Let’s talk about death #dyingmatters

Spinderella cut it up one time….

Before I go any further I feel I should share two things with you, the first is that I am *very* comfortable talking about death and am thinking about blogging a post each day this week in support of the Dying Matters Awareness Week (so forgive me if it’s not your thing – although I’m hoping I might convince you otherwise), the second thing is that I currently have an earworm, Salt n Pepa Let’s Talk About Sex, that inspired this post title! So forgive me if I bust into 90s groove half way through.

In fact we probably don’t need to leave Salt n Pepa just yet, their 90s tune was focusing on safe sex and censorship in American mainstream media at the time. A few selected lyrics as follows:

Let’s talk about sex, baby
Let’s talk about you and me
Let’s talk about all the good things
And the bad things that may be

Let’s talk about sex for now to the people at home or in the crowd
It keeps coming up anyhow
Don’t decoy, avoid, or make void the topic
Cuz that ain’t gonna stop it

Now we talk about sex on the radio and video shows
Many will know anything goes
Let’s tell it how it is, and how it could be
How it was, and of course, how it should be

OK, this connection gets a little tenuous by the second verse but I’d argue there are strong parallels to death and dying, not in terms of censorship stopping us discussing it, but certainly society’s openness and people’s willingness to do so. Re-read those lyrics and replace the word sex with death to get my point!

Dying Matters Awareness Week started today, their website is full of brilliant ideas, resources, research and suggestions for anyone who wishes to know more. Regular readers of this blog will know that my Dad is terminally ill and death is pretty much on my mind a lot at the moment. It’s interesting to me that my Mum and I have discussed his funeral wishes, but Dad and I haven’t ever had that conversation, we’ve started it on a couple of occasions but he brushes it off and says Mum knows what he’d want and he’s not too bothered because he’ll not be around for it (ever the pragmatist). In a way I think we left it too late for that to be an easy conversation. We have however discussed his wishes with regards to where he’d prefer to die, and he has an Advanced Directive and a Treatment Escalation Plan that I have a copy of, and I do feel able to advocate for his needs if I ever had to.

The interesting thing to me is that I’m quite comfortable with death, as a family I think we’ve had an unusually open approach to discussing death. My brother in law and my sister out law often comment on how much we’ll discuss death. In fact they are both uncomfortable with the likelihood that we’ll end up discussing death at some point each time our family gets together – and that’s not really to do with Dad’s illness or the fact we have older relatives. It’s always been normal to me to discuss death.

My Mum worked as a probate executive, supporting people to write wills, deal with dead people’s estates, and generally providing support to older people once they moved into care homes to protect their wishes. As a young child we were toured around care homes at Christmas or Easter to visit Mum’s clients (or sometimes people that weren’t her clients but who didn’t have anyone else to visit them) and spend time with them when other people would have visitors. As a teenager and young adult I attended a couple of funerals with Mum, in some small part as moral support, no doubt in some small part out of boredom or curiosity but mostly in an attempt to give some recognition to someone who had lived a life and died alone – on a number of occasions there would be just three or four of us to witness those funerals (Mum, myself, a care home manager or staff member and the person taking the ceremony), on one or two occasions where a person lived alone it would just be Mum and I.

I often joke about it but we were so comfortable with death in my family that when my big brother needed a work experience placement he ended up spending a week at the local undertakers. An experience that he really enjoyed and I’m sure was much more interesting than the week I spent in Natwest Bank. I think my school would have had an absolute fit if I’d suggested I was going to shadow an undertaker, so banking it was.

