What did yesterday teach me?

Well, a few things; probably.

Lesson one:

This first one won’t apply to everyone, although, if like me you are in middle-age clutter, at times overwhelmed by too much, consider daily reduction.

Every day get rid of one thing, item of clothing, utensil, book you no longer need – reduce, reuse and recycle.

This should make us all feel a little happier.

Lesson two:

To relax take six deep breaths.

One or two won’t do, too many and you risk collapse. Six. This is enough to lower your blood pressure, normalise brain waves and release a little endorphin into your system. Straightforward, isn’t it?

Lesson three:

Pulp headlined at Glastonbury in 1995 because the Stone Roses didn’t play, this because John Squire broke his clavicle. I never quite understood the reason at the time. I was there. I think. Crazed.

Lesson four, which isn’t a lesson, more a recap:

If you take the time to check an older person’s hearing aids and clean their specs, they shift from being passive to an active participant in conversation; their self-hood is realised, and you are no longer managing a patient but engaging with a person. They shift from black and white to technicolour.

Lesson five:

Again, not something new but a reiteration.

Delirium is terrifying, both for the person experiencing the acute change in personality and perception as well as those family members who are unable to understand the shift; the helplessness, not knowing and flashes of an uncertain future are scary.

Lesson six:

I came upon this on Thursday, but, it still counts.

We all know that cars are stupid and wasteful. They are the second most expensive object most of us own and for most of the time they sit outside our houses or work unused. At least we sleep in our houses.

A consequence of this extravagance is not only Global Warming but too many cars on the road – and so, we build bigger roads. Can we do more car sharing?

The thought that accompanied this relates to patients and, people in general but particularly those in care settings.

You fall, catch a virus or become ill.

Hospitalisation follows.

Out of the 24 hours you occupy a health, social care or other ‘bed’ you might see a doctor for 10 minutes, a nurse for 20, a therapist for 15 and so it goes; the day moves round, you lie in bed or sit by bedside.

Even if all those numbers doubled, to 90 minutes that is still only six per cent of the time in ‘useful’ activity; 10 per cent if you factor-in sleep.

I attended a meeting on Thursday where Professor David Ekers from York University talked about depression in older people and in particular a phenomenon called ‘subthreshold depression’

This is where people are not formally depressed – they don’t meet the diagnostic criteria for the disease, yet, they have some of the symptoms – low mood, lethargy, poor sleep for example.

This isn’t recognised as a disease more a pre-condition, like metabolic syndrome – round tummies, raised blood pressure and higher than normal blood sugar – a precursor or red-flag for heart disease and stroke.

Those with subthreshold depression are at significant risk of developing depression with its associated fallout – shortened lifespan, multimorbidity, institutionalisation and so on.

David’s research was looking at the effects of helping people in this pre-stage to avoid developing formal depression.

The results were significant and positive.

Yet, this isn’t a thing.

This is what had me thinking about cars and patients (you were wondering as to the point of that earlier paragraph, weren’t you?)

Our patients spend most of their time doing nothing. Sitting. Waiting. Passively being patient.

How about we took a little of that time and encouraged both physical and mental health wellbeing either as a meaningful activity or as a programme of change, to enable and empower those people who are caught-up in the system.

This is not for everyone, but, imagine if it improved outcomes just a little. Imagine less depression, more engagement, greater happiness.

Imagine where we would be if we shared our cars too.