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Elder Care

Living in a grateful world

by Leigh Kelly

As we’ve recently gone through a general election and two referendums, it is interesting to see the changes that are happening in the country. We certainly are getting more diversity in parliament which reflects the nature of New Zealand’s population so it will be interesting to see what happens in the future. While Labour and the Greens have worked out a deal, one cannot help but think that because Labour has a majority, how much influence the Greens will have. I guess we just have to wait and see what transpires over the next 3 years. 

As far as the End of life choice bill referendums is concerned, I wonder how many people actually like the idea of being able to make a choice but do not fully understand what it is for the health professionals who have to apply this law. While I believe the actual number of people who chose this option, when it comes to actually making a choice, few people will take it up. However, my thoughts go to the health professionals who have devoted their career to saving lives, to be put in a position of now having to actively facilitate a person’s death. 

As far as the Cannabis referendum went, I wonder that by not voting for Cannibas reform what the effects of this will be? I guess it’s just another wait and see isn’t it.

However, one thing I am grateful that for is that we truly live in a democracy where we have sensible and sane leaders at the top. When we look at the debacle that has been going on in the US, I am so pleased that we do not have any of that nonsense here.  I find it so amazing that people can actually vote for someone like Donald Trump who is so full of his own importance, makes up lies, contradicts himself, and tweets so many untruths that people actually revere him. It makes me wonder at the psyche of some people. I’m sure the fireworks are not over there yet. He’s like a screaming child, screaming and stamping his feet because he has been told to do something. 

So today, I am writing a list of what I am grateful for

  • That we truly live in a democracy where all people can have their say without violence
  • That on the most part, our politicians are honest
  • That we have a really stable country
  • That sense prevailed and we opted for short term pain for long term gain with Covid-19
  • Majority of New Zealanders are sensible and consider others
  • That we all have freedom

What are you grateful for and what are the benefits of being grateful:

Now we are not perfect by any means, but who is and what is perfect anyway.  However, if we compare ourselves with other countries, we are pretty lucky.  I can see why we are so attractive for people to want to live here.  So if you don’t think being grateful has a positive effect on you and your health, then listen to the research on this in this clip:

Improving the wellbeing of older people

by Leigh Kelly

Those of you who did the Assessment Clinical Update in 2018 and 2019 will remember Dr Jed Montayre. He is now based in West Sydney University and has started an interesting programme to begin next year. It is a Masters in Aging – wellbeing and sustainability. Here is an article on it. He says ageing is not just about decline.

This is great to see as being in this age group and having sustained a fractured humerus 2 years ago and fractured pelvis this year, it is wonderful to see work going into how to sustain older people as they age. While I admit, I may be in the minority still working, more and more people are working past the age of 65. In fact, it’s not uncommon for people to work till they are 70 and beyond. While I move around in the community of older people, let me tell you, they are a vibrant lot of people and while they may not be actively working paid employment, they are very active in the community and in living. There are exercise, education and theatre groups, just to mention a few things that I know of. 

Many are involved in travel and are always flitting overseas till Covid – 19 hit so now the are zooming around New Zealand.

There have been many studies of mixing young children with older adults around the world to. I am not aware of any in New Zealand, but it would be something well worth looking at. Some have a bit more than children visiting aged care facilities and villages to do an item but something ongoing where they are intricately involved with the older people. 

On Vibe Channel on Thursday nights, they have been televising some experiments in the UK. One was this one in Bristol which ran for 6 weeks and the second study was one held for 3 months in Lark Hill Retirement Village in Nottingham 2018. Watch here. After the show there was an interview with one of the older people and the 4 year old she partnered with. Watch here.

Now the important thing for me here is the testing that was done throughout the study. The second study in Nottingham, had older people from the age of 70 to 103. The change in the older people during this time was remarkable. They were happier, stronger, more confident and more vibrant people. We must never forget that people can be socially isolated even when surrounded by people. How hard it must be to be left with only your memories to reflect on, which often focuses on the losses rather than the good things that happened in life.   

A similar study was conducted in Australia in 2019.  Just see the results of this. Wouldn’t it be amazing if such programmes are run in New Zealand ongoing?  How much more enriched older people lives would be if they had something to look forward to each day and what a rewarding experience it is for the children, many of them who do not have grandparents living close to them. We must not forget that many people have family living away from their parent be it overseas or in other parts of the country.  Some people do not have family either so we must think “how can we make their lives better” and set a path for this to happen. 

So, when planning an activity programme in your facility, look at how you can introduce an intergenerational programme for you residents by partnering with a day care in your area. Many children do not have grandparents living locally, as I said, so they could really benefit from buddying up with an older person. Just think of the wonderful memories that can be created for both the children and the older person which can all be recorded to look back on. For the child, it can be a memory to show their own children when they get older. For the older person, it can be a memory for the absent families to treasure. What better project to work towards after the lockdown that we have all experienced? It would truly be a win/win for all.

