Long lie

 

I was talking with the medical students yesterday.

They were presenting their ‘long-cases’ – this is when a student doctor or nurse reviews, examines and presents a patient’s story to me.

Two of the cases related to older people who had fallen at home and become stuck on the floor.

In the world of medicine this is called a long lie.

As to how long you must be lying on the floor for your lie to become long, is I suspect relative.

Some long-lies can be very long.

One of the patients who fell, as described by a student, was on the floor for six hours before she could struggle to her feet; the other lay on the floor in his house for two days before neighbours alerted the police.

This says much about the place of older people in our society, and their associated frailty, fragility and vulnerability.

Two days.

That is a very long time.

I suspect there must have been times when he fell asleep, nodded-off on the carpet.

People who find themselves on the floor for this long experience several forms of trauma – the most significant which can occur rapidly is the psychical – unable to get-up, thinking, ‘How long will I be here?’ ‘When will someone come to help me…’ ‘What if I die like this.’

Traditionally, those living in flats or semi-detached houses, will bang on the wall; that must offer some sense of determination – a hope, that someone will hear, respond.

If you are on the floor in a detached house or bungalow, what is the feeling?

The postman might come – how inquisitive are posties these days? Your son or daughter might phone; what if you don’t have any family? What if the family you have don’t bother with you or have the ability or interest to maintain close contact?

You are stuck.

Before long, you will be incontinent; you will either need to go to the loo and let go which will result in becoming wet then sore, or, you will not go and you will get stuck – a condition we call urinary retention – where you cannot go. At all. Urine is stuck inside your bladder and over hours your kidneys swell then stop working; if you are stuck for long enough, your skin and muscles will become damaged and break-down – this is a further trauma to your kidneys, which will then fail.

Wet and sore then cold.

We give some of our old folk a hard time – forcing them to financially economise – heating switched-off to save money.

Wet and cold and sore.

And they might bang or shout or cry or lie silently trying to work-out what to do, how to save themselves, for, no matter how old or frail, most people have a connection to life that is tenacious – the fight to live. Most take a while before giving-up.

At what point does your thirst become an issue?

Cold, hungry and thirsty and, your muscles and skin are breaking-down. And you are afraid and wet and you do not know when or if anyone will come to get you. Will you die like this?

Loneliness is not a new concept; some of us like being alone – we seek solitude; this is however different. Solitude is a choice. Thoreau walked into the woods of his own volition.

Loneliness, that is, social isolation, not seeing or talking to another person for days at a time is a modern construct, a symptom of our ailing society.

It is hard to conceive of a grandparent falling at home 100 years ago and being left.

Sure, there has always been the occasional hermit or odd-bod; loneliness and social isolation is a 21^st Century epidemic which, when tied-to falling and frailty, is a significant problem.

And the old man or woman, alone, isolated, long-lying; this perhaps adds a dimension of despair to the experience, to the trauma.

The consequences of a long-lie are significant – this can be the end of an older person living independently; the acute and post-trauma can have a devastating effect on an individual’s sense of self, sense or worth and autonomy. The experience likely echoes throughout what remains of their life.

I suppose the question we must ask, after we have learned about long-lies, older people living alone and social isolation, is, what can we do?

Just think; there is almost certainly an older person somewhere in the UK, possibly even along the road from you who is now stuck, trapped.

My friend Mike is helping to break-down some of the islands of isolation that are growing in our society – please check-out B:Friend. This is not a panacea for loneliness, social isolation or long-lies it is however a significant position statement on society and the trajectory we should all be following if we choose to support a society that is loving, person-centred and kind.