Thursday 3 September 2009

Just wandering about in the dark corners of the Internet when I came across something called the Liverpool Care Plan. I will provide a link but, in the interests of safety and good mental health, I would like to show you something that will ensure you are in a happy frame of mind at the outset.

Right. That was jolly wasn't it? Now, I feel I can take you to the core of my blog - The Liverpool Care Plan. I can reveal now that everyone reading this - and indeed, all those not reading this that this Care Plan is something that will surely have a massive impact upon - quite literally - your lives.
Liverpool? Easy enough. City on the coast up in the North West. Scousers and scallies. Lovable rogues. Hard times and hard people as befits the North West. European City of Culture and all that. Good Philharmonic band.
Care? I am going to cheat a bit and just cut and paste a few lines here.
The Oxford English dictionary says:
• noun 1 the provision of what is necessary for the welfare and protection of someone or something. 2 Brit. protective custody or guardianship provided for children by a local authority. 3 serious attention or consideration applied to avoid damage, risk, or error: handle with care. 4 a feeling of or occasion for anxiety.
• verb 1 feel concern or interest. 2 feel affection or liking. 3 (care for/to do) like to have or be willing to do. 4 (care for) look after and provide for the needs of.
— PHRASES care of at the address of. take care 1 be cautious. 2 make sure (to do). take care of 1 keep safe and provided for. 2 deal with.
Nice cosy word isn't it? Remember the 'nice' association.
That just leaves us with Plan. This out of my head - the pedantic can Google it. I reckon strategy, scheme, idea, proposal, plot or design will cover that.
So - the whole phrase again. The Liverpool Care Plan. Nice (that word again) cosy thing signifying looking after works. Now, time to get specific The Liverpool Care Plan in all it's glory. Quite a bit to take in but what it boils down to is how the doctors care for and plan your treatment in your final hours. Doctors. Final Hours. Scary eh? You would be very scared if you read an analysis of what it is about. Go on - I dare you. This kicks in when you are 65. Believe me - one thinks that is a age that is far far away but the bugger just creeps up on you. Impotence, thinning hair, dodgy memory, people who speak quietly - all things that distract us whilst the body clock ticks on.
Don't take my word for what may well appear at your bedside clothed in a white coat and expression of concern. See what the learned Journals say
  • The Liverpool care pathway (LCP) is the UK’s main clinical pathway of continuous deep sedation and is promoted for roll out across the NHS. Rietjens et al’s study highlights some serious weaknesses in its design.
  • The eligibility criteria do not ensure that only people who are about to die are allowed on to the pathway. They allow people who are thought to be dying, are bed bound, and are unable to take tablets on to the pathway. In chronic diseases such as dementia, dying can take years, but such patients may be eligible. Reitjens et al’s paper shows that GPs often put patients on to such a pathway without palliative care advice. A pathway for general use should minimise opportunities for early or inappropriate use.
  • Murray et al are concerned that sedation is being used as an inexpensive alternative to assessment and specialist treatment. The LCP recommends sedatives and opiates . . .
  • Adrian J Treloar, consultant and senior lecturer in old age psychiatry

so, he should know

Even the Daily Telegraph has got into the act. Note the nice little panel to the left which amplifies the information. File it alongside last week's report from the Patients Association that very large numbers of aged patients were being pushed over the edge with cruel treatment - and they were not even prisoners of the War on Terror.

That should be enough to keep a few awake. Not 65 - but I bet you know someone who is? Someone you love?

I'm off to my solicitor to arrange my own departure rules. I'll call it the Everton Alternative Arrangements I think.


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