A new understanding and appreciation of aged care workers has emerged.

by Leigh Kelly

One of the few good things that have come out of Covid – 19 is there is a new appreciation for the wonderful work done by workers in the aged care sector.  It is so heartening to see you all now appreciated rather than criticized and condemned.  You all did an amazing job keeping both residents and you safe over this time and it is to be commended.

I have to say I was very impressed with the staff of Rosewood on how they conducted themselves and the wonderfully balanced programme on SUNDAY that was aired on Sunday night.  It showed the true side of those of you who own and work in Aged Care.  The impact that Covid had on everyone was still very raw and the true feelings of all of you who do this wonderful job of taking care of the frail, elderly and disabled, really shone through.

Now people like me know of your true worth. Yeah, all of us don’t get it right all of the time but we are only human. We do make mistakes and sometimes we just cannot meet the expectations of those close to the person in care. But you all do your best and your best shone through on Sunday night. For those who didn’t see Inside Rosewood watch here.

On top of this, those essential workers, yes you, are being commended in so many way.  There is a major call for all essential workers to be paid a living wage. While the Age Care sector is fortunate enough to be receiving a living wage, many others are not but the push is strong for others to receive what you do. Read this.

While the living wage is the being touted these days, we must not forget  the reason we celebrate Labour Day at the end of October each year.  It is in recognition of the 8 hour day being implemented. This came about in 1840 when Samuel Parnell, a carpenter, won and 8 hour working day. In 1890 in recognition of this, Labour Day was commemorated for the first time and New Zealander became known as a ‘workers paradise’. Other countries followed suite and celebrate Labour Day each year now to. 

Now most of us just think it is another day off, except for an essential worker like yourselves but I think we have to remember that many countries still do not have such a luxury. I have to say, the idea of a 8 hour working day is no longer treasured as a right of everyone in New Zealand or many others countries who celebrate Labour Day.  Many people work more than a 8 hour day regularly, so it seems to have gone by the wayside but it doesn’t hurt us to remember how hard fought this was for the worker.  

However, we mustn’t forget our forefathers who so valiantly strived for this to happen. While I understand that without a living wage, this is more difficult for some people, as I mentioned earlier, treasure the rights you have in New Zealand.  The right to a fair wage – a living wage. But a living wage does come at a cost. The business or organisation you work for has to have the income to provide a living wage. While many do, others do not and this cost has to be passed on to the consumer. As a result, some things you purchase will have to cost more as a result.

I also think we have to be grateful for the welfare system we have here to.  While it is sometimes open to abuse, the reason it was implemented in the first place was for a hand up when times are hard not a right to not work and pay your way.  In 1935, the Labour Government led by Michael Joseph Savage, not only set up the first social security system in the world they also set in motion free education, a salaried medical service, a free public hospital system, adequate standards of housing, a basic minimum wage and full employment to name a few.  While we may not enjoy all of these luxuries, many of them are still in place in some form today. 

So, my message here today, is do not take for granted what we do have in New Zealand. We have led the world in many things including the first country to register nurses, the first country to have a social security system, the first country to give women the vote, the first country to have a Treaty with the first settlers of the land and one of the first to be Covid free plus many more firsts.  They have all been hard fought for though as I said.

The money to prop up the luxuries we enjoy does not come about by merely printing more money. The money has to be earned and we all have to pay our share to keep affording these services when we need them. Be grateful you have a living wage and you pay taxes because it is the major way the government raises money. Pay your taxes gratefully and be thankful you are contributing to the lifestyle of all of us. Don’t complain about taxes.  Don’t avoid paying taxes. It is not the government taking from you. It is actually the government being able to give back to you. Just remember, all the money that has been spent over Covid 19 has to be recovered somehow to keep New Zealand functioning. There is, unfortunately, no bottomless pit. Read more on the evolution of our welfare system.

On to the next phase of recovery

by Leigh Kelly

This last month has certainly tested us all. Firstly, I would like to send my sincere condolences to Rosewood and St Margarets Hospital for the loss of residents’ due to Covid-19. The situation unfolded before you through no fault of your own and I am sure the whole of New Zealand’s thoughts has been with you over this time. I do hope, that with a shift to Level 3 and hopefully soon to Level 2, you will feel some sense of normality, what ever normality is for you. It would not have been an easy job looking after older people, especially those with dementia, who would not doubt have developed a delirium. Couple this with them not being able to understand why you are all gowned up. It must have been terrifying for them – and you as well.

