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We write them off as vulnerable, non-sexual burdens – but the elderly are not just a problem to be solved

A new regular column, "Nurse in the City", by Brian Kellett.

Have you heard of the “pink pound”? Of course you have – you read the New Statesman. I’m guessing that you also know about the “grey pound”, the demographic that takes in the elderly of this country.

You will know about the “ticking time bomb” of the ageing population and about how pensions are becoming so expensive that many of us will have to work until we are 68 or older. The elderly are also seen as “bed-blockers” who take up hospital places (though half of their hospital beds have been cut).

As a community nurse in east London, I spend most of my working day seeing people in their homes. You learn quite quickly in this job that the elderly are just as diverse as the rest of us and that it is misleading to refer to them as a homogenous lump. I used to work in various branches of emergency medicine. Back then, I saw patients for a very short time. After many years, I decided that struggling with drunks and dealing with young people who thought that a blocked nose was an emergency worthy of an ambulance were starting to wear a bit thin. Now, I have the time to get to know my patients and they get to know me. In many cases, we are on first-name terms. And each patient is different.

There is a woman I visit who is intensely proud of how clean she keeps her house, despite living on her own and being nearly blind. She has a little rota in her head – on Wednesday morning, she mops the floor (whether it needs it or not); in the afternoon, she vacuums the carpets; on Thursday, she dusts her house from top to bottom, and so on.

Then there is the woman who lives in a very mucky house – the sort of place that has you wiping your feet on the way out – and until recently would refuse all help from us. Finally, she agreed to let some people in to give it a tidy. It’s still dirty but there’s been a big improvement. I like both of these patients equally. They show their independence in different ways; they are quite happy in their way of life.

There are also the sisters who live together and are as thick as thieves (I swear they are conspiring to do something, like in Arsenic and Old Lace) and the woman who was thrown out for marrying a man from India – her family could not stand the “shame”. They drove her not only from her family home but from the village she grew up in.

The elderly, apparently, are nonsexual. Perhaps someone should tell that to the chap who says he enjoys looking at pornography, though “nothing down there” has been working for years, or the other man who has a wife and children but still flirts with me (it probably doesn’t help that I keep insisting on looking at his naked buttocks as part of his care package).

I see atheists, Christians, Muslims, Buddhists, Sikhs and Jews. I see those with pin-sharp minds and those in the midst of dementia. I don’t need anniversaries to remind me of wars because I hear true stories about them on an almost daily basis. As I sit on the floor in front of my patients, bandaging their legs, I hear about how they became friends with German POWs, or how they drank themselves through Italy following their commander, or how they looked after their mates, or how they got to carry the “bastard big gun” because they were the tallest in their squad. For many of them, it was the formative experience of their life, not something simply to be trotted out every 25, 50 or 100 years and “celebrated”.

As I change their catheters, I listen to them talk about their time as union leaders; about strikes and how they did their best for their members. Some of them espouse political views that I disagree with. Sometimes, I nod my head and let it slide; at other times, I’ll have a good-hearted argument.

There seems to be a consensus that the elderly are vulnerable people who get abused in nursing homes, get pensions that are unsustainable, will freeze to death in a cold snap and take up valuable hospital beds, all at the expense of the “hard-working taxpayer”. But what we need to accept is that they are people and not just a problem to be solved.

Next week: Dr Phil Whitaker’s Health Matters

This article first appeared in the 19 February 2014 issue of the New Statesman, The Space Issue

Photo: Getty
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Something is missing from the Brexit debate

Inside Westminster, few seem to have noticed or care about the biggest question mark in the Brexit talks. 

What do we know about the government’s Brexit strategy that we didn’t before? Not much, to be honest.

Theresa May has now said explicitly what her red lines on European law and free movement of labour said implicitly: that Britain is leaving the single market. She hasn’t ruled out continuing payments from Britain to Brussels, but she has said that they won’t be “vast”. (Much of the detail of Britain’s final arrangement is going to depend on what exactly “vast” means.)  We know that security co-operation will, as expected, continue after Brexit.

What is new? It’s Theresa May’s threat to the EU27 that Britain will walk away from a bad deal and exit without one that dominates the British newspapers.

“It's May Way or the Highway” quips City AM“No deal is better than a bad deal” is the Telegraph’s splash, “Give us a deal… or we walk” is the Mirror’s. The Guardian opts for “May’s Brexit threat to Europe”,  and “May to EU: give us fair deal or you’ll be crushed” is the Times’ splash.

The Mail decides to turn the jingoism up to 11 with “Steel of the new Iron Lady” and a cartoon of Theresa May on the white cliffs of Dover stamping on an EU flag. No, really.  The FT goes for the more sedate approach: “May eases Brexit fears but warns UK will walk away from 'bad deal’” is their splash.

There’s a lot to unpack here. The government is coming under fire for David Davis’ remark that even if Parliament rejects the Brexit deal, we will leave anyway. But as far as the Article 50 process is concerned, that is how it works. You either take the deal that emerges from the Article 50 process or have a disorderly exit. There is no process within exiting the European Union for a do-over.  

The government’s threat to Brussels makes sense from a negotiating perspective. It helps the United Kingdom get a better deal if the EU is convinced that the government is willing to suffer damage if the deal isn’t to its liking. But the risk is that the damage is seen as so asymmetric – and while the direct risk for the EU27 is bad, the knock-on effects for the UK are worse – that the threat looks like a bad bluff. Although European leaders have welcomed the greater clarity, Michel Barnier, the lead negotiator, has reiterated that their order of priority is to settle the terms of divorce first, agree a transition and move to a wider deal after that, rather than the trade deal with a phased transition that May favours.

That the frontpage of the Irish edition of the Daily Mail says “May is wrong, any deal is better than no deal” should give you an idea of how far the “do what I want or I shoot myself” approach is going to take the UK with the EU27. Even a centre-right newspaper in Britain's closest ally isn't buying that Britain will really walk away from a bad deal. 

Speaking of the Irish papers, there’s a big element to yesterday’s speech that has eluded the British ones: May’s de facto abandonment of the customs union and what that means for the border between the North and the South. “May’s speech indicates Border customs controls likely to return” is the Irish Times’ splash, “Brexit open border plan “an illusion”” is the Irish Independent’s, while “Fears for jobs as ‘hard Brexit’ looms” is the Irish Examiner’s.

There is widespread agreement in Westminster, on both sides of the Irish border and in the European Union that no-one wants a return to the borders of the past. The appetite to find a solution is high on all sides. But as one diplomat reflected to me recently, just because everyone wants to find a solution, doesn’t mean there is one to be found. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.