4th August 2015

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Sir Robert Naylor

One of the longest serving leaders in the NHS, running one of the biggest Trusts.

What's life like at the top? Find out; in conversation with Roy Lilley; King's Fund 16th September 

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Don't get old
News and Comment from Roy Lilley

There are three news stories... in the course of a week I can link to well over a hundred. There are three that stayed with me; they had me wondering... I just have to revisit them.


The first, in the Guardian; trade puff for a book by Rudi Westendorp, Prof of medicine and old age at Copenhagen Uni.


She says don't worry about dementia. Because of better diet and education the numbers of people at risk of dementia, in old age, is significantly lower after the year 2000, than before.


Westendorp says; "... cardiovascular disease... [is in] ...decline, beginning with a fall in the numbers of heart attacks in middle age... followed by a drop in the number of strokes suffered by old people. Now... dementia figures falling for the oldest..."


I see dementia as the silent thief that steals the years and robs us of our most loved. So, this is good news. Such are the financial rewards in finding a second generation Aricept, big-pharma is likely to come up with a solution. Whether or not it is affordable is a different matter. There again, 1,200 for a week in a care home isn't what I'd call affordable.


The other story? From the BBC; "One in five elderly has 'no-one to turn to'..."


We now face the prospect of living longer, not in a jungle of bewilderment but in a desert of solitude.


Last year I wrote about an old-fella who told me, after his wife died, he still sleeps 'on his side of the bed' and finds himself reaching out to touch the hand that once held his.


At the Duchess' funeral, one of her contemporaries told me how much she had enjoyed coming to the funeral. It was the first time she'd been out since Christmas.


As you get older your life will not fill up with new people. Your life will empty out. Your contemporaries will pass on and if your health gives out, your home becomes a detention centre and you're watched over by strangers.


The BBC story was a survey from the Campaign to End Loneliness; 'One out of every 5 elderly people in the UK who feel lonely say they have no-one to turn to...'


A combination of direct interventions and gateway services, transport and technology can help but the world is full of older people who close the door on a Friday night and don't speak to a living soul until Monday or Tuesday. I wonder how many older people who 'manage to get by' don't speak with anyone from one week's end to the next.


I wonder how many seniors there are whose only human contact is with people paid to be there.


The Duchess once told me, I was the only person who had been in to see her that day who didn't smell of cigarettes. There is a difference between feeling lonely and being alone.  A difference between being in control of your care and being in charge of it.


Twenty four hours of staying put. Twenty four hours of compounding, accumulating, gathering loneliness, sadness, fear, depression. Throw in declining mobility, illness and pain.


Would you get angry with yourself for getting old, cross with the people around you that have no real idea how you feel.


How would you react to poorly trained people scurrying in for a minimum few minutes; rush you through a meal, wash or medication and dash off to the next person. Whose first language may not be English and with whom a nuanced conversation is impossible.


Maybe pain is bearable with companionship and laughter. Perhaps illness is tolerable with someone who cares. Feeling unwanted is the cruellest emotion. A life without purpose is not a life, it is an existence.


The third story; Gill Pharaoh, 75, a healthy retired nurse died at an assisted suicide clinic in Switzerland because she 'didn't want to end up a hobbling old lady'.


Gill said; "...said her experience as a nurse, including working in nursing homes, had shown her that the reality of old age was "awful".


What is there to fear in death? It is inevitable.  The final act.  It is the journey to the end we should fear; the prologue of immobility, the preamble of lost independence and a prelude of pain. The overture; depression and debility.


Take my advice; don't get old.



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Sir Robert Naylor
One of the longest serving CEOs of one of the
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At the heart of strategy and policy for over 25yrs.
What does the future hold for the Vanguards, strategy, regulation, funding.
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