Dementia sufferers deserve better treatment

The abuse of those suffering with dementia has come under the spotlight recently with first the revelation of the over subscribing of anti-psychotic drugs to elderly people and then that those with dementia are not receiving the treatment they deserve when in hospital.

A report from the Alzheimers Society has found half of all dementia patients leave hospital in a worse state than when they arrive and that they stay in far longer than others coming in with similar conditions. The Alzheimer's Society blames longer stays on a lack of communication, which can exacerbate problems associated with dementia, such as incontinence. The main reasons for a hospital stay were falls, broken hips or hip replacements, urine infections, chest infections and strokes.

Meanwhile, an independent review for the government found that 180,000 people with dementia are being prescribed a powerful cocktail of sedative drugs of which more than three quarters - 144,000 – are being prescribed inappropriately.

The drugs are estimated to cause 1,800 deaths and 1,620 strokes a year but despite warnings about the risks prescribing has continued. There are 700,000 people in Britain with dementia, of which half suffer with symptoms of agitation, aggression wandering shouting and other difficult behaviours.

As the son of a father who suffered with Alzheimer’s disease I have had first hand experience of how staff in care homes seek to control patients. When my father became unmanageable for my mother at home he went into a residential home. This home was unsuited to deal with dementia, so after a period in hospital he went on to a home that was more specialized in dealing with dementia patients. As things declined, he then moved a third and final home. The second home felt it was unable to cope with his increasingly agitated behaviour.

There was a perceivable change in Dad after the third home. He went from being alert to very drowsy. This was all the more perplexing, given that the manager of the home had sold the move on the basis of being able to stimulate and get better responses out of Dad. I became increasingly suspicious that Dad was being drugged and raised the issue with the manager. He acknowledged my concerns and said he would review the drug dosage.

This experience and others also underlined the importance for dementia sufferers of having an advocate to stand up for their interests. In many cases, dementia sufferers can be as vulnerable as babies. They are open to abuse at almost every turn so there is a need for someone to stand up for their rights as well as proper stringent regulation. For those without advocates, the abuse endured can no doubt be truly horrendous.

The other side of this story was that Dad could get quite aggressive. Despite being a shadow of his former self he retained a lot of upper body strength and when he started throwing his weight around the care assistants struggled to cope. On one occasion, a care assistant touched him on the head and he jumped up but my brother was present and managed to restrain him. Just prior to his death, I was in the room as care assistants edged round him, one declaring, and “I don’t want to get hit.”

Care homes that house dementia patients are not always nice places. There are no inhibitions with patients often screaming out or suddenly launching off towards a complete stranger. The occasional one will come and confine they think their own family is robbing them, sometimes. So given the circumstances it is possible to have some sympathy for those in the homes who resort to drugs by way of restraint. However, as the review points out it is not acceptable practice.

The government is now moving to impose long overdue regulation on the sector. There is to be investment in specialist dementia training with a new national director of dementia overseeing a reduction in the use of the anti-psychotic drugs. While this may reduce the use of the drugs it does not address the fundamental problem of how dementia is dealt with in the UK.

The problem is that dementia sufferers are farmed out to privately run homes, whose primary motivation for existence is profit. This means that most of the staff are on the minimum wage, many are migrant workers who are more easily exploited. In the worse case scenarios, these homes are warehouses of death, simply storing elderly dementia sufferers, while making money at their expense until death strikes.

Each dementia sufferer is no doubt viewed as a profit centre. This was underlined with in own father’s case as the extras beyond the £700 a week we were already paying for care began to roll in. One of the more amusing exchanges was over the exorbitant monthly charges for haircuts. My own plea was that Dad was having more haircuts then than at any other point in his life. “He’s having more hair cuts that I am and he only has about 100 hairs,” I said.

It is the precedence of profit over care that really needs to be addressed if dementia sufferers are to start receiving the care they deserve in a civilized society. The use of the “chemical cosh” is to a large degree symptomatic of the make a profit out of suffering culture that exists when it comes to the treatment of old people.

