The neglected elderly

John F. Kennedy during his all too brief presidency

shared, amongst many insights, observations on the

elderly which resonate today.

‘A medical revolution has extended the life of our

elder citizens without providing the dignity and secu-

rity those later years deserve’. July 1960

‘Prolonged and costly illness in later years robs

too many of our elder citizens of pride, purpose and

savings’. February 1962

Fifty years later we have not universally resolved

these concerns although there is no doubt that in

certain societies, cultures, religions and countries

quality of elderly care has partly addressed the needs

of ageing. Sadly we still hear of elderly patients in

hospital being deprived of any dignity by being

unwashed, left in their own soiled bed linen and

unfed. It is almost as if some young health care pro-

fessionals (I use the words professionals as a label

rather than with respect) despise those who in their

older years have acquired the degenerative diagnoses

associated with old age such as arthritis, dementia,

stroke, vascular disease and general immobility which

make them dependent on others.

Treating another person with respect involves

showing consideration for their values irrespective

of age, gender, ethnicity, religion and class. This

translates into helping individuals think, decide

and act as an individual when as a result of illness

they may be unable to do so without guidance.

We do need time and patience and it is often dif-

ficult and frustrating, but coping by ignoring the

elderly abdicates us from our duty as health care

workers and devalues our inner personal respect

for ourselves.

As I write, I am only too aware of the contrasting

realities of elderly care. My 90-year-old very active

mother-in-law fell and fractured her hip last July and

was found on the floor 48 h later. The care she

received in the National Health Service acutely and

subsequently has been excellent, although sadly as

often happens she is now dependent on others rather

than totally independent. One event can age a person

almost overnight. My wife visits every other week-

end, flying the 200 miles with the help of Airmiles,

and we are greatly helped by a wonderful family

doctor and carers.

By contrast, I was phoned by a 92-year-old long-

standing patient’s relative pleading with me to take

him from the NHS hospital to restore his dignity. In

bed without the basics of care, he had been neglected

for several days. Although he was 92 years old, his

academic brain is as sharp as ever. When I asked

him if we were doing everything to make him com-

fortable his reply was telling:

‘The nurses here are wonderful. I no longer feel

ignored. No one stopped to talk to me, they just

looked and walked past’.

Instead of leaving his food on a table and collect-

ing it untouched, he is now helped with his feeding

and a dietician supervises. What is so hard about this

level of care – it is simple, human and respectful –

qualities that are cheap but priceless.

In health care as we are an ageing population, we

need to show compassion and avoid age discrimina-

tion. However, in the wider arena of our lives, the

elderly deserve respect and schools need to instil in

their pupils the pride of purpose in giving up their

seat on public transport or helping those with lim-

ited mobility or vision to cross the road or find their

way. Politicians need to recognise the needs of the

elderly and improve provision of care without finan-

cial penalty – time to translate noble words into

valuable action.

Hoping for a long life but being afraid of old age

reflects badly on society. Old age should not be an

oasis surrounded by death, but an island of dignity

and respect.

Disclosures

None.

Graham JacksonEditor

doi: 10.1111/j.1742-1241.2010.02452.x

ED ITORIAL

ª 2010 Blackwell Publishing Ltd Int J Clin Pract, August 2010, 64, 9, 1169–1175 1169

Old age should

not be an oasis

surrounded by

death, but an

island of

dignity and

respect