Habit, hospital & older people

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Habit is one of the greatest developments in evolution. Habits have allowed us, in particular, as a species, to achieve, to grow, develop and improve.

What is habit? Habits are behaviours that animals form through repetition. What starts as a process of learning, study or drill, after a period of time becomes an act that requires no mental processing – your body is able to run on auto-pilot, freeing-up the rest of your consciousness to do what it does best – think, plan ahead and organise.

An example of one of my habits is what I am doing just-now – typing as I write this; another might be how I brush my teeth, tie my shoe laces or turn the key in the lock when I get home.

It is sometimes more difficult to break habits than to establish them – anyone who has been a smoker, an over-eater or a drinker will understand this; it is one thing to overcome the physiological cravings associated with addiction to nicotine, it is another thing altogether to break the habit.

Habits exist through neural pathways in our brains; these are constantly changing constellations of electrochemical stimulation that over time become established and embedded, like the tracks you see in grass where people have walked or, the fingerprints on your iPad.

How does this relate to older people?

Well, imagine, you have developed a habit – and this is something I can’t do, as I am too young – over decades. Imagine you have lived in a house for fifty or sixty years, with the same morning routine – habit – associated with washing or breakfast or getting-dressed; imagine unexpectedly having that routine disrupted through a hospital admission.

Also consider the multiple layers of disorientation that are likely associated with that time – the ward and bed moves, different staff, location of doors, sinks and toilets, different cutlery, food and light, sounds, sleep patterns – in a bay with three or when times are tough and bed-pressures great, five other people.

The medicines you have established as a habit – every morning – Aspirin, Atenolol, Allopurinol or whatever, being given to you at a different time, in a different way, in a situation that is odd.

Imagine all this disorientation added to what might be an illness, what might be delirium – acute confusion related to pneumonia or a fracture or a stroke; wedded with new medicines – blood thinners, pain killers, sedatives.

Mix this together and those neural pathways – the grooves that have grown over time, that struggle to re-form, to change or alter or evolve.

In this situation; how easy would you find it to re-learn the signals coming your way from the environment, how easy it would be to become disorientated, to fall, to be afraid, anxious or scared, to retreat into yourself.

If we allow habits to do what they do best – manage the day-to-day stuff of life, we can get on with what is important; by changing environments, transporting people in their times of need, when habits are possibly one of the last surviving vestiges of self, we need to look-out.

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