conversations about medicine and life

The treasures we surround ourselves with …

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Max Reid

woodcut by Janet de Wagt
Woodcut by Janet de Wagt

Some years ago, I was managing a large not-for-profit aged residential care facility in Wellington. We offered a range of rest home, hospital and dementia level care, and we were operating in a very competitive market, a market increasingly dominated by private ‘for profit’ aged care providers.

A perennial question for organisations in the aged residential care sector – be they private or not-for-profit – is, ‘What makes what we offer distinctive?’ Even earlier in my career, while undertaking a business degree, I remember a marketing lecturer defining the three key aspects of ‘market distinctiveness’:

You have to be either the biggest, demonstrably the best, or the most innovative.”

Sound enough concepts in themselves, perhaps, but somewhat difficult in a sector (like aged residential care) where virtually every aspect of the service you provide is detailed in standardised specifications and contracts, and then audited to within an inch of a contract’s life.

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Smoke in the head

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Grace Carlyle

opening blindsI have an elderly neighbour. We have a signal: each morning I look to see whether she has pulled her curtains. Then I know she is all right. This became less important after she had three falls followed by two operations and acquired a St John alarm, as well as home help to call in three times daily. Still, every morning I look to see the curtains are pulled. I go across whenever I am able and we have a cup of coffee. Often I cannot walk that far but I try to manage at least once a week.

She arrived in New Zealand with her eldest daughter sixty-five years ago, soon after the New Zealand government allowed Chinese wives to immigrate. She speaks a Chinese dialect and her English is limited but her ability to capture difficult concepts with the words she does know frequently takes my breath away, they are so poetic. What a poet she would have made had she only learnt to read and write. My only language is English but we mime at times and laugh a lot. She gave birth to twelve more children and worked in her husband’s market garden. She cannot manage the garden she has now, but for years I would see her out there for hours – small wonder her garden and house were immaculate. They put mine to shame. Once house-proud, now I value poetry above dust.

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Euthanasia and the common good

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Charlotte Paul

When I started thinking hard about euthanasia, I visited my friend who has a progressive illness affecting his body and mind, and who is in hospital-level care. His partner has moved into the same residence to help look after him. She responds to his suffering with love, and you can sometimes see in his eyes that he recognises this. I honour them both: his endurance and gratitude; her generosity.

But, with euthanasia in mind, I think about them both in a different way. Is his suffering unbearable? Although he wouldn’t be competent to make a request for euthanasia, should it become legal in New Zealand, their situation calls into question the value of his endurance and her generosity.

In what follows I explore my intuition that actively ending suffering by causing death undercuts the meaning of suffering.

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Song for Rosaleen: “the heartbreak that is dementia”

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Sue Wootton

song for rosaleenA memoir, by definition, is composed of memories. It is almost unbearably poignant, then, that Song for Rosaleen is a memoir that exists only because of memory loss. Written by Wellington oral historian and editor Pip Desmond, it documents her mother’s slide into vascular dementia and the effects of this on the entire family.

Perhaps this sounds grim – and of course in many ways it is. But Song for Rosaleen is gripping. It is at one level a personal account, at another a meditation on memory itself, and at yet another an erudite critique of how our society treats the frail, dependent and voiceless. For this latter reason alone it should be essential reading for everyone who works in health: management, non-clinical and clinical staff alike.

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Living in the A zone

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McMullan family Sunflower Judging Day
McMullan family Sunflower Judging Day

Kaitrin McMullan

When my mother was diagnosed with Alzheimer’s, I had the good fortune, as a storyteller and dabbler in the arts, to be able to give up poorly-paid work and move into a kind of early retirement … albeit with an elderly dependent. Swapping poverty for poverty, not too hard! The rational was that we (my partner and I) would move in and care for Mum while her brain still lived at the same address as her body, in order to make the most of these precious years, much as some people decide to devote time to their children’s  early years, only in reverse. Luckily Mum’s disease has progressed very slowly and in a benign way, and we now find ourselves in a four-generation “compound” with family living next door and a rainbow gate connecting the two houses.

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