This week I’m going to try and blog a few times about #dyingmatters. In the hope that it sparks some interest or debate amongst people, or that it provides an excuse or prompt for you to discuss death with your nearest and dearest (if you need one). I promise it won’t all be doom and gloom, I think I’ll do one post about eulogies, one on memorial benches as an artefact of a life and death, maybe one about Dad and one about discussing death – just in case Salt n Pepa didn’t provide enough advice. Let me know if you have any special requests! Now…

Let’s talk about death, baby
Let’s talk about you and me
Let’s talk about all the good things
And the bad things that may be

Social media for social care – let’s not forget personalisation

This is going to be a short post, I promise, it’s also a little thrown together as I’m finding 140 characters just isn’t enough space to try and explain what I mean! This post builds on two previous posts of mine Social media is not the answer written in January, and a post from the end of October about measurement of impact Social media metrics: reach ≠ quality and three excellent posts all written this week, The role of social media in a social worker’s continuing professional development from @mgoat73, Use and application of social media in social work and social care education from @jaxrafferty, and Social Media and Social Care/ Work Education from @Ermintrude2. All of these posts discuss the role that social media can play and it’s relatives benefits and limitations. I’ll not repeat what they say here.

Before we go any further, do you know who this is? You’ll find out by the end of the blog if you don’t!

I just wanted to make one small point. For a sector that has spent the past few years struggling (and continues to struggle) with developing a personalised approach to support, those of us currently using social media to discuss social work or social care, seem to have forgotten (or be in danger of forgetting) about the need for personalisation. Social media can certainly be a useful tool, in my experience it has opened doors, formed and supported connections and relationships, provided a viewpoint I wouldn’t otherwise have, given useful context from many worlds I don’t regularly inhabit or have access to.

The benefit of social media as a support for broadcast or information share is well established, even in social care. Well maybe not well established, but it’s logical and easy to explain to someone, and I’m confident we could find examples of it being used in this way. I don’t believe we’ve even scratched the surface on its potential as a tool for collaboration or crowd sourcing, for creating content and sharing ideas across the sector.

I also have yet to see any evidence of social media making much impact as a support for those wishing to access and use services, I’m sure there are one or two notable exceptions, but I’d hazard that these anecdotes are just that. Those of you in the social care sector who are familiar with personalisation will almost certainly have heard the anecdote of the guy from the north, who bought a season ticket for the football/rugby/cricket with his personal budget*. Social care is full of these examples, genuine stories from service users that get borrowed by politicians or civil servants and before you know it they become part of the folklore, and yes I deliberately put in the vague notion of what the season ticket was for because I’ve heard it claimed as so many things in recent years, a classic case of Chinese whispers!

So my plea, because I promised to keep it short. Let’s not forget about the true meaning of personalisation, about giving choice and control to the end user. To do so that means a range of methods for learning, sharing and communicating. A range of approaches for doing our business and providing support. So let’s talk about the benefits that social media provides, let’s dream expansively about the possibilities, but let’s not claim it as a panacea.  It has huge potential, within a range of approaches, but let’s ensure our end users get to choose to use it, rather than those of us who are converted trying to convince them it is the most appropriate choice!

*The season ticket holder (shown in the piccie above) was Gary Croft from Oldham, you can read about his story here.

Abuse and Neglect – do we love animals more? The Sequel.

Back in June I wrote a blog post comparing the public response to two current news stories – the first about Winterbourne View, the scene of institutional abuse of people with learning disabilities, and the second about two Metropolitan Police dogs who suffocated when their handler left them for too long in a vehicle. These stories were both equally horrific, but the public response to the animal cruelty was far greater than to the abuse of people with learning disabilities.

Tonight when I checked the BBC news site I was appalled to see the headline story of a local woman who had abused a kitten. This story was reported this evening and has so far (at 21.30pm) been shared 2800 times.

The news story I was looking for was about a new report from the Equality and Human Rights Commission (EHRC) that has found home care for older people is so bad at times it is breaching their human rights. This story was the headline this morning, was reported on the site just after 8am and over 12 hours later has been shared 1300 times.

As I argued back in June, both of these situations are horrific. I’m not advocating that abusing humans is far worse or far better than abusing animals, I’m just surprised at our reaction to it. Still surprised.

