it, darling? - no more managing grandmas pension remittance! "Really, doctor, was there nothing you could do anymore?" [cry, weep, refuse to accept the inevitable, produce thick crocodile tears].

There they sit locked in their rooms, armchairs, wheelchairs and beds, watch TV only to be interrupted by the clockwork of breakfast, pills, blood pressure check, lunch, pills, dinner, pills, blood pressure check, sleep, and every thursday - entertainment program! - the absolute highlight, watching TV together with the other inmates and playing a game of parcheesi maybe with other dried up, debile vegetables unable to remember their own names. Or watching old Elli crochet, time has treated her well, at least from the point of view of a 90-year old, incontinent, dirty old man.

The cleaning ladies are doing the real work of "caring", showing real sympathy and commiseration as the old people whine and complain, ruminate and ramble, while they are crawling under the beds to catch dust bunnies, shake up the beds (and fold them just like the old ladies like it), and wipe the only small cupboard the inmates were allowed to keep of all their once so luxurious posessions amassed in a lifetime of travel, joy, and abundance. Their "Oh!"s and "Hm-hm!"s and "Yes, yes, of course"s might be the only thing keeping these old people from climbing out of the window or using their automatic beds to strangle themselves with a towel.

Ah no, they hold on to dear life, until the end, it is their way of taking revenge for the unjust banishment from society! And they know all the old tricks, believe me.

And I haven't even been assigned to the station where the truly hard cases are locked in, haunting the corridors like humpback spectres with empty eyes, small steps, saliva running down their chins, mechanically petting a doll in their arms, where from every second room desperate cries for help echo when it's time for a new round of painkillers and sedatives and the nurses - mostly male and built like disco bumpers - have scratch marks in their faces and bruises on their forearms. You know, the places visitors can't escape from unless a nurse types in the 10-digit code for the lock.

But I will tell you about the nurse born in India, who, in his most holy voice, announced his patients are now suffering their Karmic justice - for indulging in the vices of the modern world instead of listening to the words of wisdom in the Scriptures and caring for their children, leaving the education to a vile brainwashing institution instead.

How did the world treat the Elderly before Care Homes?

@lloydy asks, and answers:

Until the 19th century, there was no such thing as a Care Home. Elderly people who were unable to survive alone, would be housed in the same accommodation as the homeless or the mentally insane. The records of the earliest Care Home, originate from a women's Church group in Philadelphia, in 1823.

Aaah! What a great opportunity has been wasted! Did history begin with the 19th century?

Let us be true and sound: what to do with old people who have outlived their usefulness, how to treat a liability? What have we traditionally done, throughout the ages and cultures?

Take the Celts, for example, who had a "death hammer" or "Holy Mawle" the oldest son would confront his parents with when they were unable to care for themselves and became a burden; you will still find it hanging in the old churches of Ireland, behind the door (and Germans wonder no more what it means to "show someone where the hammer hangs"). If that did not imbue the seniors with untapped spirits to get up and face another day, what could?

Honoring the weak and old and keep them alive and well? That was a comparably Indo-Aryan thing to do, it seems...

Or let us take the Eskimos. When grandmother felt sick while travelling, and slowed down the trek, endangering the dogs and the family, the father would remain behind with grandmother, and build an igloo for her. Meanwhile, mother hurried on with the children, and when father caught up a few days later, he seemed silent and sad, and grandmother was not with him, because she didn't make it, just like last summer, when grandfather did not return from the hunt...

Wait, am I seriously suggesting euthanasia - εὐθανασία - a "good death"? Godwin to the rescue!

Humans are a relatively unique species in allowing the females to stick around for another few decades long after their fertile, biologically "useful", phase. From an evolutionary perspective, it must have proven advantageous to profit from their wisdom, knowledge, and help around the tribe - child-rearing, watching the fire, gossip- I mean: exchanging information, baking cookies, healing wounded knees and so on. That explains why even those barbarian Celts and Eskimos cared for their elders as long as possible and did not "euthanatize" them on first opportunity.

Modern medicine, lifestyle and diet allow to protract death far beyond what was known since the days of Noah. At the same time, contraceptives allow for birthrates way below what would be necessary for the preservation of the species: the age pyramid turns on its head.