The whole attitude needs to change. There needs to be a more holistic approach taken to dementia sufferers, seeking to stimulate the senses rather than simply dull them. The new regulations are welcome but can only be a start. As the number of dementia sufferers continues to grow over one million in the next decade this is a problem that needs addressing now. The present approach is in many cases inhumane and a sad reflection on our society that seems to put a very low value on sanctity of life.

Other articles by Paul on dementia -http://www.churchtimes.co.uk/content.asp?id=81949
www.newstatesman.com/society/2008/08/dementia-case-loved-dad-family
www.thetablet.co.uk/goprev.php?issue=1000107

Racist jokes target the weakest in our society

The publication of three irish jokes by prison newspaper Inside Times caused much offence recently among other prisoners and support groups.
The Irish Commission for Prisoners Overseas reported receiving complaints from a number of prisoners. “There is no debate about this – anti-Irish jokes are racist and totally unacceptable. They should never be printed,” said Conor McGinn of the ICPO.
The paper responded to one prisoner’s complaints, quoting Dave Allen making jokes about the Irish, claiming “you might as well laugh at yourself once in a while – everyone else does.”
There is no doubt that there are Irish comedians around, like Patrick Kielty, who do make jokes at the expense of their own nationality. But there is somehow a line that says it is ok to joke at yourself but when others of the opposing dominant nationality in the society take the same approach it has a different context.
Jennie McShannon, chief executive of the Federation of Irish Societies, does not think that irish jokes are any longer meant to offend and ridicule. “They do however by their nature carry on such a tradition which is now outdated and irrelevant. Why would successful people such as Bono, Bob Geldof, Dermott O’Leary, the Cusacks, Michael O’Leary, Tony O’Reilly and those of Irish decent including parliamentarians such as such as Stephen O’Brien,…., etc find such jokes either relevant to them or funny?” said Ms McShannon. “And who do they target but the more vulnerable Irish people in our society, those who perhaps did not benefit from education or economic success but who still contributed greatly to British life.”
The question of racist jokes surfaced recently in the context of the Strictly Come Dancing show where one of the dancers Anton Du Beck said his partner looked like a paki. There was much furore resulting in the dancer apologising. Then show host Bruce Forsyth chipped in questioning the whole context of political correctness. "We used to have a sense of humour about this. You go back 25, 30, 40 years and there has always been a bit of humour about the whole thing,” said Forsyth, who also later apologised.
Go back 35 years, though, and there was Alf Garnett on Till Death us do part ranting on about black people. The ITV opposition saw Love thy neighbour starring Rudolph Walker, now or Eastenders fame, in another attack on black and ethnic minority peoples. These programmes disappeared with the passing of the Race Relations Act in 1976. So to a large degree did the No blacks, irish or dogs notices in boarding house front windows.
It is significant that the ethnic jokes are always made at the expense of a weaker minority that is not in a position to defend itself against attack. How often do you hear jokes about the stupid Brit or English person?
This tendency to pick on the weakest is no better illustrated than in the case of Irish Travellers, who over recent years have often been the butt of this type of humour. Comedian Jimmy Carr was recently forced to apologise for comments he made on the BBC programme Loose Ends. Maybe it is in the anti-traveller joke that can be seen the real agenda running behind such humour.
The Travellers are among the most vilified of groups in British society, under constant attack particularly in the tabloid press. Derogatory comments are made about them without any concern. This is due in part because Travellers lack advocates to stand up for them – though this has improved in recent years. It is felt ok to attack Travellers in the mainstream so they are seen as fair game for the joke world.
The Irish community has been voluble in its denounciation of slurs aimed at their nationality. A few years ago columnist Julie Burchill made derogatory comments about the Irish. A complaint was made to the police under the Race Relations Act and an investigation followed. The matter was taken no further but the bad publicity that followed, no doubt made an impact on the liberal Guardian for whom the column was written.
It has been as a result of the culture that has developed in the wake of legislation brought in to outlaw overt racism that has largely seen the death of the ethnic joke.
Jennie McShannon refutes the claim that political correctness has gone mad, that people have lost their sense of humour, and that British culture is now under threat. “This is the kind of rhetoric which undermines all the very positive work done here to create a more cohesive, accepting and egalitarian society and which has supported so many from different minorities to engage positively and contribute to a thriving British society,” said Ms McShannon, who welcomes the forthcoming Equalities Bill as providing further legislative impetus for the inclusive agenda.
Ruling out offensive racism whether in joke form or normal conversation has helped cut down discrimination. The world is not a worse place for the absence of jokes aimed at ethnic minorities. This is not to say ofcourse that racism has disappeared as a result of these developments. In many ways racism has tended to become more covert. Moves are made to exclude ethnic minorities in far more subtle ways from work and other arenas. Public attacks are launched under other guises. Immigrants and refugees can be catch all phrases symptomatic of attacks on the other.So there is still plenty of discrimination around against ethnic minority groups. Fortunately much of the overt racism has disappeared from popular discourse as a result of legislation and the growing confidence of the minorities under attack. As a result the gutter humour reflecting an “acceptable racism” has largely disappeared in most areas of life. This is something to be welcomed but will only remain so if the minorities under attack continue to volubly complain when someone seeks to get a cheap laugh at their expense.