Signposting

RSPCA Cruelty Line 0300 1234 999

NSPCC HelpLine 0800 800 5000 and ChildLine 0800 1111

Action on Elder Abuse Helpline 0808 808 8141

If you are concerned about a vulnerable person (adult or child) suffering abuse and don’t know what to do about it contact 999 if it is an emergency or a crime or contact your local council or police force for other concerns. Usually if you Google ‘reporting adult abuse’ and ‘the area where you live’ you will usually find what to do.

Reflections on #NCASC – let’s start with people

For the last three days I’ve been in London for #NCASC – the National Children and Adult Services Conference. A considerable focus of the conference was #integratedcare and the need for #health and #socialcare systems to work closer together, set within the current economic situation and reduction of resources. I think its fair to say that at times at conference you’d have been forgiven for forgetting that what we are all really interested in is improving life for people who need to use health and social care services. I guess that understanding is absolutely implicit, and the challenges are great at the moment, so much so that it would be easy to reach a state of being overwhelmed with the magnitude of the challenge, and disillusioned with what can actually be done.

So, I’d like to share a good news story.

While I was going about life at conference, back in sunny Devon unbeknownst to me (because my Mum didn’t want to bother me when I was working), my Dad was getting increasingly breathless. For anyone reading this blog for the first time, my Dad has cholangiocarcinoma (bile duct cancer), and he has a terminal diagnosis. Just over a week ago we had an appointment with his consultant (you can read the post I wrote the day before we went) where he told us that one of his tumours had shrunk slightly (and the reaction). This is great news as we’d tried to prepare ourselves to hear that the cancer had spread to his lungs given his difficulties to breathe and recover from the slightest of physical activity. We were told that Dad was anaemic, and the relationship between tumours needing blood supplies and the tumour shrinking was gently explained. More blood tests were taken, the possibility of an endoscopy floated, iron tablets and vitamins promised once the results were available.

On Thursday Mum decided they could wait no longer, Dad didn’t want to hassle (neither of my parents ever do) but Mum balanced up the possibilities of Dad’s health deteriorating sharply over the weekend (anyone who has had to rely on our health or social care systems knows not to get ill at the weekend) and the need to just gently nudge the system. One phone call from Mum to the Oncology Dept revealed that they had the results and someone would phone back with them. Hours later a chance inquiry into Dad’s health by their GP when dealing with my 93yo Grandad led to him getting involved and prescribing iron tablets and following up with Oncology too. A day later Dad has a course of iron tablets and a blood transfusion booked for Tuesday because his haemoglobin levels were so low. I’m confident that we have that outcome for two reasons, because my Mum didn’t wait until things got worse and chose to take action herself (in spite of how uncomfortable that makes her feel) and because our GP knows enough about my family to ask about my Dad when dealing with my Grandad. I’d like to think that his information recording computer system is good enough that when he looks at my Grandad’s notes he is able to see that he lives with his 91yo wife next door to their daughter and son-in-law who provide them with care and support, one of whom also happens to be terminally ill. I know I’m pipe dreaming but you know what I mean.

So what has this got to do with NCASC?

Well, as I sit here musing on Saturday, the words that made the most impression on me were from people who I know and respect, all of whom focused on people as part of the solution. These were Councillor Sue Anderson from Birmingham City Council who addressed a session on Health and Well-being Boards #hwb and focused on the need to focus on good relationships rather than bureaucracy. She wasn’t suggesting that the systems and strategy are not important, she was however stressing the need to start with relationship building and trust.

Next up on my thought provoking list has to be Richard Jones. The Director from Lancashire CC and former ADASS President took the floor in the Think Local Act Personal session #TLAP on the final day and challenged #socialcare to focus, arguing that we were getting caught on second order conversations about #integration and #resources and forgetting the people at the centre. Making it Real the new publication from TLAP will prove useful for anyone working on #personalisation to judge their progress against the end results that citizens have identified they need. Sue Bott also talked a *lot* of sense in the TLAP session, with a humour and personality to her delivery that few before her in conference had managed – she even got a room full of conference weary delegates to raise a virtual toast to Making it Real!

