The Commission on Improving Dignity in Care Care for Older People released a report yesterday which hit the headlines for all the wrong reasons. I heard an interview on BBC Radio 4’s The Today Programme, and Sir Keith Pearson, co-chair of the Commission on Dignity in Care, outlined the main findings of the report. It was stated that dignity is treating someone the way you would like to be treated if you were on a ward. He added that dignity is showing compassion and respect, and that being compassionate should be as important as being clever when it comes to the recruitment of staff to care for the elderly. Dignity means more than being kind, showing compassion is key. The elderly have different needs to younger patients, and these need to be addressed respectfully and compassionately.
An interesting point was made that the nursing to patient ratio on children’s wards is typically 4:1 whereas on geriatric wards its often 8 or 10 : 1. But the elderly often need the same level of supervision and assistance as children.
It struck me that there can be elements of the same tensions in general practice. That is an increasing number of surgery consultations will be for older patients, their conditions are often more complex with several co-morbidities , and multiple medications. They need more time to explain themselves, more time if needing to undress for an examination, and then more time to dress again, and more careful consideration when being assessed due to these factors.
To be compassionate one has to like people. I don’t recall whether at interview for medical school or GP training scheme I was being assessed as to my level of liking working with people, and / or my compassion index. But to work in general practice with all the stresses and strains without a basic enjoyment of human interaction the job becomes that much harder. Compassion cannot be taught, it must be in us at the beginning of our careers. But can we lose it or at least have it eroded by chronic stress and overwork?
In a busy surgery, maybe running a little late, the fact that a patient takes much longer to assess and manage in a consultation due to age related infirmities can easily add to our stresses. Do we ever start to have negative feelings towards those who require more time? An honest examination of our conscience can be quite sobering at times.
When i left full time practice partnership it was for self preservation; being a GP locum allowed me to work in a much less stressful manner, my enjoyment of this special career returned and i continue to thrive on the work , what i can do for people and what the interaction and serving does for me.
We need to have compassion and dignity for all groups we care for, if the elderly receive it, all will receive it.