Housebound

I struck upon this last night after reading the section in Hilary Cottam’s book, ‘Radical Help’ (See below).

It is interesting, how people acquire certain statuses – handicapped, disabled, impaired; the same applies to housebound.

This is a term we use to describe – I imagine (I haven’t consulted the dictionary), a person who is unable to leave the confines of their house unaided.

I say ‘unaided’ as anyone can be removed from a house, providing you have enough paramedics or firemen.

Once there is a requirement for others to transfer, rotate, accommodate you, once that element of free-will is gone, ‘I think I will check the weather,’ you have passed the point.

Sure, this is not always physical.

Someone who has agoraphobia might be equally trapped in their house – it is their mind rather than the mechanics of muscle and sinew that keep them inside.

Those of us physicians who have spent enough time in A&E departments will know that ‘housebound’ as a descriptor is often the death-knell for the critically sick; breathless, infection, sepsis – housebound; the minute those words are uttered, interest from the intensive care team wanes, and, you, the patient, their family are left on their own, to fight the infection or whatever.

Don’t get me wrong – there are good reasons for this; Intensivists – that is doctors who work in Intensive Care departments have many validated tools and assessments to predict that if someone is bed-bound (there is a separate classification developed by the World Health Organisation – if you want more, see here.) their chance of ever leaving ITU is very small; therefore, best not to risk it.

Tools are OK, but, they aren’t very person-centred. We are more than numbers and percentages.

And, back to the term.

What does it mean?

Is it literally that you need someone to push you in a wheelchair? Is it that you don’t go out very often – only at Christmas?

It is certainly something we associate with ageing.

‘The housebound widow’ type of thing.

Yet, who amongst us, doesn’t at times require some form of support to leave the house? If my car wasn’t parked in the drive, it is likely that I would go out far less; if I didn’t have to go to work, even more.

It is so very easy to write-off an individual with a few words – some of my most disliked – ‘demented – aggressive’ for example, reveal, to me at least, more about the person who has recorded the information that then vulnerable old man or woman described.

In essence, it is all about language.

Society seems to have become sloppy with this aspect of communication.

You are just texting, so, it doesn’t matter how you spell the words or your use of phraseology. Let’s move-on, there are more important things. My sentence is ungrammatical, but, that is just for school, for proper. Yet, we know that what we say directly relates to what others hear and understand.

Has anyone read Heathcote Williams’ Mokusatsu?

Let’s spend some more time ensuring that what we write, what we communicate is more relevant, is, at the very least, on the periphery, true.

Housebound.

Who has bound the person to the house?

How can we facilitate independence? Mobility? A trip to the seaside?

I was drifting over the fields yesterday in a hot-air balloon (reference to Hilary again) – tomorrow I am housebound.

Let us get the words right.

Let us acknowledge the good and the bad that can be taken from a simple turn of phrase.

mokusatsu 7 August 1945

*I am trying to organise an international book club discussing Hilary’s recent book. If you would like to join the Zoom-Cast discussion, please follow this link to establish the best date and time.

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