My final sense talker has to be Peter Hay, the Director of Adult Services in Birmingham and this year’s ADASS President who took the floor a number of times at conference. He joined the panel in the final session that focused on #integratedcare and the work of the Future Forum and again brought the focus back to those who use #socialcare services, reiterating a challenge from Lord Crisp at the conference opening to build services around #life not around #care or #health.

Isn’t that all a bit naive and over simplistic? 

I’d like to think not. We are without doubt in need of large scale system change, #Dilnot challenges us all to consider our own future and how we will provide for our old age or social care costs, whatever your view on the Health Bill the creation of Health and Well-being Boards present an opportunity, our demographics are changing, as is our technology, our family life and our expectations. None of this is new though, not really, the likes of @RichardatKF can tell you all you need to know. Surely, we have known for long enough what works and doesn’t work with regards to integration and we must know by now that people just want to feel well and live their lives as independently as possible. Maybe it’s just me but I’ve yet to meet someone who cares which budget their support comes out of, people just want to live their lives.

So what can we do?

This was my third time at NCASC and each year I leave exhausted with a lot more to think about (and a head full of more ideas) than when I arrived. I usually meet a few people in person that I’ve not met before, my favourites this year were @jaimeelewis @mroutled and @philblogs and I was also delighted to see far more real life networking inspired by twitter connections. [As an aside I do believe that the #socialcare sector is finally realising the potential of #socmed]. I’m sitting here believing that change can happen, we have clear evidence around these challenges, we have enough people with enough experience to move on some of this. Personally I believe that this requires commitment and leadership, from those at the top of government (I too struggle to see how bin collections are more important than social care) to match those from the sector who I’ve mentioned above. As much as I welcome any attempts to engage people on the future of care and support (6 weeks left to contribute) I do wonder whether what we really need is a commitment to action.

The one consistent in all of these discussions and system challenges is the person who is trying to live their life. Start with the person, they (and their carers or family members) are the lynchpins in all of these systems and services. Let’s start improving services now, we can’t afford to wait.

NB: Just a thought, #socialcare readers of this might be interested in an earlier post What is Service Design? – the comments and discussion especially may help unearth some thoughts for how we can move on such large scale system redesign, without forgetting the end user or person who uses them.

#JSWEC Social Work Education Conference

I’m up in Manchester for this year’s Joint Social Work Education Conference – this is the 13th year that it has been run but the first time I’ve attended. I’m talking about ChangeCards – what they are, where they came from and how they are being used in social care. I’ll post about my presentation afterwards, on the off chance any of you are interested.

In the meantime I found this tweet from last year’s conference:

This year’s programme is packed with brilliant sessions, you can see what is going on here.

I’ll be there, I’ll be tweeting and using the hastag #JSWEC. I’m sure I’ll not be the only one, whether we’ll succeed in quadrupling I don’t know – not sure how many people were tweeting last year, but I’ll do my best to provide highlights. I have a niggling suspicion that there wont be many people tweeting – in my experience social work isn’t a sector full of tweeters, but I’m hoping I’ll be proved wrong. We’ll find out tomorrow.

To do no harm, first count the harm

This weekend I stumbled across Medical Harm - I believe I have @amcunningham to thank for bringing it to my attention.

In a nutshell the blog is run by Dr Phil Hammond and Andrew Bousfield. It is a blog site that allows readers to submit information and documents to them, safely, which they may in turn put in the public domain. The site contains a bank of inspirational stories and experiences and it aims to build networks of people who wish to raise concerns about medical harm and work together to identify ways to reduce it.

So what is medical harm and why should we be worried about it? 

Medicine is unique amongst legalised industries in that it causes significant harm as well as enormous benefit. We think that in order to do no harm, first you have to count the harm. Patients, relatives and staff should be united in speaking up when shit happens or,  better still, just before so we can stop shit from happening.