This generation has interesting times coming at it, if the current system is to be upheld. Imagine all the old, rotting conservatives who will sit in prefab concrete buildings and get their butts wiped by Muslimist immigrants in 40 years...!

There are plenty of self-help groups of old people who are just a little senile, there are also projects where a few younger and abled people are invisibly in the mix to aid where really necessary.

In my opinion, this shows up much better ways than stuffing old people into these diaper silos.

Keeping the old people around is an expression of nature's lavishness, of our species' superiority over the mindless beasts of the forests and deserts, of our collective, natural, evolutionary, gods-given wealth and abundance, testament to our cultural achievement.

We devalue it greatly by upkeeping these compost pile institutions to throw our ancestors on like used toilet paper.

The only way I see to defend the practice is by referring to the slave duties one has to his masters - both sons and daughters-in-law as well as all three daughters and sons-in-law have a job, or two at least, and up to four kids, bills to pay, tax forms to fill and a plane to catch. How can you possibly look after your own parents then!

It ironically even makes sense, the system had much greater control over our time, emotions and education than our parents... time to give back now :)

These thoughts automatically lead back to the question "how did we do it in the old days" - we lived in clans and tribes and kept the old and wise around as long as possible. Some knew when to do the Yoda [Return of the Jedi spoiler alert!], some were stubborn and needed a little "nudge" (and when they began to talk silly, they got a cup of conium maculatum [Socrates' biography spoiler alert]).

Jacques-Louis David, The Death of Socrates, 1887, PD

The global tribes will be wise to rethink their values and, mayhaps, return to the ways of old in some aspects. Instead of "outsourcing" the burden, caring, nurturing and listening could be second nature to every human like lacing his shoes if he grew up with the old and wise and confused and smelly, and surely develop a completely different thanatology - and thus, a more realistic perspective on life.

I am obviously not advocating a Logan's Run scenario, nor should anyone be expected to go to the extremes Paul Lafargue and Laura Marx went. Yet, since it has become apparent that governments and charities can, in an overwhelming number of cases, not keep their promises, attention may be drawn to alternatives to dumping relatives in these institutions - leading them deep into the woods and tying them to a tree would at least bear a semblance of moral honesty.

And finally, an economical and profitable solution:

Let's hook them all to the blockchain. The hopeless cases as TRNGs, the rest as content providers (old knowledge and leaky memories) and curation-robot trainers, mechanical turks in games of checkers and streem police (that's what old people good at). This affords them enough steem so it can be practical to automate the whole tendance business and they won't care or even notice. They happily float in a tank that provides them transdermally with nutritients, have electrodes on their fingers and Oculus helmets on their heads and prowl vigilantly around the "active" pages.

One day, they power down forever, and after two years, their @username is sold in an auction.

I greet you adieu with a photo of the glass roof of the nursing home I worked at in winter, the wise uplifting words of an old Chinese proverb - memento mori - and the sources for all the humbug I pulled out of my hat:


It strikes a chord with me. My father is in such a home, and in a state where I couldn't really care for him if I tried. Well basically from a massive stroke and a past/severe drug addiction, he needs lock up and 24 hour care as he is a flight risk. He just runs, he doesn't go anywhere particular anymore, but he can't cross a road safely, yet he will try.

I think a few things will help change the difficultly you bring awareness to and one is VR. If he could practice with VR, even simple scenarios, he could do so with complete safety. It would keep him busy and give him something to strive for. I have no doubt his brain would grow and change and so the plasticity would help him in all areas, even if he could never truly be safe out in the public on his own.

I think also we can grow socially. It's difficult for people not trained or experienced in dis-functioning brains. It's scary, frustrating, and takes a lot of energy to deal with someone in such a state. For family, there is a lot of emotional content, and it takes a tremendous amount of energy, especially because in many ways our loved ones are "there" but then all of a sudden there is a total "gap". It's really hard to resolve I think.

With a little education and discussion I think family would get more involved and alleviate some of the work load of the care takers. I don't get to see my father near as much as I should, and I feel bad not just for us, but the care takers as well. I'll see him more than the others get visits though, I notice this :(

It's all really related to our global economy and advances in technology and our society. We'll make great strides soon I am sure, I appreciate writings like yours that address it head on. Thanks.

