Why would you build a smaller hospital

to replace one which is already too small?

That's a serious question. This has already been done once - and now they are planning to do it again. 

The main hospital in the CBD was replaced by another several years ago. It was one of those "budget blow-out" affairs that paid homage to a  political party but does not do the job it is supposed to do. The main entrance is the size of a cathedral - if not bigger - and serves no purpose except confusion. There is no place for the staff meet, no place for them to store personal belongings, no place for them to eat and limited places for the lucky few to park. There are no wards. Each room is individual and has its own en-suite facilities which might sound good but actually means less monitoring of all but the sickest patients. The meals are delivered by robot.

The Senior Cat spent several nights in there almost three years ago. I've been told that the food has improved by then but a friend who was in there for five nights not so long back has said that, had it not been for her family, she would not have eaten because she couldn't reach her food. 

"Individual rooms are lovely if you are ill Cat but they need to be combined with the level of care that actually allows you to get better."

I have to agree. 

It is therefore with alarm that I read about the plans for the new women's and children's hospital in the CBD. I most certainly support the old one being replaced. It is a rabbit warren. A late friend of mine actually lived in the hospital for a number of years. There was nowhere else for her to go. Every morning the staff would help her into her electric wheelchair and she would spend her days going all over the hospital and sitting with anxious parents and frightened children, taking messages to other places as she went. She knew the building inside out and there were few places she had not managed to find a way to access. All the same she knew it could be improved. More than one simple ramp was put in at her insistence.

A new hospital was not on the horizon in her time but I think she would have a thing or two to say about the plans. I can hear her now, "It's smaller? Why? It needs to be bigger!"

M... would not have been interested in individual rooms with en-suite facilities for anyone other than those children who were critically ill. She would have found the downsizing of that area unbelievable. 

M... would have been looking for a school within the building, more than one play area, rooms for meetings, staff facilities, parent facilities, therapy areas and much more. Her thoughts would have been on well lit spaces with access to "outside" and "fresh air". 

Children have very different needs from adults when it comes to hospital facilities. M... knew that. Most parents would know that too even if they cannot always put it into words. 

I once went on a visit to one of the best known children's hospitals, Great Ormond Street in London. The buildings were old even then but it was still catering for patients in a way which would have met the approval of M....  There were many very sick children there, often with life threatening conditions. Despite that many of them were out of bed. The older children were doing school work - the activity the group I was with had gone to see. The younger children were, as far as possible, actively engaged in other activities. We saw children who were too ill to be involved in any group activity. There were volunteers reading to some of them or playing simple games. Yes, there was tragedy there but it was not a place of despair, rather of hope. I doubt the staff at that time would have been interested in the provision of individual rooms except for the most critically ill. 

It is much more likely that they would have laughed, as we did, at the young doctor who crawled out from underneath one of the beds and, giving us a wry smile, told us, "First catch your patient."

 

The WITS are back!

The WITS (workmen in the street) returned this morning. There was some speculation among the residents as to whether they would appear again. 

Nobody expected them to be there over the Easter break. For the WITS that began at lunchtime last Thursday. I wondered if they would extend it - perhaps until tomorrow. No. They arrived just before seven this morning.

Just before that I heard the council rubbish vehicle going slowly down the street and emptying our bins. I am not sure who put the green bin out for me. It was filled to capacity with the lighter parts of the apple tree we have lost. One of the male neighbours would have done that for me without even asking. 

We have excellent neighbours. I have needed a little help recently. There have been tiny things - like raising the seat on my new trike - but things I cannot do myself. I try to repay them. T....and H... across the road have been munching their way through the apples that came from the fallen tree. Still, they don't have to do these things. I might have managed the bin myself - albeit with some difficulty.

I was about to go out and bring the empty bin in again - out of the way of the WITS when I heard it being returned. One of the WITS was doing it.

I am now hoping they won't find something rather more important not to be a problem either. Brother Cat phoned to let me know he and his partner will be over here for a few days next week. They plan to bring the trailer again. This time they will stack it with the best of the timber in the shed. They also want to spend some precious time with the Senior Cat. The big question is going to be whether or not they can get in and out of the driveway while the WITS are here. I gave my brother the relevant phone number - the one we were given - so he can make inquiries today. 

