To wonder who will look after us in old age?

[malificent7]

I am curently a care assitant temp until my permanent job in healthcare is sorted. It is very rewarding but hard, dirty work for little money.
They are understaffed and many are leaving due to bad pay. As we are an aging population aibu to think this is going to get worse? How can we get carers to stay,?

Disclaimer...there is no way i want dd to look after me...not fair on her...i'd rather go to a home.

I agree @babdoc. The older people I know who were still active and driving at 95 still needed several years worth of care until they died at 100+.

My lovely Dad died suddenly of pneumonia in his seventies and we were all devastated but wonder if his reticence to ever bother a doctor was in fact a blessing for him.

You are completely missing the point @hopeisallineed but I can't be bothered to say again why.

babdoc a very honest insightful post.

DH and I have only ever known two people who had a great quick death as very old people. My uncle dropped dead from a massive heart attack in his mid 80’s, he had been a farmer all his life and DH great uncle who was a fireman in the blitz and was still walking two miles a day to fetch his newspaper and then just keeled over aged 92. They were extraordinarily physically fit people.

@Peggytheredhen why? Because it’s different from your point?

Assisted dying aside, what I do think there is too much of, is ‘striving to keep alive’. My DM was in her (dementia only) care home for her final 8 years, so I saw quite a bit of it, though not for her, since past a certain stage, family wishes for her welfare were made very clear. TBH we thought it would be verging on cruelty to try to prolong her life, given the pitiful state she was in.

But a lot of it did go on with others - in and out of hospital, on drips, stuffed with tablets for this or that to keep them ‘healthy’ - for what?? Not to mention people being badgered to eat and drink (albeit with the best of intentions) when they no longer wanted to.

From all I’ve ever gathered, the ‘striving’ is often at the insistence not of medics but of relatives, who are outraged/terribly upset at any suggestion that it might be kinder to let nature take its course, and give palliative care only.

Possibly the most extreme case I heard of was of an over 90 year old with at least moderate dementia, who was fitted with a pacemaker. This despite relatives being told that without it, s/he would very likely just drift away in their sleep. But no, the relatives wouldn’t hear of that, and it was their choice, for a person who no longer had the mental capacity to decide for themselves.

I must emphasise that my decision is nothing to do with the care crisis. I've said from a very young age that I don't want to live to be really old. I don't want to live to have no quality of life. I am very independent and I genuinely don't want someone to have to take me to the toilet and bathe me. Some people are absolutely comfortable with this. I am not. I never will be, even if something were to happen to me now in my 40s.

@Youcancallmeval

If I get to a point I need care, I will be booking a one way ticket to Switzerland.

Same here.

Quite true, @Babdoc

Mil’s care home was in an area with high unemployment. It was a decent home, and the manager told me that in spite of paying well above minimum wage, with proper contracts and good t&c, they just couldn’t get staff. Most staff were actually women in their 60s. Meanwhile this area has one of the highest teenage pregnancy rates in the country. I don’t blame the young women: I would rather be on benefits for as many years as possible than tending to multiple dementia patients none of whom were aware of whether it was Christmas or Easter.

I’ll say again, these are not characters from Richard Osman’s Thursday Murder Club, living semi-independently and playing bridge (even solving murders) - a care home will be full of people who are sitting in giant nappies and dribbling, staring into space because their brain has completely died or it’s been subdued by drugs.

It saddens me that one of the answers is AI or robots for care.
Before the pandemic a big concern about elderly people especially, was loneliness, and the number of older people living alone with little interaction with other humans. And for a lot of people in the last 2 years, not seeing, hugging, being with friends or family has been worse than not going to the pub or a concert.

The issue with assisted dying is the fact that every single contact with a HCP will have to have a part about ‘you know that you can chose for assisted dying. Many people in your situation have chosen that option because they found is degrading/hard/whatever to life their life like this’

It won’t be just people knowing it’s an option. It will be brought up repeatedly to people who really do NOT want that option.
It can easily become a form of pressure. ‘Oh I’m supposed to not want to carry on. They don’t want me to carry on. I am a burden. I can chose to die and then my dcs will have some inheritance at least etc….’

I also think that many people who say now they will chose assisted suicide instead are not that place. Maybe, due to the circumstances they will want to. Maybe they won’t. Saying you are sure that will be your choice is naive on all front tbh.

Only in our culture do we feel old people are burdens instead of realising what they can offer and how enriching inter generations living can be.

I'm a big fan of inter-generational living and was raised in such a home but hate this romanticisation of other cultures as though they're some kind of utopia. Elderly people are still abandoned(sometimes literally) and neglected. I've seen documentaries and read reports on it. It's a nice idea in theory but the reality means that it's almost inevitably the women who have to do most of the work. That the person may be receiving inadequate care, because and that the mental health of the carers may be suffering.

It's one thing helping your parents with a little cooking and the odd shower, though that can also take its toll. Caring for a parent with dementia is on another level.

Do people not think that there will be visas for carers from overseas, just as the UK is now issuing temporary visas for lorry drivers?

If I get to a point I need care, I will be booking a one way ticket to Switzerland.

I remember a doctor in a TV documentary saying that people who say things like this when the eventuality is remote almost always change their mind when it comes to the crunch. It appears that people are very bad at predicting how much they won't want to die, no matter how bad the alternative is.