The first part is amazing piece of writing.
"Telling a volunteer, who just took a minute, maybe one of the last, to listen to an old lady's story about her flight from the Red Army over the frozen Baltic and how the horses broke in and drank and the bombers made low-altitude fly-overs, to hurry up collecting the dishes, that is despicable " what a sentence....
I too have seen what going into dementia can do to a person, even a well-cared person. It's a tragedy.
Yet, I am not well-informed enough to have a valuable opinion so let me just say that the whole article is great, greatly written and i hope i'll see more of your work soon.

[ PS: I like to answer to people asking me " you know how did socrate die?" with\ "yeap! death by being a smart-ass!" The painting is perfect :) ]

Thank you for your kind words, @razvanelulmarin! Ironically, you highlighted a terrible "false friends" mistake I made, the horses drowned, they didn't drink.

From what I've learned, there are over 60 clearly distinguishable forms of "dementia", and any real root cause for the mind's self-disassembly has not been found yet. Medication can protract, but not cure. The reversal of the age pyramid is one of many huge problems our civilization is facing, and it won't be solved by pretending it doesn't exist.

@akareyon care for the elderly currently accounts for 43 percent of the total health care spending in the U.S. --- about 1 trillion dollars a year - Mayo Clinic report, August 19th 2016. Info taken from Ray Kurzweil's newsletter. ( Full article link:
I have a vested interest. Home caring my father with Alzheimers for 2 years now. There are no easy options, but thank you for raising awareness.

Thank you for the hard numbers, @davidbrogan! I did not even think about going into the financial costs because the point seems to make itself, but I must admit: 43% of the total health care spending in the U.S., that was still a figure that surprised me. Power to you and your family; being human is nothing special when the options are easy.

A great read, sad to see it not getting more attention so far. I think agathusia is a concept that could be much more popular for old adults facing loneliness and sickness. But there's still a lot of stigma about this and euthanasia and not a lot of progress was made. Seems everyone is talking feminism and black lives matter right now, not that they are not important but we still have a lot of other barbaric and old ways of thinking to deal with.

Nitpickers would have pointed out that assisted suicide is not "euthanasia", technically... and I barely managed to refrain from building in the word apoptosis.

It would be a hard thing to list all issues and sort them according to importance! Maybe, however, some of them are closely related and rooted in the same cause, and can be mended, over time, with patience, by going directly to the source.

Thank you for your resonance, @moonjelly!

These are very interesting and important ideas that need to be debated more in my opinion but few people would dare to because it's too real and it's about our own mortality after all.

I think the real issue though is that implementing assisted suicides, euthanasia and other methods of "mercy killings" is because you would need to legally enforce someone to actually do it. Abortion went and it's still going through similar growing pains. Perhaps in the near future machines and AI could randomize the guilt factor if you know what I mean. Anyway, to me denying the comfort of a peaceful death it's nuts that in this day and age to someone who is wary about life, very old or don't want to "fight" an incurable illness anymore. I just don't see any valid reason in becoming a burden (in all senses, economic and emotional). Who wants to become that? I personally don't know how would I react if I were lonely, sick and old, perhaps many could find strength and remain stoic and graceful.

A similar comparison could be done for inmates facing life in prison sentences if you think about it.

I don't think the enforcement would be that much of an issue; it would be among the honors and duties of many a healer, shaman, medicine man, doctor or specialized assistant. I understand your randomization scheme well! And from a "guilt" perspective... it is considered a great honor for a kaishakunin to second a friend's seppuku...

Forgive me if it looks like I'm blurring lines, but these are clearly cultural ones and can be overcome in a matter of a few generations only. Those who can make such a choice for themselves should not be forbidden or prevented to choose such an option. What is more absurd than forcing someone to live through pain and suffering against his will by all means possible?

Yes, you are right, many remain stoic, peaceful, outright defiant and euphoric as they watch the hour approaching. But you used the word stigma yourself. Without doubt, many will still refuse to take the "easy route" or however they may call it - by religious decree or conviction - or plain fear of death, as funny as that may sound.

Others would choose what they deem more dignified for the same or other reasons if they had the option and knew they will not be judged (or not care if), and knew whom to ask for assistance.

And yes, imprisoning people wasn't one of humanity's brightest ideas either :/

Thank you, @lloydy! Both for the inspiration - and for your understanding :)

Fantastic wize and mature article. We really need to re-appraise our approach to our elderly. It seems the more affluent society gets the less it values and respects its elderly.

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