Wednesday, February 11, 2009

Tiresome obligatory notice

click to enlarge  —  image by jarcob

In light of the mounting weight of evidence that, in 2009, the known universe has gone certifiably insane, this blog(ger) shall be taking an indeterminately long leave of absence.

Among other things, this blogger will do the only humane thing, and take said crazed universe out the back and shoot it.

Hush, Baby Jesus, hush; your cries fall as insubstantial autumn leaves into the wastes of Chaos.

Take it from me, BJ, it’s always better to leave ’em laughing...

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Tuesday, February 10, 2009

Milk of human kindness

An email yesterday from our personnel area advises they

...have been in contact with the Red Cross, who ask that we do not send staff down to donate today — they are absolutely inundated down at their offices. With a large number of their nurses out in the field dealing with burns victims they have limited free nurses for donations for us today. They are also managing a huge amount of public walk-ins who want to donate today also.

They have stressed that blood donations made next week and over the next month are the most crucial donations in this situation. Burns victims are going to require ongoing transfusions and there is a high need for plasma.

So there is no immediate urgency, but do keep the stuff flowing. (Note that the above relates to the Red Cross in Melbourne.) You can phone 13 14 95 to make arrangements to donate blood, or see here for more information.


Monday, February 09, 2009

Flash: Not all difficult situations solvable

Self neglect in at-risk groups, particularly the elderly, presents some unique problems for those working in the community care sector.

A recent Australian study (PDF) by Dr Shannon McDermott of the University of New South Wales explores the distinction between self neglect, squalor and hoarding.

Self Neglect: inability or refusal to perform essential self care tasks, such as adequate feeding, shelter or medical care for themselves.

Squalor: neglect of one’s immediate personal environment.

Hoarding: inability to throw objects away.

Such behavioural problems can present challenging practical and ethical dilemmas not only for community health professionals, but also the person’s loved ones, neighbours, etc. The study cites an extreme case in which

an older woman kept 500 pigeons inside her home. The birds were noisy and their faeces had an extremely strong odour, which prompted complaints from the neighbours.

The woman refused assistance and was determined by local authorities to be legally capable of making decisions; this meant that professionals were bound to respect her decision to refuse assistance. Eventually the local council became involved because they believed that the situation threatened public health.

The council spent thousands of dollars to remove the birds but, because the woman refused to stop leaving food out, the birds quickly moved back in.

One can only agree that this kind of thing does indeed present dilemmas in spades. It may be tempting for local councils to pass ordinances outlawing actions which, whether deliberately or inadvertently, give rise to a threat to public health. But then, assailing a little old lady with the full force of the local bylaws would be too much like breaking a butterfly on a wheel.

Dr McDermott suggests what might be thought of as a ‘middle way’:

Resolving these situations required that professionals strike a balance between the duties of autonomy, beneficence and justice with a wider organisational context which required that they also manage risk and provide services in an increasingly efficient and effective manner.

The research found that a pluralistic approach to decision-making, along with formal and informal support from their colleagues, was important to ensure consistency between ethical approaches and to accept that not all difficult situations could be resolved.

Leaving aside the challenge of unpacking all that jargon, it must be said that “accepting not all difficult situations can be resolved” is hardly a cutting-edge ‘finding’. Most people out in the field know only too well.

Clues to some solutions may be afforded in Dr McDermott’s research paper of some 340 pages. I’ve added it to my (interminably yawning) reading list, and suggest interested readers might like to do the same.


Sunday, February 08, 2009

Spirit of place

Tell us about it...

In the heart of the next morning, under its early carnation sky, Lunt and his dog went round to the horse-yard. The mills were creaking, straining their guts to drag trickles of love from the red powdered earth. The land lay flat all round with its dusty scrubby shade trees making black dawn patches.

Lunt bent down and took a pinch of dust between his thumb and finger, sucked it and swallowed.

“Ah, you bitch country,” he said. “I love you.”

  • Thea Astley, A Kindness Cup

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