Helen Martin: Care sector needs an overhaul to keep up

THE crisis over care of the elderly in Edinburgh is the focus of an ongoing Evening News ­campaign. It's a campaign that should be run by every paper in the country.

By The Newsroom
Friday, 31st August 2018, 12:20 pm
Updated Friday, 31st August 2018, 12:24 pm
Kindness and compassion are essential but more medical care is needed for elderly people. Picture: John Devlin

Funding is a main problem and the Capital is certainly facing massive financial problems for that, along with every other public service.

But elderly care is not just about council money. The whole sector needs a radical overhaul. Much still functions on an old-fashioned basis formed many years ago when life spans were shorter, fewer people suffered from dementia, and the vast majority of support was delivered by people with minimum qualifications.

Kindness, compassion and common sense make a great care assistant, along with today’s training in moving and handling, hygiene, feeding help, etc. But the older people get, and the more dementia advances, a greater level of medical care is needed.

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Festival and Fringe overcrowding is a major problem. Picture: Neil Hanna

Even hospitals fall short. Many nurses and doctors, especially in wards not devoted to dementia or geriatric needs, know little about dementia. If a patient can see and move their hands and arms, the assumption is often that they must be able to eat when food is placed in front of them. If they are left alone for ten minutes sitting on a bed, the assumption can be that they will stay put. Neither of these can be assumed with dementia.

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Research from University College London recently revealed that in the UK around half the people admitted to hospital over 70 will have dementia, as do approximately 40 per cent of patients in acute wards.

More than a third of dementia patients in hospital are left in pain and agony because they can’t communicate their suffering.

The problem gets even worse because when pain is not recognised and treated, delirium can kick in, and too often that is “dismissed” as part of their dementia.

The same can apply to elderly ­people with dementia still living in their own home with assistance, or those in residential care. There often aren’t enough specialised nurses present who know how to carry out dementia pain assessment.

The assessment includes facial expressions, body language, increased delirium and other factors. Some cannot talk at all, some can but not understandably or cognitively enough to express their pain.

There are, of course, many ­people who live long lives and don’t ­suffer from the dreaded ‘D’, or whose dementia is at early stages, nowhere near advanced.

But the UCL statistics spell it out. All doctors and nurses in whatever speciality or general nursing, need to know more about dementia. Care homes now need to upgrade to “nursing homes” with more nurses rather than just one or two overseeing carers looking after 40 or 50 residents. We need more district nurses backing up home carers.

Since we already face a desperate shortage of nurses and doctors, this might be an impossible challenge.

Even worse is the news that health boards across Scotland are about to cut front-line staff, including nurses, in a ridiculous attempt to balance their books.

That will only plunge NHS services further down the plug-hole. Cut back on the management army first. What we really need, for everyone but especially the elderly, is government intervention to increase nurses and prevent boards rolling out such a deadly policy move.

Don’t shut down city by closing roads

WITH Edinburgh being such a geographically small and compact city, Festival and Fringe overcrowding is a major problem – hence the sensible call for road closures next August, not from councillors but from heritage and environment campaigners.

Even this year, well away from pedestrianised areas, tourists blindly and dangerously ambled into the path of oncoming traffic – The Pleasance was a nightmare. More pedestrianisation will lull them into free sauntering throughout the centre. So, we also need some measures in place to tell them to use crossings and behave responsibly on traffic routes – or risk being run over.

For locals, who still need to get from A to B in their day-to-day life, central closures are awkward but catastrophic when sometimes the only alternative, such as Holyrood Park, is also closed off for an event, along with the Capital’s random roadworks.

If most of the centre is closed off, everything else must be left open for access, or we will see the whole city accidentally shut down.

Prisoners to cigs should vape instead

A MERE £200,000 is not a lot to spend on getting Scottish prisoners switched from smoking to vaping.

Here’s some advice for the “porridge” guys. Don’t try to switch gradually while still smoking. Go straight to vape and it will take only a couple of days to adjust.

Motivate yourself by remembering the equivalent of 20 fags costing you £8 is around £1 worth of eliquid. In jail, but more importantly when you come out, you will no longer smell like an ash tray. You probably won’t cough and spit any more either.

And, if you were nabbed thanks to DNA on a cast away fag end, well that won’t happen again either.

Welcome to the Vape Club!

Count me in on Corbyn stance

HAS Jeremy Corbyn ever said he doesn’t like Jewish people, supports anti-semitism or encourages discrimination? No. Why is he constantly accused? Because like so many people he supports Palestinian equal rights and doesn’t like the Israeli government’s actions. Me too. Pity that campaign name’s already grabbed.