Activists opposing detention without trial

A group of human rights activists have been at the forefront of opposing efforts by the government over the past eight years to impose detention without trial.
Most well known of this group is Bruce Kent, who has for the past four years been visiting an Algerian man called Mustafa Taleb. Mr Kent has visited Taleb in prison and under control order. Today after six years in detention, Mr Kent travels regularly to meet up with him, detained as he now is under house arrest style deportation bail.
Taleb was originally arrested back in 2003 in what was to become known as the "ricin" trial where no ricin was actually found. He and seven others were finally acquitted in April 2005.
A free man, he then tried to pick up the pieces of his life, having fled Algeria for fear of his life in the early 1990s and gained refugee status in Britain. Freedom, though, was not to last for long.
Following the London bombings in 2005, he together with a number of other individuals, were picked up under immigration law and taken to prison. They were served with deportation orders on the grounds of being a risk to national security.
After another period in prison, the judges at the Special Immigration Appeals Commission (SIAC) finally granted Taleb deportation bail to live under house arrest conditions, unable to go outside a prescribed area, tagged and only able to meet people like Mr Kent who had been vetted by the Home Office. Throughout this period of detention neither Mr Taleb or his lawyers have been told what he is accused of doing. He has become a victim of secret evidence. At the SIAC hearings only the judges and appointed special advocates are allowed to see the material upon which detention is being sought. Neither the men or their lawyers get to see this material.
For Mr Taleb, the only route out of the nightmare is to agree to return to Algeria – a place where he has already been sentenced to death in absentia.
Mr Kent recalled that on one occasion he was accused of breaking bail conditions on a control order when living in a flat. “He was never told what he was supposed to have done but returned to Long Larten prison for another 18 months nonetheless,” said Mr Kent. “This whole process has been about forcing a number of individuals to return to their countries of origin. Life has been made so difficult that it is hoped they will give up and go home. That is regardless of what might await them there such as torture or ultimately death.”
“No one should be detained unless they have been before a jury or panel of judges in a fully accredited court of law. Everyone has the right to be dealt with under the law,” he added.
The whole process that has ensnared Mr Taleb and a number of other individuals began following the attacks on America of 11 September 2001, when the British government rushed through the Anti-Terror Crime and Security Act (ATCSA), which allowed foreign nationals to be detained without trial indefinitely.
In 2004, the Law Lords ruled that it was unlawful under the Human Rights Act. It was as a result of this ruling that control orders were devised under the Prevention of Terrorism Act 2005.
This meant effectively being detained under house arrest. There were short periods when the individual could go outside into a proscribed area. They were also required to wear a tag and ring up the tagging company a number of times a day.
East London justice and peace activists Desiree Howells, MBE, and Olive Flynn became involved in the detention cases through the group Peace and Justice in east London. This began following 9/11 and in the early years was in the main a peace protest group. However, following a number of public meetings at Our Lady of Lourdes Pastoral Centre, the group members found out about the individuals concerned being detained without trial.
Desiree and Olive monitored on an almost daily basis the trial that was to clear Taleb and the others accused of the ricin plot. They are also regular visitors at SIAC monitoring those proceedings. They are vetted to visit a number of the men being held on deportation bail. Both appear in the award winning film Taking Liberties and are appalled at what they have witnessed over the years. “I did not think it possible in Britain,” said Mrs Howells. “It has dragged British justice through the dirt and destroyed its reputation internationally.”
She has been particularly effected by the way in which this form of detention has ruined so many lives. “These young men’s lives have been destroyed completely. The single ones have been unable to develop meaningful relationships, “said Mrs Howells. “For those with families there has been a collective suffering. The children are growing up with a fear of when the police are going to come calling.”
One of those first detained under the ATCSA in December 2001 was an Algerian man known only as G. He was imprisoned, then released on house arrest style bail conditions then re-arrested after the London bombings, and served with a deportation notice. While in prison he tried to kill himself using wire. Today, G continues to live with his wife and two young children under house arrest conditions on deportation bail. “No one here has ever told me what I am accused of. I have no rights here it seems. In Britain animals have rights. I have less rights than an animal,” he said.
A regular vetted visitor to the family is Adrienne Burrows of Peace and Justice in east London. “There is incredible stress that builds up from so many years of being detained without knowing what you are supposed to have done. This is made worse by seemingly indefinite nature of the detention,” said Ms Burrows. “Restrictions that can seem minor come to put an intangible strain on family life with particularly bad effects on the children.”
There are though some encouraging signs of progress in the effort to roll back the operation of this secretive system of injustice.
In July, the Law Lords ruled that control orders breached the Human Rights Act in that the reliance on secret evidence denied the appellants a fair trial. There are 15 individuals still on control orders but these are expected to be overturned during the next few months in accordance with the ruling. The Home Secretary Alan Johnson has set up a review of control orders under Lord Carlile.
This breach of the secret evidence type system though has not yet effected those like Mr Taleb and G being held in similar style conditions, pending possible deportation from the country, though the principles are similar. Their cases at present look set to go all the way to the European Court of Human Rights in Strasburg.
The Coalition Against Secret Evidence (CASE) was established back in March and some 91 MPs have signed an Early Day Motion calling for an end to the use of secret evidence. CASE have organised an open letter to the Home Secretary that will soon be published in national newspapers demanding an end to the use of secret evidence. So there are signs that the tide is turning against secret evidence and not before time. Few would have thought that individuals could be held for year after year, denied a fair trial on the basis of secret evidence. Only now is it becoming clear just how much damage has been done to the British justice system as a result of the decision to take part in the war on terror, begun by US President George Bush and Prime Minister Tony Blair in 2001. There are many casualties and they are not all to be found on the battlefield.
* To sign Downng Street petiton on detention see: http://petitions.number10.gov.uk/secret-evidence/