I looked in the shed yesterday. There is still a lot there. I know some of it is valuable - Huon Pine, Blackwood, Black heart Sassafras, Tasmanian Oak and more. There are tiny pieces known as "pen blanks" for turning wooden pens or making buttons. There are larger pieces which my brother will turn into boxes and still larger pieces which will become cupboards and display units. He has some commissions now that the machinery he took last time is in place. 

He sent photographs for the Senior Cat to see it all.  I showed the Senior Cat yesterday. He sighed but in a more contented sort of way than usual. 

"It gives me so much pleasure to know that your brother is taking over where I left off."

I look at it and I see the Senior Cat there in my brother. 

And, shortly, I will go out and thank the WITS for bringing the bin in for me instead of leaving it in street.  

Dementia patients

vary as widely in their behaviour as anyone else. 

"Oh, it's what they would really be like if there wasn't that social veneer," I was told yesterday.

That's nonsense. I have known too many people with dementia to believe that. 

There was O... a lovely, gentle, kind man who became so confused and angry that he had to be given medication to calm him. He had no idea who he was or where he was. That he would have been like that apart from "good manners" was nonsense.

There was C... whose dementia was brought on by a brain injury. He had a doctorate in one of the physical sciences. One of his pleasures had been bush walking. Prior to his brain injury he would help to find people lost in the bush. When dementia set in he would wander the streets and become lost himself. Knowing who he was local people would guide him home but have to be careful how they did it because he would lash out at the merest provocation. More than once I had to pretend that he was taking me home rather than the opposite way around.

There is K..., the Senior Cat's oldest friend. K... is now so confused that he asks his wife things like, "Who am I sleeping with tonight?" He has been married to her for over sixty years and never slept away from her apart from trips to hospital. Before dementia set in he would not even asked the question as a joke. He's still a gentleman even if he can't remember something he was asked to do from one side of the room to the other.

There is M... who lives in the same residence as the Senior Cat. She spends her days wandering the building. People have to be constantly on the watch that she doesn't escape. It is not really the right place for her to be but there has been no success in getting her into a unit intended for dementia patients. Two days ago she tried to tell me to get into bed. Perhaps it was a left over from her days as a hospital matron. She was very insistent and becoming quite agitated. I lay down on the Senior Cat's bed for a moment. It seemed to satisfy her and she wandered off. When I left one of the staff was trying to get her to have something to drink. She was behaving like a toddler at that point and she looked at me as if she had never seen me before.  The staff tell me that "bossy" is her more normal way of behaving.

I am not convinced by the "social veneer" idea. Yes, people change. It is likely that all sorts of things can cause us to be less patient or less polite when we grow old and frail and downright frustrated. 

The Senior Cat can be forgetful and, if he mishears something, he can get confused but he is still very polite and thoughtful of others. He doesn't bother the staff unnecessarily. He watches people like M... and tries to be tolerant of them. He can still enjoy a one-on-one conversation about many things. I know we are lucky. I sometimes wonder, especially when he is so concerned about K..., how he would be if he had dementia. 

It seems to me we know very little about dementia...and people with dementia can't tell us what it is like.

Please write a will!

I am going to be more serious than usual on a Sunday morning and say, "Please write a will!"

If you haven't already done so then this is one of the most important things you can do. I know none of us want to think about this but the consequences of not doing it can be horrendous for the people you love and for whom you want to care. 

The subject came up twice yesterday, once while I was talking to a neighbour. He came over, apparently casually, to ask my advice about changing his will. One of his children has made a disastrous marriage and he wanted to be sure that the partner could not benefit. It's much more complicated than I am competent to handle but I explained why he needed to see his solicitor. (He's the sort of man who actually has a solicitor so that helps.) He asked some questions and I know he will actually make an appointment to get the situation sorted out.

And then, late yesterday, someone phoned me about something else entirely. Somehow we got onto the topic of her right to live in the house she is currently living in. That situation is complicated too. It is further complicated by the fact that she knows nothing whatsoever about the law. If she had known something about the law she might never have agreed to do what she did. It was certainly to her disadvantage. Now, unless she writes a new will, the one person she does not want to benefit will end up getting everything. 

