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  • 27th June 2016 | By David Jolley

    This is the week which will be remembered for the vote for the UK to leave the European Union. 

    Our younger daughter was left unable to speak for the morning when the result became known and a young lady consultant at our weekly seminar was similarly dismayed. 

    The analysis suggests, as I understand it, that older people and people in the North and Midlands were heavily in favour of leaving. These are people I would usually turn to for wise counsel. 

    This is now our situation. We have a government heavily laced with Eton education; taxes and other features of our lives are skewed to favour the wealthy and to be harsh on the less well-off, services for the old and those weakened by any sort of illness are severely rationed and means tested. 

    Is this a bed of nails? If so it is a bed made by us (corporately) and so the bed we (corporately) lie on – at least until we do something to change it. 

    Volunteers work on our park, to keep it tidy, to care for the budgies, cockatiels, zebra finches and one kakaricki who live in the park aviary. We enjoy the involvement and sense of ownership – people talk to each other – about the weather, about dogs and children and friends and relations, football, cricket, music, church, hospitals, plants, trees, the length of the grass – all sorts of stuff. 

    On Saturday we looked at the sky and there were showers which followed on the pattern of heavy showers which had been with us through the week. See how weather-wise we are – not quite rural but definitely creatures of the open air. 

    At 1.45pm the rain stopped. We had put up gazeebos and the Altrincham and District Dog Training Club had prepared an arena for a fabulous two hours of demonstrations, competitions, races – Dogs’ Delight – There was a good turnout of gentle people, gentle dogs. A lovely day. 

    When all was finished and cleared away there was no litter left behind – but beautiful memories and a promise that we will do it all again next year. Puppies will be adult dogs for then – and veterans will be even older. That man will need to keep his beard if he wants to hold on to his crown as the owner who looks most like is dog – Or was it the other way on? 

    Everything in this routine gives joy and refreshment and from these, strength to make something good whatever. 

    Sunday morning there was scattered glass from one broken bottle beside the octagonal island bed – we cleared it up before 7am – and most people will never know 

    But: Ouch! – Brexit – How absurd

     

     

     

     

     

     

     

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    Jo Cox 21 June 2016 | Comments (0)

    21st June 2016 | By David Jolley

    It is a terrible thing to learn of the killing of a blameless, generous young woman in her st early 40s.

    Jo Cox was identifiable by her work and her clearly expressed views in support of a better society for everyone.

    I am worried that the ‘loner’ in his 50s and with a history of contact with mental health services took the dreadful action which killed her whilst affected by a serious mental disorder. The worry is that his difficulties were not identified or if they were known, insufficient action was taken to help him. Over and again I hear or read of services for people with mental illness, dementia or learning disability being inadequate for the need. Professional responses are too often deemed correct because they are what is affordable or comply with a check-list and inclusion/exclusion criteria – whether or not they counter problems effectively.

    A man in his seventies is in hospital – hopefully recovering from the wounds he sustained when intervening in an attempt to prevent the tragedy. How wonderful that he was and is so brave. Bernard Kenny is a retired mine rescue worker who was previously mentioned for bravery in his work. It is believed that he and his wife were shopping when they saw the developing crisis – Bernard responded without hesitation. He received attention from a man in his 20s who was nearby and is a trained First Aider

    This is a terrible business. There is much to be worried about but the values of Jo Cox and her like, and the values and selflessness of ordinary people across the age bands, shine true and golden

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    13th June 2016 | By David Jolley

    It was my sadness and privilege to attend the funeral of Professor Rob Jones at St Michael’s and All Angels Church, Beeston on Tuesday of this week (7.6.16).

    Rob and I came together as trainees in psychiatry in Manchester during the 1970s. At one wonderful time we, with Clive Hyde, formed the junior members of the ‘firm’ supporting Dr John Johnson who was the clinician who led and established the teaching service in South Manchester. We were proud to learn so much about the real characteristics and needs of patients and families and to make use of the understanding which came from the phenomenological school which JJ and others had been part of. We were and are its extension into the future.

    We were colleagues but the bonds were those of friendship and trust, shared visions and commitments.

    Rob diverted for a time to a research project with David Goldberg and Beverley Hughes (Now Dame Beverley) – this was to study the clinical, social and economics of life with schizophrenia amongst the clienteles of a District General Hospital Psychiatric Unit (Withington Hospital – now much reduced as Laureate House, Wythenshawe Hospital) and a District Mental Hospital (I think this was Prestwich Hospital – Salford/Bury – now replaced by a unit at Hope Hospital, though a Forensic unit remains on the Prestwich site). Their seminal paper, with Rob its first author, appeared in Psychological Medicine 1980 10(3) 493-505.