Professor Nutt sacking proves policy is made by tabloid

What the sacking of Home Office drugs advisor Professor Nutt reveals is how policy is formed on the basis of certain powerful newspaper's editorials and headlines. A serious examination of the areas of drugs, immigration and prisons policy show this process at work.

The drugs policy is not working. Prohibion has grown the problem and now the prisons are full of addicts who have been stealing to feed their habits. The recommendations of experts like Professor Nutt target reducing demand and also point out the danger of other legal drugs like alcohol and tobacco. The tabloids disagree, so expert advice is ignored.

On immigration, with a rapidly ageing population no serious economist advising government would advise putting blocks on migration. But what does government do but obey the tabloid witterings that migration must be cut if not stopped altogether. The result migration has been literally halted with the largely unworkable points system - already the CBI has warned on the serious impact this will have on business in the long term.

Similarly in the area of criminal justice, all credible evidence shows that locking more and more people up does not cut crime but makes for the creation of better criminals. It is expensive and two in three reoffend inside six months. But rather than follow expert advice about alternatives the government continues building more and more prisons.

The foremost objective of any newspaper is to sell copies and make profit. Sadly, this often amounts to pandering to the lowest common denominator. In the case of immigration that is racism and in criminal justice it is a collective desire for vengeance. This does not provide a basis to make effective policy. Governments are elected to make reasoned decisions on the basis of objective evidence not make policy on the hoof depending on what headline any particular newspaper editor decides will sell most papers on any given day