Healthcare harms patients and staff in all sorts of ways. Missing or delaying a diagnosis, giving the wrong or suboptimal treatment or even giving the right treatment badly causes harm every day….There’s a difficult balance between an open culture that allows staff to admit to errors and near misses safe in the knowledge that they won’t be punished, and a ‘no blame’ culture where noone is ever held to account for serious failure because it’s always the system’s fault.

By calling this site Medical Harm, we want the NHS, public, press and politicians to acknowledge that healthcare is very dangerous and harm is surprisingly common. Then we need everyone – patients, relatives and staff – to be encouraged to step in to stop it, or failing that report it so we have continuous ‘harm alarms’ – like smoke alarms – on every ward and in every GP surgery.

So why am I interested?

Well, I consider myself to be a realist. I understand that when you’re dealing with people who are ill, mistakes will happen. When you are working under stress and pressure, mistakes will happen. When you work in an environment where there is no support when mistakes happen, more mistakes will happen. I also have spent *a lot* of time in hospitals and critiquing the NHS systems over the past four years – my Dad has a terminal diagnosis of cholangiocarcinoma (bile duct cancer), my mum had a TIA a couple years ago, and my grandparents have both had medical concerns of late, with my 92 year old grandfather being admitted to hospital twice in the last two years.

I’ve seen the absolute best of the NHS, I’ve seen fantastic individuals going the extra mile, working in spite of broken systems. I have no doubt that I have seen a few near misses, Dad has been discharged with the wrong medication, has been given incorrect treatment (poor communication), he has jumped out of bed with a newly fitted stent to get a nurse’s attention when no-one was available to respond to the alarm and the old guy opposite was fitting, and my absolute most irritating situation the Junior Doctor who patronised the hell out of me, told me to give Dad some TLC and tried to discharge Dad with a box of antibiotics for Swine Flu – until we demanded a second opinion and he was admitted with MRSA septicemia that required two weeks of intravenous antiobiotics and a three week hospital stay (little bit angry about that one still).

That said, if it wasn’t for the risks taken by his consultant and medical team Dad would have died years ago. That’s the harsh reality of my experience of medicine – it doesn’t always come down to science, more often than not it comes down to balancing possibilities of risk and taking chances. As a family member of someone who has already outlived his diagnosis, who has received life saving treatment, I wouldn’t want to complain….but I do want to highlight dangerous practice.

I hope that Medical Harm will help more people to share their experience, and identify what can be improved. I’ve always felt that Dad is lucky as he has a number of us loudly and (most of the time) articulately advocating on his behalf, not everyone is in that position.

Waiting for #Dilnot – what is care and support?

I’m sat waiting for the Dilnot Commission to report – there are about 10mins left until it goes live on the Department of Health website. The few tweets that are leaking out of the press briefing, together with the media presence this weekend, suggest that Dilnot will be recommending that our politicians take some hard decisions about funding care and support. This has been suggested before but I’m optimistic that the appetite is different now. People are facing up to so many financial challenges throughout their lives, society knows that change is required, we all know that demographic changes mean that many of us are living longer and healthier lives. If you’re interested in the changes in trends and developments that have led to these changes, in terms of public policy, social trends, political context, technology and a few more, check out the Dartington review on the future of adult social care - published by @ripfa last year and written by Richard Humphries from the Kings’ Fund.

That’s all context but it still begs the question for most people of what is care and support?

A couple weeks ago I blogged my initial thoughts about #Dilnot and just wanted to pull two snippets out of that post to try and answer that question:

Care and support is usually referred to as social care. It is enabling support, it helps people to be independent, active and healthy throughout their lives. It is the support required to enable people to do day-to-day things such as live at home, work, cook, shop, care for their family, engage with their friends, family and community, and essentially lead a fulfilling and independent life for as long as possible.

This support is provided by a range of services, including support to live independently, benefits for disabled people, practical support such as meals on wheels, day centres and care homes, home adaptations and adjustments and other housing support. Services are also available to provide support for carers.