While we will never forget this time, when we look back in 6 months, it will be seen in a different light and you will be congratulating yourselves on how you all got through it. I think the greatest testament to the whole aged care industry is that so many of you kept the virus out of your facilities.  WELL DONE.  Your systems and processes are working.

So, in order to move forward, we have to start looking for ways in which to do this. One of the recognized ways is gratitude. What can you be grateful for over this time? What have you learned from it?  What wonderful things happened to you as a result? Did you find an inner strength you didn’t know you had?  Did your family come to the fore and show you the true strength of unity? Is all the work you put into your family coming back to show you what a wonderful job you have done?  Have there been some people who have surprised you with the support you have been given?  What extra ordinary things have arisen to give you hope and be grateful for.

It is so easy to focus on the terrible things that happen to us and around us, yet there will more good things than you realise. Complaining about your our boss, colleagues, children, partner or the governing bodies serves no purpose.  We should be looking at more positive things in life, because believe you me, there are many positive things in life to be grateful for. Did you know the average person spends 10 hours a month complaining!  What a waste of energy.  Just think about what you could do that was more beneficial to you or others with those 10 hours. Don’t believe me? Well check out his article.

Pop Psychology really has so many worthwhile benefits. When you stop complaining, you find you no longer need the buzz that adrenalin gives you to get all fired up. You channel your energy in much more worthwhile directions and the surprising thing once you start this, you get to like people. They no longer fire you up in a negative way.  I have heard of instances when couples were on the verge of divorce but when they stopped complaining or griping about each other, they fell in love with each other again.  So, you see when you stop complaining, you are more at peace inside and with the world around you. It is very easy to feed this addiction, because that is what it is. We often unwittingly get drawn into the a gripe session – it is like a magnet and we jump on the bandwagon. Social media is a breeding ground for gripers. Don’t be tempted to get drawn into it so you can feel vindicated. Does a gripe session gain anything? How much satisfaction does it give you and how long does the satisfaction last?  So, over the next month, stop griping about people, work, the effect Covid-19 or anything else that has had a negative effect on or around you, and think and talk about the great things that have come out of it. It will amaze you when you shift away from complaining tbeing grateful how many positives you will see from this time.

Human kindness is another important factor at this time.  Being kind to others is another positive stream to lowering your stress levels. Being kind to others doesn’t cost you anything but it does help you build up your bank of happiness which makes you feel good.

So how does this work?  Well, being kind boosts oxytocin which is the love hormone.  It also releases dopamine which is a chemical messenger which gives you a high and makes you feel good. It also releases serotonin which are neurotransmitters that regulates your mood. So, the more you are kind, the more you build up you bank of happiness. Don’t believe me? Well take a look at this.

So, what’s my message this month?  Yes, its been a hard month for everyone but you have come through it.  Be grateful you still have a job, colleagues, a purpose in life, something to get up for in the morning and you are not alone.  Be grateful we have a compassionate leader that has been thinking of you at this time regardless of your political views.  Be grateful that most of your residents didn’t get Covid-19 thanks to the care they received from you.  And finally, be kind to each other and use your energy for good. Remember, what can you do with the extra 10 hours a month you gain by not griping? 

Food for thought.

It’s the little things that count.

by Leigh Kelly

Having just spent time in hospital with a fractured pelvis, I am reminded again of the little things that make recovery easier. While I can’t fault the care, it is the little niceties that make it more bearable. I’m talking about somewhere to put your little bits of rubbish that accumulate around you.  Easily solved by putting a rubbish bag attached to your nightingale. Like pain relief being given on time so you can at least be more comfortable. When receiving care, have it all completed before the nurse goes on to the next person. Having to sit and wait to have your morning cares does not make the morning start well.

I have to say I am very impressed with the new grads too. The standard of care they delivered was exceptional. They were well organised in their day too which was very pleasing to see.

However, a lot has happened in a week hasn’t it with the World Wide Pandemic being declared. But again, it is the little things that count – like handwashing. Being sloppy around this very basic of practices is what can cause the harm. For those using Care Training Online, I have posted some updated videos on Virus’, what they are and how to combat them on the Infection Control topic.  I have also updated some videos on the Pandemic planning topic as well.

Back to the little things again. It is these that will keep you all safe. The gold standard for hand hygiene is soap and water. While many think that hand sanitisers will protect them, some pointers to remember are:

  1. Not all hand sanitisers are equal. They need to be at least 60% alcohol to be effective
  2. Hands need to be clean in the first place for hand sanitisers to work
  3. Even if using hand sanitiser, if you pick up the container, you are contaminating it as is everyone else who picks it up so it less likely to be effective.  On top of this hands needs to be washed frequently with warm water and soap as well, so soap and water is the best defence against cross infections.

