Friday, 26 September 2014

Toothpaste, Vinyl versus Latex and ‘DNACPR’

Helping out at a home owners and registered managers’ event recently I noticed three interesting topics were animating discussions.

One: toothpaste as a hazardous substance. This started off as a tale told to emphasise another ludicrous CQC inspector going over the top— until somebody posed a personal care scenario where toothpaste could really be potentially harmful. It is worth weighing the benefit of toothpaste to basic dental hygiene against the possible dangers to eyes from misuse, we learned.

Next: the relative merits of latex and vinyl gloves was in terms of practicality versus cost discussion. It centred on a contractual requirement to use only latex. Apparently both makes of gloves meet the same standards for infection control purposes. So, if this is the case, why the insistence on latex given vinyl is half the price? We speculated on the added sensitivity to touch of the latex and contractor ignorance of how and when gloves are used. However according to one home owner there were potential savings of £1,000 per year – and it’s a matter of personalised practice for another?

Three of three: DNACPR stands for ‘do not attempt cardio-pulmonary resuscitation’, which came up discussing the 5 key questions CQC will ask of registered social care services. In true workshop fashion, the questions were allocated around tables for discussion, and the table that had: Are they responsive? came up with a really helpful description of how the practitioners in their care home respond to situations when possible resuscitation may be a matter of choice – and may be potentially more harmful than beneficial. Clearly, caring and common-sense make it not only responsive to the resident and their relatives but importantly professional. On a personal level it gave me useful information that I could have done with several months ago, when my father was terminally ill.

So what did these three vignettes teach us at this event – besides, that is, the subject matter of the day (the Care Act and CQC Fresh Start)? We learned that it is often the little things, the details, which make the biggest differences in people’s life — indeed, they are often the crucial difference between harm and benefit.

Thursday, 11 September 2014

Connecting Memory and Imagination

Mike Wright shares his thoughts

One thing that could be said of both memory and imagination is that each only exist in the mind. Now that could be said of many things (in fact, some would suggest that everything exists as an expression of Universal Mind, but forgive me if I side-step that one for now!), after scratching my head and pondering over what connects the two, I looked into my own mind – and there they both were!

The consideration that I may have to go outside of that mind to find another connecting factor convinced me it was wise to stay put, and further explore this initial discovery.

Essentially, memory and imagination are both processes of thought, the activation of which places a slight veil over our immediate experience, and therefore, reality. This is not to undermine the usefulness of both as tools helping us to live practical and high-functioning lives, but we do not ‘exist’ in our thoughts: rather, the fact that we have consciousness means we are able to think.

Therefore we should not mistake either memory or imagination as conditions of who we essentially are, as the following quotes convey:

“…if you made a mistake in the past and learn from it now, you are using clock time. On the other hand, if you dwell on it mentally, and self-criticism, remorse, or guilt come up, then you are making the mistake into ‘me’ and ‘mine’: you make it part of your sense of self, and it has become psychological time, which is always linked to a false sense of identity.” Eckhart Tolle

“Thus I know that none of those things that I can understand with the help of my imagination is relevant to what I know of myself, and that the mind must be turned away carefully from those things so that it can perceive its own nature as distinctly as possible.” Descartes

Of course, I’m not suggesting that we refrain from the free use of imagination – say, reminiscing about the momentous impact that sliced bread had when it made its debut in the shops, or attempt to inhibit the creative impulse by forbidding Jeremy Paxman to rewrite Harry Potter as a polemic against fascist dictatorship.

What I am suggesting is that when our memory and imagination come together to construct some sort of narrative thread as to what type of person we are, or what other people think of us, this only exists in the realm of thought and does not constitute an immutable truth.

False senses of Identity

The implications of this are that we are not bound, as Eckhart Tolle says, ‘to a false sense of identity’. Rather, if we allow thought to dissolve back into its source, which is our ever present consciousness, we are eternally born back into the present moment - free of the suffering we may have experienced in the past and with our essential nature undiminished and without the limitations so often imposed through our imagination.

By the same token, if we merely view memory and imagination as tools of thought, to be taken up and dropped as and when they are needed, not as inseparable extensions of our identity, then we are surely free to once again to enjoy our present experience and dwell in our true nature.

This has implications for the way we view and behave towards those people who experience dementia, or other diseases which inhibit a person’s mental function. If a person’s overt ability to think or reason appears to diminish, this does not imply that the essential nature of that person is also diminished.

The disease does not therefore render someone less of a person - and it should not allow for a person to be stigmatized or treated as though they are. Again, if we are able to free ourselves from negative judgements and opinions which belong entirely to our imagination, then we may allow ourselves to act more in accordance with our nature, and instantly reduce the likelihood of someone feeling judged and undervalued.

If we seek to connect with a person on the level of our mutual fundamental nature, rather than our ability to think, reason, and remember, then perhaps we would be closer to sharing in the experience of the only reality that truly exists and not find ourselves so caught up in the ones that we construct in our minds.

Just a thought.