Not sure if that makes it any clearer but care and support refers to support for anyone who requires it – that could be myself and yourself, it could be due to a physical disability, an illness, due to getting older. It is not just about older people or ‘elderly care’ – it is about much more than that. It comes down to how as a society we wish to treat those that require support, it is not just about middle class people having to spend their inheritance or just about the death tax.

This is much, much more important than that. As I finished a couple weeks ago:

The vast majority of people don’t recognise themselves as health or social care users, they are just people, who need some support. Until social care gets itself to a point where it can define clearly what it is, how it helps, and openly discuss its limitations (whether financial or otherwise) we’re in trouble.

Social care has an opportunity, society has an opportunity, to use Dilnot as the start of a bigger discussion. Many people are forced to understand social care, once their lives reach crisis point. If you do one thing today, take time to think about how you would access care and support if you needed it – just give it two minutes reflection time, it’s as good a place as any to start!

Déjà vu…or why most people don’t know who #Dilnot is and don’t care!

I fully expect that over the next couple of days there will be many tweets sent and words written about the publication of the Dilnot Commission on the Funding of Care and Support; there is likely to be much musing about what it covers, what it doesn’t, whether its remit was right, how else we could address the challenges and so on and so on. From mid morning tomorrow you’ll be able to access the report on the DH dedicated website here. The following day (Tue 5 July at 11.30am) you can join David Behan, the Director General for Social Care for a live discussion about the implications here. There will be a lot of activity, which is good and right and proper.

So why the provocative, damn right rude and possible cynical title to this blog post?

Well because I do drive myself to distraction when I realise how many times I sit down to write a blog post and realise that it is all rather déjà vu. What started as a simple reflection earlier this evening, about how many times I have started a post that talks about the problems with social care…extended into a bit of a twitter conversation with Harriet Clarke, who draw my attention to work she had done looking at Long Term Funding for Older People over ten years ago, you can see a snippet here and here. These are not new problems and I’m sure Dilnot has done all he can but we’ve yet to see whether our politicians can reach a consensus on funding for social care.

Last November I was reflecting on the state of social care research and guess what the number one reflection was? Yip, identity:

Reflection One: Identity – I believe that social care has an identity crisis! When we talk about social care and the role that it can play in supporting people, we all talk about very different things. There is not one thing meant by it and without clear definitions or parameters it is hard to make clear arguments.

I believe the biggest challenge to social care, to society, for a useful legacy from the work of Dilnot, is identity. So many people don’t know what social care is, they don’t understand care and support and don’t care that they don’t. A couple of weeks ago I provided an intro to Dilnot here and a slightly dismayed reflection on it here. The dismay came from the same place.

The work of Dilnot, his commissioners, the DH staff supporting him, and of course us, the service users, carers and workers who have provided evidence and engaged with his work, will I hope, make a difference. I know that the government will publish a Social Care White Paper, they are waiting to respond to the Law Commission and Dilnot together – check out David’s coverage on that here:

I know that for a brief interlude tomorrow my world will feel a little brighter, those of us who toil in social care circles will step a little lighter, we’ll believe that we have reached new ground. Let’s not get complacent though, Dilnot is really only the first step of the next journey. We’ve a long way to go…and may I suggest that we start with the basics and focus on really engaging the general public with what social care is, what it does and why they need to care.

Abuse and Neglect – or do we love animals more?

When I got home from work tonight I checked the BBC News website as I’m prone to do. One of the tragic headlines that caught my eye was about two MET Police Dogs suffocating in an unventilated vehicle. This report describes an avoidable situation, whether a simple accident or careless neglect, it is a really sad story and one that I couldn’t read without feeling angry and sad for both the animals and the people involved. I believe this story went live on the BBC Website at 7pm today (27 June 2011), by the time of writing (11pm) the article has been shared over 2000 times. Quite rightly too, it is sad and newsworthy, and preventable, so sharing the message makes sense.

