Wednesday, February 3, 2010

The Shadow of Old Age

The reasearch published today jointly by the London school of Economics and the Institute of Psychiatry telling us that, by 2051, more than 1.7 million people in the UK will be suffering from dementia should really come as no surprise to anyone, least of all the medical profession.
The exponential development of ever more effective pharmaceuticals over the last seventy-five years or so has meant that people no longer die from simple diseases. Which is good in one way- no one really wants to die from something that is easily treatable - but the flip side of this advance is that the only things left to die from are the Big Nasties; cancer, heart disease, stroke and degenerative illnesses. What a delightful prospect.

People are living longer and mental degeneration is part of the territory, and one that is greatly feared. Quite right too. I would far rather die at an earlier age from, say flu, than be cured, only to spend my old age wandering and widdling to the disgust and exasperation of the children and grandchildren.

And there is the continuing debate over assisted suicide.....

The government both want us to live longer, hence the constant nagging about cigarettes, alcohol units, 5-a-day fruit and veg, yadda yadda, so we can keep bringing in the cash to the treasury until we retire in our seventies (or whatever the latest figure is), and don't want us to live longer, as the the hand-wringing over the increasingly elderly placing an ever-greater burden on social, financial and medical resources shows.

My solution: stop giving out antibiotics to patients over fifty (that includes me - I'd happily take my chances). That'll cut down on the old buggers cluttering up the place.

1 comment:

Steven said...

Hypatia

I fully agree with you. The problem is that we have lost the distinction between quality and quantity of life. I remember having to sit through ward rounds when I worked in cancer care, in London; we went through each person’s reasons for admission and crucially (where I came in) who would be a problematic discharge. Every so often we would have patients in receiving chemo- or radiotherapy for cancer who were suffering from dementia. I used to think ‘What’s the point?’. It was cruel for the patient – they didn’t understand why they were feeling so ill as a result if the chemo; it was difficult for other patents and (pragmatically) I felt the bed and money could used to treat other people.

My mother’s side of the family have almost all lived well into their 80s (her brother into his 90s) and not succumbed to dementia (my maternal grandfather (who lived with us) lived to be 87, born in a workhouse, drank like a fish and had smoked untipped cigarettes from the age of 10); my father’s family have almost all died in the 50s and 60s of heart problems; my father is the exception, he’s 83. Thankfully we have agreed that if they permanently lose mental capacity they should receive only passive care for any infections etc. – i.e. let nature take its course. At present I am drafting my ‘Power of Attorney’ document with my solicitor to say the same thing. Why do people want to live on, dribbling and drooling? That said I worked in residential care for several years and sometimes, if you have your wits about you, it can be a good place to end your days as long as you remain in charge of your care. Alas this rarely happens.

No – once you score less than 25 out of a 30 on the ‘mini-mental’ test twice in a 12 month period I think antibiotics should not be prescribed and no more ‘flu’ jabs – not to mention the cornucopia of heart and blood-pressure medication. Let nature take its course. One of my biggest fears is ending my days in an old people’s home, doubly incontinent, mentally vacant and with no dignity. Hence the Enduring Power of Attorney! We should all have to have one...

Regards:

S.