    So Rob learned the skills of clinical research from one of the masters of the art and in company with another outstanding social scientist. He came back to clinical work and, most happily for us all, joined our South Manchester Psychogeriatric Service as its Senior Registrar. From us he went to support Tom Arie as Senior Lecturer in the unique Department of Health Care of the Elderly. Together they have done marvellous things – establishing that department as an international leader in the fields of psychiatry of old age and the medicine of old age and emphasising the advantages of those disciplines working together as one unit. What a pity so few services have been able to follow this example – though its credibility is widely acknowledged. Frustratingly it is now common for the psychiatry of old age and the medicine of old age to be provided through different and potentially competing NHS Trusts! How absurd.

    Both Rob and Tom also contributed generously and effectively to the work of the Royal College of Psychiatrists, particularly the Special Interest Group – Section – Faculty of Psychiatry of Old Age. Rob was a loyal, honest, determined, reliable presence in all these settings over all the years. He was the man to turn to for wisdom and knowledge in matters of law. Many have been thankful and many have been inspired. Though experiencing ill health for a number of years, and despite being beyond the usual age of retirement, Rob was still working on a part time basis at the time of his death. It was in this role that his worth and stature were eventually acknowledged with the award of an Honorary Chair.

    But how little I knew him. How much there was to learn on this sad day. St Michael’s and All Angels graces Church Street. At right angles to this is Chapel Street where I parked near to the Methodist Church. At the end of Chapel Street is King George’s Park – where I was to spend a little time just to think, be grateful and feel very small. Beyond the hedge a buttercup meadow is home to three elegant ponies who played in the sunshine and the grass and the buttercups. This tiny, tidy, welcoming piece of earth has been the secure setting for his life and the family.

    The service began in Welsh: Ar Hyd y Nos – and finished in Italian – Nessun dorma. But most was conducted in English.

    There were caring words from family: his elder brother Michael, children Hayden, Rhian, David and Sian, son-in-law Mark. Tom Dening gave an appreciation of Rob’s professional life. A granddaughter sang: Be still for the presence of the Lord, the Holy One is here.

    The minister remembered his last meeting with Rob at his youngest grandson’s baptism in this church just a short time ago.

    We heard of Rob’s enthusiasms for nature, travel and athletic pursuits from his youth and continued through adult life – Inspiring others, taking delight in their interests, abilities and views. He edited his own newspaper from his bedroom whilst at school, cultivated pet mice, snorkelled for hours – and drew others to the joy of it. He ran for his health despite his health, worked on for this was his passion; knew music and culture as enrichers of all our lives. This is a great family and they shared their thanks and love and pride and anguish and acceptance in their loss. Diane, his wife, did not speak but her presence now and through all these things is a power for peace.

    Even in the direction for donations Rob’s generous commitment to local endeavour rings clear:

    The Trent Dementia Services Development Centre: www.trentdsdc.org.uk/. How wonderful to find that this DSDC has survived and is still an impressively useful resource

    The Radford Care Group Centre for Care: www.radfordcaregroup.org.uk/. Not something I know of – but again impressive and entirely in keeping with all that Rob stood for and stood by.

    By our friends we come to know a bit more of ourselves.

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    29th May 2016 | By David Jolley

    Wednesday saw the death of a very frail relative who was in her 90s. After a full and productive life she had become less able and not coped living alone. Her final 6 years were spent in a Methodist Home for the Aged. Her family saw her to be happier in those years than they had seen at any time through her previous adult life. The company, the routines, the care – all complemented her own fading competences so that she could be herself – mischievous, flirtatious, opinionated, superior but generous and loyal. She valued the staff as friends and equals as in her earlier professional roles.

    The ending took ten days but was well organised and supported by the end of life team working with responsive GPs, the staff and family. It’s OK.

    The same day we learned of the sudden death by stroke of a colleague – of retirement age but still working on a part time basis. Same age as me – we were postgraduate trainees together and continued in similar work. He had experienced episodes of ill-health and had some ongoing pathology but was conscientious in healthy eating and exercises. The sudden death is a shock – it has to be that it is OK.

    The Law Commission is making steady and cultured progress in its task to suggest how to rewrite the legislation concerning people who lack mental capacity and are in 24 hour care. The present system has been exposed to be absurd, extortionately expensive and causes distress to individuals and families.

    Our 90 year old relative became subject to DoLS – amongst other things we were advised, in a formal note, that when she died her doctor could not sign a death certificate and her body would be possessed by the Coroner and would rest in a hospital mortuary until he had opportunity to conduct an inquest. Ludicrously but happily the DoLS became time-expired and was not renewed – so her peaceful, natural death in a place where she had found love was not spoiled.

    In their interim statement published this week, it is clear that the Law Commission is addressing the Coroner’s issue with what will be good effect. There remains mystery around the remaining complex considerations

    www.lawcom.gov.uk/wp-content/uploads/2016/05/mental_capacity_interim_statement.pdf

    We look forward to the final thoughts – and hope they will include reference to legislation of this area in other European countries

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