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We must follow the African example and respect our old people properly

The recent scandals in the NHS highlight our society’s lack of respect for old people. We should offer more help to families caring for relatives, but we also have to change our attitude towards the elderly

By on Friday, 14 October 2011

Just when the failure of our National Health Service to look after the elderly properly is in the news again, I was coincidentally giving a talk in a West Sussex parish on end of life care and the various moral questions that this raises.

As always when one gives a talk on a subject that may not occupy all one’s waking thoughts, one discovers something about one’s own views on the subject, views you did not perhaps realise you held. So, for what it is worth, here is what I think.

First of all, we must look after our old people properly. No ifs, no buts. The alternative, the sort of society that deals with old people as nuisances, is not the sort of society that anyone would rationally wish to be part of.

Secondly, we are Christians: people are of value and to be treated as such. For those of us not Christians let us at least be Kantians: people are ends in themselves. We must not go down the Lady Warnock path and talk of old people with dementia having a duty to die. This is simply wrong, because, while it is true that people with dementia are non-productive and a drain on resources, people can never be reduced to mere economic entities.

But here is the crunch – if we want to look after our old people well, then it is going to cost us something. The price may not necessarily be one in money. The institutionalisation of old people needing care is very expensive, but there is an alternative – care in the home by members of the family. Most people I speak to think that is preferable: being in the home, not in a “home”; being looked after by your nearest and dearest, not by strangers who are paid to do so. But for this to happen, quite a few social and economic changes would have to take place. Family life would have to change: we would have to move away from more and more people living alone, towards more people living together, particularly in three generational family groups. It would mean more people working in the home and not out of it, and rewarding and valuing such work accordingly.

In Africa, which we Westerners sometimes think of as undeveloped, people are shocked to their core by the fact that we place our old people in nursing homes rather than looking after them ourselves. On this matter, we could profitably learn from Kenya, where old people are revered. Incidentally the word “Mzee” in Kenya means “old person” and is traditionally applied to people as a mark of respect: the first President of the country is usually referred to as Mzee Jomo Kenyatta; when you meet the President, you call him “mzee”; when you address a group of dignitaries, you use the plural, “wazee”. Now think of the way we use the term “old man” or “old woman” in this country. The difference is startling.

  • http://twitter.com/gskineke gskineke

    This is an essential part of the feminine vocation, but the thought of so rearranging family life is terribly daunting:
    http://feminine-genius.typepad.com/femininegenius/2011/10/warehousing-people.html

    Thank you for a timely piece — if those who value life don’t set a better example, then those who prioritise costs will make the choice for us. Prayers!

  • Anonymous

    Remember the bad old days of the pre-Vatican II Church where ‘pastoral ministry’ hadn’t yet been invented and it was left to the family, the neighbours, friends, associates [and their children of these who felt an extended duty of care] the Local VISITING Priest[S!!!], the local charities, the Legion of Mary, the St Vincent de Paul society, the Knights of Columba, the local religious orders , the doctor [remember house visits?] district nurse [ditto!] the postman, milkman, coalman, window cleaner etc etc etc who felt a collective duty , common decency and civic responsibility towards the elderly and housebound?

    But We are Church these days aren’t we? We’re the Big Society aiming for the Common good…

    Sigh!

  • Damo Lennon

    The scandalous treatment of the elderly in our hospitals is a result of the culture we have allowed to develop in this country over the last 50 years, where abortion has made human life a disposable inconvenience, and there is a serious danger that euthanasia will be legalised before long.

    In those circuimstances, is it really any surprise that vulnerable people are stripped of their human dignity by our medical professionals as they near the end of their lives?

  • Ann

    “This is simply wrong, because, while it is true that people with dementia are non-productive and a drain on resources, people can never be reduced to mere economic entities.”
    Having, in the past, been a residential Care Giver to Dementia Sufferers in their own homes I find it hard to agree that they are non productive.
    I will never forget one lady whom I looked after who was a lesson to me in joyfulness every single day. I will never forget you Lydia..
    Another was a lesson to me in gratitude and remembrance. Whilst at times  their Care Givers may be driven to the edge, it should be remembered that we have so very much to learn from those afflicted with dementia. Please don’t let us think of those so afflicted as ‘non productive’. They truly are not.

  • Ann

    An Imaginary Letter From A Dementia Sufferer to A Care Giver:

    My very dear Care Giver,

    When you read this, please try not to consider me an ungrateful wretch.
    I am truly grateful for all that you do for me but I would like to try to
    explain how I often feel.
    This illness is a robber. It is robbing me of all that made me the person I
    am and I am so afraid that I will come to be looked on as an ‘it’ , a
    ‘sufferer’ rather than ‘me’. I am still here. Often I cannot express myself and
    it may seem like I no longer care but if you only knew how much I do care.
    These are some of the things I care about.

    My clothes. I always took such pride in looking well groomed and smart.
    Sometimes now, you forget to ask me what I would like to wear and I would so
    much like you to try to involve me in these choices.

    Our meals. You cook very well. I used to love to cook too and it would
    be so welcome if you sometimes talked to me about the meals you are planning
    for us.

    The house. I do not mean to be obsessive, but sometimes I feel like a
    stranger in my home when you start to move things around ; furniture perhaps,
    or ornaments. It would be good if we could talk about this together.

    All these things are like little bereavements or losses to me. I am so
    frightened when everything, including my mind seems to be slipping away . You
    are my only anchor and I need you to try to understand how important it is to
    me to still be treated as the person you used to know, and hopefully still
    love. Demonstrations of affection mean so much to me. Hug me sometimes, please?

    I know how trying it must be for you. Should we have a little shed filled
    with old china so that you can go there sometimes and have a ‘smash up’ to make
    you feel less frustrated?!

    I may as well admit too that I am apprehensive of death which is surely
    drawing nearer. Besides the suffering, it is fear of the unknown, of a change
    of world. Teilhard De Chardin, whom I used to find so encouraging said that
    there must be terror and bewilderment when one has to pass from one to another
    but if one can surrender oneself totally to God it makes us enter into Him. It
    becomes an active reality. One more phase in a world and a ‘becoming’ that are
    those of our own experience.
    It would help if you would sometimes read a Psalm with me.

    This is not meant to sound morbid or melancholy. It is just an attempt to
    explain some of the things which frighten me and in which your patience and
    your love are such a strength to me.
    Underneath all this I am still the old familiar me with many frailties but
    with a sense of humour and a deep care for others.

  • ConfusedofChi

    …and?

  • http://www.facebook.com/people/Adrian-Johnson/100002117620278 Adrian Johnson

    . . . and what one future elderly and perhaps demented person can do to ensure care by a perhaps indifferent family is to make and make known to them the terms of my contingent will.  

    If my “too busy” family allow me to be neglected and to be euthanized against my Catholic principles, my estate will go not to them, but to a charity (perhaps for the elderly!) of my choice.  I will legally give authority to, and appoint as one of my executors an unrelated young person, an active member of my parish, to whom I will give  authority to periodically check up on me in my probably second-rate care home, to see that my family do their duty of seeing I am fed, hydrated, and do not develop pressure sores & gangrene. If I am in pain, this person will see that I have adequate but not “euthanasia-quantity” painkillers.  

     It is sadly common that children who were raised Catholic abandon their religion and its ethics, so if it seems cynical not to trust them, it is only realistic and prudent!   If you keep your family from allowing you to be euthanized, you will at least prevent them from sinning, which is itself a spiritual work of mercy you can by your foresight perform for them.