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One could be forgiven, whilst watching the latest Panorama expose on scandalous care of older people, for thinking that we do not care for our elders in this country and maybe the assisted dying bill will simply encourage older people to free society from looking after them. Yet, every working day, I never cease to be impressed by how much effort families willingly put in to supporting their elders. Compassion and respect are alive and well just not given the spotlight, for it is what is expected and so nothing out of the ordinary. But it is that very ordinariness that we should be applauding and giving due to credit to. When teaching on the subject of dementia friendly hospitals and care homes in the Far-East, I am often greeted with a response of well we like to look after our elders within the family here. That this is no different to our views in the West is greeted with incredulity, but once the impact of falling birth rates in those countries is understood, they see that there is, or soon will be, a need to develop a social care and care home infrastructure as we have had to do in the UK. So respecting our elders and filial piety are universal, should be recognised as such and given greater publicity. I dont mean that we should ignore bad practice but lets not assume that this is the norm. Yes Saville and others were terrible people but not everyone is a paedophile, equally not all carers are abusive and not all care homes should be shut down. We need to recognise what is good, strive for excellent and admonish that which is poor. Failing organisations or individuals can often be improved but this requires effort and education and a willingness on their part to change. Our role, as specialists in caring for older people, must be to praise those who are doing a good job (when was the last time you congratulated staff you work with for a job well done as opposed to admonishing them for an error?) and offer support to those who need to do better. Lead by example and not just within your workplace. Surely there could never be a better time to be a role model and enthuse people to join our ranks in demonstrating their care and love for older people. We dont need everyone to take up our specialism but we do need everyone to understand that they need some of our specialist skills. But most of all, we need compassion and dignity to be at the forefront of everything we do.
Some years ago a public survey asked what were the most important things when admitted to hospital? The responses (in order of importance) were an eye-opener to many of my erudite colleagues:

1. A bed
2. A nurse to care for the sick individual
3. To be hydrated
4. To be nourished
5. Visitors
6. Car parking for the visitors
7. A doctor!

I leave you with this reflection what was described was good delirium management! Although, to the best of my knowledge, car parking has not been tested as part of a multi-component intervention to prevent or manage delirium.

Duncan R Forsyth