Writing a will is not a complicated business. It is what you want to say in it that can be complicated. My will is a one page affair. I wrote it myself because I am competent to do that.  It makes two bequests and then a division of my assets - whatever they happen to be at the time of my death.  A solicitor friend who read it over for me was kind enough to say, "Well that's perfectly plain. Nobody can argue with that." 

Why did I get someone to read it over when I know I am competent to write it? Because it is a very important document and I needed to be certain that I had said what I intended to say.

But, when I move from here, I know I am going to have to update my will because my circumstances will have changed. It is something people don't always recognise.

That is the problem for the person who needs to write a new will. Her circumstances changed. She should have written a new will when her husband died because there are complications but she was unaware of those.  She also needs an "enduring power of attorney" and an "advance care plan" to be put in place. Her particular circumstances make these things essential. There are forms available for the latter two things. They aren't difficult to sort out. We will meet and I'll help her get to the point where she can get the forms signed with a minimum of fuss. 

I don't mind doing this because, without it, she will soon be even more vulnerable than she is now. She has been taken advantage of and it is going to be hard enough to face that. Writing a new will should help. 

We all need a will, even if we think we haven't much to leave. When we do have something to leave it is even more important. I once saw the will of a farmer. It was written on the back of a docket from the local town's "stock and feed store". He had written it standing at the counter and got the manager and an assistant to witness it. They had been talking about wills because the farmer said he was "feeling a bit rough".  The farmer took it another couple of hundred metres to the bank to deposit - and then collapsed on the floor. He died three months later.  The difference the will made was the difference of a lifetime for his family. More than once they have said,"We are so glad Dad made that will when he did."

Make a will? Yes, I have. I am glad I have.

 

Lance Armstrong was paid $4m

to participate in the "Tour Down Under" - the bike race held in this state as a "tourist attraction". 

That was ten years ago. It was a lot of money then and it would be even more now if inflation is taken into consideration. 

Lance Armstrong is also a cheat. There was no "morals" clause in the payment so he has kept the money.

All this came to light yesterday when the "confidentiality" clause came to an end after ten years. Predictably there are people who still claim that what he was paid was worthwhile because of the "benefits" it brought into the state.

Yes, people came to see the race. There were a relatively small number of people but they did spend money on accommodation, meals and so on.  Yes, some local people went out to watch and they also spent some money.

But was it really worth it? Yes we have a "bikeway" named after the man who organised the races at the time. I use part of it occasionally. Perhaps it would not be there without those races. I don't know.

There is perhaps also a little more interest in that sort of cycling, or even in cycling in general. It has not stopped people complaining about a proposed bicycle track in the CBD. I understand their concerns but part of the answer is an increased awareness of the interaction between cyclists and pedestrians, cyclists and cars and the need to encourage safe passage.

But the revelations about the payment also made me wonder whether we don't have a problem in sport simply because people do get paid far too much for things like the ability to hit a ball, kick a ball, pedal, run, jump, swim, dive and so on. It is perhaps "nice" to be able to do those things and it is important to be active in order to help maintain good health - but is it right to pay a very small number of people such ridiculous amounts of money because they can do these things? What does it really contribute? 

I have said elsewhere that we don't pay the people who work in laboratories and hospitals anything like these amounts. We pay teachers a tiny fraction of what Armstrong was paid. There are endless numbers of people who are in caring professions or who, like rubbish collectors, contribute to our overall welfare and well being who get paid a pittance compared with Armstrong. Many artists, musicians and writers get paid too little to live on and so have second jobs while Armstrong and others like him are cheating their way to the top.

The Tokyo Olympics are coming up. There will be cheats there - cheats who hope they can get away with it or who might not even know that they are being used to "win glory" for their countries. I have no doubt at all that a few scientists have been trying to work on performance enhancing drugs that cannot be detected.

Why is this so important? Aren't there more important things we need to think about - for the good of everyone perhaps?

Proof of identity

is needed to get a passport, open a bank account, get a licence to drive and many other things. Now there are suggestions that proof of identity should be required to open or maintain any sort of social media account.

This would stop cyber-bullying - or so those suggesting it claim. It wouldn't. There will always be determined people who would find their way around such a move.