 

Now, let me rewind to four weeks ago when a BBC Panorama reported on serious institutional abuse against people with learning disabilities in Winterbourne View – I blogged about it here. This hour long documentary reported on hideous treatment of some of the most vulnerable members of our society. I think you’d struggle to watch it, or read the news item describing it, and not feel incredibly angry or sad.

This story went live on the BBC Website mid morning on the 1 June 2011, by the time of writing (27 June) the article has been shared almost 14,000 times. Again I’d expect as much, it is *also* sad and newsworthy, and *also* preventable, so sharing the message makes sense.

So, what’s the point?

I’m sure most of you will have worked out where I’m going with this. The story about animal cruelty was shared 2153 times in 3.5 hours, the adult abuse story was shared seven times as much – but in four weeks. Now I appreciate that the rate of sharing will drop off sharply once the story is removed from the BBC front page, over time, and I’m not claiming this is some scientific observation. That said, I am shocked at the high levels of concern for animal cruelty when viewed in relation to abuse of our fellow humans.

I dug a little deeper with this and checked out the statistics for the RSPCA Cruelty Line. ”On average every 30 seconds someone in England and Wales dials 0300 1234 999 – the RSPCA’s 24-hour cruelty line – for help. We received more than 1.1 million phone calls during 2010″. RSPCA Key Information

The next place I looked was for an equivalent adult abuse line – but no such thing exists. Action on Elder Abuse run a free national helpline for those concerned about abuse of elderly people, but that does not speak to all adult groups. I was unable to find any figures about it’s use.

So desperate to explore my theory that we care more about animals than people, I checked up on stats from NSPCC, I couldn’t find 2010 figures but what follows is the stats about calls made by children to ChildLine (which covers any concerns they have, including abuse) and calls from adults to the Helpline in 2009-10: ”ChildLine counsellors dealt with over 500,000 contacts from children calling about various problems including bullying, sex abuse, violence and mental health issues. Nearly 12,000 allegations of children suffering abuse were passed from the NSPCC Helpline to police of social services” NSPCC Facts and figures about child abuse.

I’d like to conclude by offering the suggestion that we really do love our animals more than our fellow people.

I’m not sure if I believe that, but I think it’s relatively easy to see that we appear to be more appalled by animal cruelty and if not more appalled, more likely to act about it. Whether it’s a self-protection, not wanting to consider the reality situation; or a lack of awareness; or a lack of knowledge about what to do about it, I’m not sure. What I am sure about is that no animal or person should be subjected to abuse or neglect and as a society we should be more appalled and more proactive in preventing it.

Signposting

RSPCA Cruelty Line 0300 1234 999

NSPCC HelpLine 0800 800 5000 and ChildLine 0800 1111

Action on Elder Abuse Helpline 0808 808 8141

If you are concerned about a vulnerable person (adult or child) suffering abuse and don’t know what to do about it contact 999 if it is an emergency or a crime or contact your local council or police force for other concerns. Usually if you Google ‘reporting adult abuse’ and ‘the area where you live’ you will usually find what to do.

Are you planning on getting old?

I’ve just written a blog post about the Dilnot Commission looking at the funding of care and support. I wrote it and tweeted about it and realised that the vast majority of people in my twitterstream wouldn’t look twice at such a post. There in lies the problem – it’s vaguely technical, too detailed, and about something that few of us would realise we needed to know about.

But we do. Most of us will get old. Some of us will become disabled or get ill during our lives. We all need some care and support occasionally.

If you recognise that any of these things are likely to feature in your life then you might want to take a look at the Dilnot Commission findings in the next couple of weeks. By the time most of us are older and needing support, the State is unlikely to be providing it. Reading comments on the Observer article: Middle class face £35k bill to help pay for care in their own age, I was struck by how many people think that their National Insurance or Tax contributions should be enough to provide care. They’re not. Something different needs to happen. If you’re interested in more detail check out my earlier blog post here.