Loneliness is a killer

The coronavirus shut down has made us all more aware of the problems of loneliness. Loneliness itself can be a cause of mental health problems, of morbidity and of premature death. A new study in the United States shows the impact of loneliness on the end of life experience.

In a study of Americans over age 50 years who died between 2004 and 2014, individuals who were characterized as lonely based on survey results were burdened by more symptoms and received more intense end-of-life care compared with non-lonely people.

In the 2,896-participant study, which is published in the Journal of the American Geriatrics Society, one-third of adults were lonely. In addition to having an increased likelihood of experiencing troublesome symptoms at the end of life, isolated individuals were more likely to use life support in the last 2 years of life (35.5% versus 29.4%) and more likely to die in a nursing home (18.4% versus 14.2%) than non-lonely individuals.

Dr Nauzley Abedini, who led the study at the University of Michigan, says:

“Loneliness is a pervasive psychosocial phenomenon with profound implications for the health and wellbeing of older adults throughout the life continuum, and particularly at the end of life, We must do more—as healthcare providers, but also as a society—to screen for and intervene on loneliness not just during the dying process, but before the end of life period.”

The charity Campaign to End Loneliness says that there is substantial evidence that having a lack of social connections significantly increases the risk of premature mortality.

Studies show that loneliness increases the likelihood of mortality by 26% and has and effect on mortality comparable to the impact of well-known risk factors such as obesity or cigarette smoking.

Loneliness is associated with an increased risk of developing coronary heart disease and stroke, and also increases the risk of high blood pressure.

Loneliness also puts individuals at greater risk of cognitive decline and dementia, and lonely people are more prone to depression.

Loneliness and low social interaction are predictive of suicide in older age and loneliness and isolation are associated with poorer cognitive function among older adults.

Prioritising people in nursing care.

There has been in recent years concern that care in the NHS has not been sufficiently 'patient centred', or responsive to the needs of the patient on a case basis. It has been felt in care that it as been the patient who has had to adapt to the regime of care, rather than the other way around. Putting patients at the centre of care means being responsive to their needs and supporting them through the process of health care delivery. Patients should not become identikit sausages in a production line. The nurses body, the Nursing and Midwifery Council has responded to this challenge with a revised code of practice reflection get changes in health and social care since the previous code was published in 2008. The Code describes the professional standards of practice and behaviour for nurses and midwives. Four themes describe what nurses and midwives are expected to do: prioritise people practise effectively preserve safety, and promote professionalism and trust. The

Ian Duncan-Smith says he wants to make those on benefits 'better people'!

By any account, the government's austerity strategy is utilitarian. It justifies its approach by the presumed potential ends. It's objective is to cut the deficit, but it has also adopted another objective which is specifically targeted. It seeks to drive people off benefits and 'back to work'. The two together are toxic to the poorest in society. Those least able to cope are the most affected by the cuts in benefits and the loss of services. It is the coupling of these two strategic aims that make their policies ethically questionable. For, by combining the two, slashing the value of benefits to make budget savings while also changing the benefits system, the highest burden falls on a specific group, those dependent on benefits. For the greater good of the majority, a minority group, those on benefits, are being sacrificed; sacrificed on the altar of austerity. And they are being sacrificed in part so that others may be spared. Utilitarian ethics considers the ba

The Thin End

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