Several years ago two students at a local primary school hacked into the school's computer system. They had access to all the data in the system, including some very sensitive information about their peers, about the staff, about the school's accounts and much more. They did it not out of mischief so much as to show how easy it was to do it. These two boys were not even twelve at the time. Security was upgraded but  I do not doubt that there are other able students in the school now who could find their way in to the system.

I know another boy, one who has caused a considerable amount of trouble, who hacked into a computer at the behest of his grandmother. He admitted to me later that it was "dead easy". That frightens me.

My day job involves working with people all over the world. The system we have set up involves some fairly serious security. This is not because anyone intends anyone else some harm, just the opposite. There are people however who would prefer others not to know that they are spending two weeks of their four weeks annual leave doing a stint in a hospital in a far off place or that they are helping to repair a mosque when their normal place of worship is a synagogue. That's commonsense. I don't know how many of them have social media accounts for the sole purpose of discussing the issues they come up against. I have never met most of them and I never will. Could they all provide the "100 points" of ID proposed by the people making the suggestion that proof of identity is needed to have a social media account? I doubt it. One of the people I work with on a regular basis doesn't even have a birth certificate.

Proof of identity is not the answer to cyber bullying. It is not going to stop it. Devices will still get hacked, indeed it will encourage hacking. People who have been in abusive relationships might actually be more at risk.

I don't know what the answer is but it might help if the police had greater powers to "search" when bullying is reported.  

"He's on the autism spectrum"

a mother told me yesterday.

I was at the library and her child was running around. He had almost knocked me over a moment before but she did nothing to stop him. I raised my eyebrows but she just shrugged and said,

"If I try to stop him he will probably scream the place down."

Oh, that makes it acceptable behaviour? I didn't know her so I was not about to argue with her. Perhaps he is on the autism spectrum but the knowing look he gave me a moment later suggested that he was well aware of what he is doing. He was also well aware that he was not going to be reprimanded for  it. 

I waited until his mother went off to look at the DVD collection and then I stepped in front of the child as he came running back down the shelves I was looking at.

"Are you having a holiday from school?"

He grinned at me and said, "I do all the time. If I don't like it then I don't have to go."  

My response was, "That's a pity. You miss out on all the fun." 

He looked at me as if I was completely mad and ran off - but he did not run anywhere near me again. 

This child must be about six.  He already has the system worked out. If he misbehaves in certain ways then he is going to be suspended. It may well be that he is having problems at school but is really on the autism spectrum.

I know children who have serious issues with school. I know a child with very high intelligence who simply cannot get things down on paper or on a screen. She is extremely frustrated by this. She will throw a tantrum because of it. She wants to do it and, hard as she tries, she cannot do it. Last week she came home from school with a long story she had written. Her new teacher had told her something like, "Wait until I have everyone else started and then I will help you."

Her family have praised her. Her parents emailed it on to me to see. I have praised her. We have all told her, "If you don't throw a tantrum then someone is going to help. You can do it but you have to learn to do it your way."

The school tried to say she was on the autism spectrum. Her parents took her to be assessed.  The assessment said much the same thing but her parents refused to accept this. When their neighbour introduced me several months ago the father told me, "I thought autistic kids weren't able to relate properly to other people. You watch her. She loves to cuddle. She looks us right in the eye. If she isn't frustrated she's a loving and pretty well behaved kid."

I could only agree. They went for another assessment armed with observations her mother had made during the home-school period during lock down. S..... can read - and read above her age level. She can do all her maths in her head but she cannot put it on paper. A second assessment came up with a different diagnosis. She has a specific learning disorder but yes, she can learn. Her new teacher is aware of that and she is trying to accommodate that. S....is much happier at school now. I just hope it continues. At least her parents are aware of the problem now - and they have made it obvious what their expectations are in respect of her behaviour.

But the child in the library isn't getting that sort of help. I don't know whether he is "autistic", whether he has a similar learning disorder, or whether he is simply a very poorly disciplined child.  His mother may need help more than he does. 

Perhaps it is just too easy to say "autism spectrum disorder" or ADHD or some other label and leave it at that? All I can think is that it is not helping the child.