So, nothing beats hand washing with soap and warm water, not cold water.  This article will explain more.

So how are you going to prevent the virus from getting into the facility or your home in the first place? Have some form of soap and water hand washing at your door. While warm water may be a bit difficult to provide in these circumstances, I am reminded of Ignaz Semmelweis, the father of Infection Control, who prevented postpartum woman from dying by having buckets of water and chlorinated lime in the wards. All his medical students had to wash their hands before they examined any women in labour and dropped the death rate to as little as .85%.  It worked in the 1800s, and it still works today so let us not be resistant to the importance of using soap and water and when not available, use hand sanitiser with a high alcohol content. 

When fractured families make life difficult for parents

by Leigh Kelly

This very common occurrence can cause major distress for many families.  It is difficult to understand why a loving family can sometimes turn on those that love them, but it is unbelievably common. This all becomes more apparent around Christmas time. Being isolated or forgotten at Christmas is all to common an occurrence and causes sadness, heightens loneliness and increases anxiety especially among the elderly.

While it is rare for all family members to be involved in the discourse, but the power of one person can cause immense stress to many.  Often the reason the fracture has occurred gets distorted over time with the original cause of the discourse forgotten but this impasse continues. The passage of time does not heal, it just festers all the more. 

However, for the parent, this is very distressing and very difficult to deal with. They often have to bear this on their own or they may discuss it with other family members to try and get some sense of the situation and achieve some sense of understanding. Either way, the effect on the parent’s health is insurmountable.

While the study of pyscho-immunolgy, or the effect of stress on the immune system, is a relatively new science, there is no doubt the prolonged emotional stress of family discord will impact significantly on the physical body eventually.  You can see more on the effects of stress on the body here.

Now it used to be considered that older people suffered less from anxiety and depression, but this is now known to be untrue. Anxiety disorders are the most common form of mental illness in USA, affecting an estimated 40+million people. 

While traumatic events like falls or acute illness may often trigger anxiety, the effects of long-term family discord will always lead to conditions or situation which may even lead to the fall or acute illness in a person.  So, the effects of prolonged stress do affect the person’s ability to remain healthy and active. See more here.

So, what are the signs of anxiety and distress in the elderly? Well there are the common things like withdrawing from society, crying, insomnia, anger and so forth but for more information on the symptoms.

If your parent is showing any of the symptoms, look at what is happening or has happened in their life especially within the family.  You see, a parent will do anything for their child, no matter how old that child is.  It is something they never let go of.  Yes, they may not have been a perfect parent in the eyes of the child, but it is important to recognise they did the best they could with the skill set that they had.

When a child marries or takes a partner another dynamic is thrown into the mix.  The partner may or may not have grown up with the same values and beliefs, but it is important that this partner does not make the parent wrong.  What does need to happen though is the adult child must always remember whatever the parent has done they have done out of love.  Rarely is their malice intended and the partner also needs to consider the “other family” as well as their own. 

The role of adult child is to protect and speak up for on behalf of the parent as the parent no doubt did for them when they were a child. You see for most people, when you were a child you adored your parent.  You didn’t see their short comings, just the love they had for you and the way they guided you.

When you become a teenager, you hated your parent. They were unreasonable in your eyes when they were only guiding and protecting you to be safe and to enter the world of adult hood.

As an adult your parent had prepared you for life and you wanted to make it on your own. Your parent became less important in your life and, dare I say it, a little bit irritating as by this time you were able to think for yourself and objected to any influence they had on your life. The parent had done their job, but they may not always know it, because you are still their child and they want to continue to love you, guide you and protect you.

When they are old and frail they may become a burden on you, your life and your family but one thing is for sure, when they are gone, you will miss them. 

So, it is Christmas time now. While this should be a time of families getting together, for many it is not. All they are left with is their memories. They are often at the bottom of the list of importance in their child’s life – they have their own family(s) and Mum, or Dad are not so important now. They get fitted in to their child’s time schedule unaware of the impact of not seeing them or joining in Christmas celebrations has on their parent. 

So, have some compassion for your parents. Mend the rifts that may be plaguing your family so when the time comes to say goodbye you will be free from any regrets. Be proud that you did not contribute to your parents decline through sickness caused by stress and anxiety.  Help them to be the best they can be by giving back to them what they gave you – love.  Be a good example to your children and show them how to be a good child as an adult because you never know how your children, or their partners, will treat you. 

Also have some compassion for those in your care who are alone with only their memories at Christmas and remember it is not a joyous time for everyone.

Now it is not all doom and gloom. If you can find 13 minutes to listen to this wonderful video on 3 centenarians and even show it to those who are feeling sad at Christmas it might uplift them. Very inspiring.

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