Monday 22 January 2018

American carnage... the emergence of "Grandpa Dumping"

Theme-park retirement villages are a very foreign concept, says Maurice Gueret, as he surveys the Towers of Dublin

A recent UK survey found that half-a-million older folk spend every day alone (stock photo)
A recent UK survey found that half-a-million older folk spend every day alone (stock photo)
Dr Maurice Gueret

Not a great start to 2017 for the humanitarians of America. "Grandpa Dumping" is the latest headline to cross the Atlantic. Word reaches us of a severely demented man who was flown from Los Angeles and left alone in a car park in the historic English city of Hereford. NHS ambulance men were surprised to find Roger had an American accent. He could speak his own name coherently, but little more. He told carers that he had been doing some training nearby, which led them to think he may have been a military man. A careworker later googled his name and matched him up with a American high-school photograph from the 1950s. He was returned to the care of the state of California. Those accused of abandoning him came in for a surprise visit.

Care of older people is certainly cheaper on this side of the world, but there is little evidence that we do it any better. A recent UK survey found that half-a-million older folk spend every day alone, and a further half a million spend five or six days alone each week. There is little imagination among politicians about how to improve matters. One said recently that families need to take responsibility for the care of older people, just like they assume care of children. That fails to take into account that many families today have both parents out working just to pay off the mortgage. The price of modern property is, perhaps, the real enemy.

I am looking at the commercial property section of a daily newspaper. There are four nursing homes for sale. Well four sites for nursing homes, to be precise - the swimming pools and tennis courts haven't gone in yet. You could buy all four Dublin suburban sites for €10m and still have enough change to buy a bus. The dearest site was less than a half-acre. It had planning permission for 138 bedrooms in a seven-storey nursing home. For generations, Irish rebels lived in mortal fear of ending their days in the Tower of London. Now they'll have their very own Towers of Dublin. Just because you wouldn't sell your granny, doesn't mean you wouldn't put her in a tight squeeze. Can HIQA and their teams of nursing-home inspectors not urge better than this?

I watched some of a television programme earlier this year about retirement villages in the USA. They are certainly not for everyone, but at least they offer a degree of choice for people who have been able to put dollars aside for their older years. There needs to be a middle path between loneliness at home and full-time nursing care in an institution. As we try and stuff more and more beds into tower blocks or out-of-the-way fields, more enlightened developers should see a bigger picture where there is more to ageing than cushions and beds. One of my favourite American movies of all time is Cocoon, the one where a space ship descends to a retirement village with a promise of a space trip to eternal life. Many were having such a good time, they didn't want to go! Unless private golf courses and public parks start to develop residential facilities on their grounds, I don't see a great future for retirement villages in Ireland. But I do see a future where more older people up sticks and head for purpose-built retirement villages on the sunny Mediterranean.

I'm in trouble with one lady reader for using the apparently now-offensive term "lady doctor". A couple of weeks ago I was telling you about an American study that found better hospital survival rates if your hospital consultant was a woman. Evidently I caused "huge dismay" by saying "lady doctor", an expression which my lady reader tells me "belongs to the dark ages of sexism and misogyny". I apologise unreservedly for this Trump-like behaviour, and promise in future to describe lady doctors only as non-gender-assigned bachelorettes of medicine.

Last year, they were confiscating our sausages. Now the food police want our toast, too. The latest wheeze from the fraternity of medical finger-waggers concerns acrylamide. This odourless compound was first discovered in well-cooked starchy foods 15 years ago, and the jury is still out on precisely how much of it is bad for you and how many people it gives cancer to. In the meantime, food-standards agencies have given yellow cards to toast, roast potatoes, chips, biscuits and crisps. Their campaign slogan is 'Go for Gold' which suggests that we should be aiming for a golden-yellow toast and less dark fluffy crumble on our parboiled roast potatoes. I hope to update you on this public-health message before you flame the spiders out of the barbecue in May.

All doctors have bees in their work bonnets. We are as peculiar as anyone else under the white coats. Death is a preoccupation of mine. I don't enjoy funerals, but I do like to survey death columns, read obituaries and most of all, visit graveyards on my own. A friend once said it brings me closer to my patients. Ha, ha, funny guy! When I get my copy of British Medical Journal each week, my favourite page is the obituary one. The English do them particularly well. Last week, there was one about an eye doctor who made dolls' house furniture in his spare time. There was another about a surgeon who once operated on the testicles of a Barbary ape in the morgue of a Gibraltar hospital. Mine won't be as exciting. "He particularly enjoyed reading about the demise of his colleagues."

Dr Maurice Gueret is editor of the 'Irish Medical Directory'

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