Wtf am I reading? I am living in a society where people think it's the right thing to kill yourself rather than rely on others to find care ? Where assisted dying should be supported as a way of overcoming the care crisis ? That really to me seems like a return to base animal nature , a move away from civilisation

I've known older people at the end of their life live for many happy years one they get the right kind of care

But that does cost. There are those in this society who can't afford to pay more but there are an greater majority who choose new baubles and plastic and handbags over humanity

It's realistically not quite as simple as 'realising what older generations can offer' @Hopeisallineed.

I agree though, that in other cultures, mainly ones where women do not work it is perhaps 'easier' though. Is that your answer to the care crisis?

@stairway

I think in the future carework will be done by robots.

Certain things can be done by robots, but I do wonder how a robot is going to be programmed to talk someone down who's stripped off for the 8th time today and is fighting off anyone who ventures near them with any weapons to hand, or someone who's attempting to climb out of a window convinced you're a Russian spy trying to poison them, or hiding under their bed because they're reliving a childhood trauma that's as real to them as the day it happened, or offer some comfort when someone is desperately searching for a relative who died 50 years ago, or recognise the subtle signs that someone who doesn't have the ability to do so themselves needs the toilet and which toilet they prefer as another one increases their anxiety and makes them aggressive?

So many comments on here today about popping off to dignitas or robots are just re-enforcing what I already know - most people don't have the faintest idea about social care, dementia and associated conditions, and the state of social care, and what's achievable and what isn't.

Having said that I agree with @Babdoc.

There is amongst HCP a refusal to accept death and a wish to try to save people’s life at all cost which isn’t healthy.
I remember a story about a little girl with a Brain tumour. After 2 years of gruelling treatment, she can declared cancer clear. Amazing isn’t it? Well she had lost lost so juicy with te treatment that she couldn’t walk anymore, couldn’t see, could hardly hear, was considered as having ‘low IQ’ which, just because of that, meanest she would never be able to be living independently. She had lost so much. Was it really worth it? :(:(

I’ve seen the same happen with cancer treatment with my MIL in the recent months. Many treatments decided in order to solve whatever problem (blood clot, infection, new chemo etc….) that have robbed her for her quality of life in her last months.

Yes - show me the culture where the men give up their lives to look after a demented relative for years.

I also agree that most people are in denial about dementia. Mil and fil did a fine job of covering things up. When bil finally called their GP when things became extremely obvious they went berserk and when the GP came round fil had set mil up at the desk with spreadsheets to pretend she was doing their finances….

Dementia is messy. It is not a vaguely dotty but sweet elderly person needing a bit of help. It is complete loss of dignity.

My mum was finally diagnosed with dementia at 85 after a gradual decline. We looked after her at home as long as we could until it became impossible. She was gradually robbed of all her initiative and ability to perform tasks. She was just about able to feed herself but not to make a cup of tea. Like a PP she lost awareness of time and would be awake shouting all night. Her home of 60 years became a strange and unfamiliar place - certainly not home anymore. She recognised us her children until the end but didn’t really remember her husband, my father who’d died 30 years previously. She spent the last three years of her life in a care home and died aged 93.

Maverickess I think some kind of AI will definitely be used in the future, birth rates are plummeting and we are living longer. No one is that keen to send their relatives to a dignitas institution. I don’t know how robots would cope with dementia patients so maybe the robots would just keep them sedated. When I was a student nurse we had cushions that talked to the patient, so if the patient stood up it would say please sit down Mrs Jones and the funny things is they worked!

Yes - show me the culture where the men give up their lives to look after a demented relative for years.

My DB did step up and do his bit but I agree it is rare.

@Youcancallmeval

If I get to a point I need care, I will be booking a one way ticket to Switzerland.

Me too, I have money set aside for it. I know how fortunate I am to be able to afford this option.

@Babdoc

Several PPs say that they will keep healthy so they do not need care when elderly, or mention relatives still active in their nineties. As a doctor, I can assure them that the vast majority of healthy old people do not stay fit to the last minute, then conveniently die of a quick heart attack! At some point, they will begin to deteriorate. If they have good genes and kept fit, the process may start later than average, but it will still happen. They will just be 98 and needing care, rather than 88 and needing care. Secondly, some PPs say that we can all sell our homes to fund care. Great, but that solves nothing if nobody wants to work in the care sector! How will you staff your care home? There are currently nearly a million job vacancies in the UK, and most are in much more congenial jobs than having to wipe elderly bottoms for minimum wage. Modern medicine has created a monster. We artificially prolong life well beyond its normal expiry date, and now we are struggling to deal with the consequences. I remember a debate in the BMJ over 20 years ago, asking whether, by treating hypertension etc, we have simply converted a quick clean death from heart disease at 70, into a lingering ghastly death from cancer and/or dementia at 80. I think we are now seeing the answer.

So true, we are not living longer, we are dying longer.

Thing is though, @TravelLost, the 'refusal' to accept death has come from society and filtered into healthcare by way of treatment and directives of what people should be offered and how.
I work on a dementia unit, we have people who have lost the ability and the drive to eat, we supplement them with fortified drinks to keep them going, some laid in bed 24/7 with (especially during covid) next to no human interaction, unable to talk, unable to do anything for themselves.
Why?
Because we have to. Because medical science has advanced, and there's an expectation that it's used to increase life, because no one wants to lose their loved one when it comes down to it and want everything done to stop that happening. Because it's morbid and taboo to talk about it.

As a society we've lost sight of quality over quantity, it's not that HCPs alone have this refusal, it's the demands of society that have led to the policies that are followed.

I think there will be visas for foreign care workers before AI.