Guest blog by Peter Ellis

Peter was in his fifties when he had a massive, dense and complex stroke on 26 March 2018. Although he lives in Norfolk in Britain, his experiences as a stroke patient will resonate with others worldwide. He writes:

As you approach this blog I want to assure you, the reader, that I am in a good place despite what I am writing about. But I want to be honest and true to myself.

What a tricky subject! Suicide is often unspoken about and difficult. We don’t like it. It is an unutterable consideration. People who have had a stroke often feel, depending on the severity, that their quality of life is so compromised that what is the point of continuing to live. There is perhaps a feeling you are too much of a burden and in the way. Pompili et al state that, “stroke is a dramatic event and is associated with potentially severe consequences, including disability, mortality, and social costs. Stroke may occur at any age; However, most strokes occur in individuals aged 65 years and older. Previous research has found that stroke increases the risk of suicide” (Pompili, et al 2014).

I have become very distressed on occasions. The thought of being seriously disabled, is completely overwhelming, wondering if I will be like this for the rest of my life. As I write I am listening to Songs of Praise and a couple of hymns and worship songs are featured, those I used to play on the piano. I start to cry, feeling immensely sad as I will probably not be able to play again. I wonder, again should I sell my piano?

When I was in hospital I remember a woman talking in a support group, she announced that her favourite pastime was driving her car and if she could not do this again she would end her life and said she was very serious about this. I just hope this was followed up by the psychologist. I also wonder what impact this might have had on other members of the group. This encounter still plays on my mind.

I have, at times, when I am distressed, feel overwhelmed and how life would be unbearable in the future. I struggle with not knowing how to escape and deal with the loss I experience. I wonder sometimes if I would be better off dead. On one occasion, Duncan was at the bottom of the garden and I was trying to contain my distress, I was sitting by the back door and I knew there were plenty of paracetamols in the kitchen. I had a choice, turn left, walk into the kitchen and swallow a handful of them or turn right and join Duncan in the garden. Clearly, I turned right and I am able to write this now. I honestly now feel I would not really want to take this selfish course of action. Those with their clinical/therapeutic hats on – there is no need to start the risk assessment!

Research has shown that stroke patients are up to twice as likely to commit suicide as people in the general population, and the risk of attempted suicide was highest in the first two years after a stroke. Among stroke patients younger than 55, the risk of suicide was five times higher than in the general population.

When I worked in the NHS I started working towards an MPhil (I ended up completing an MBA – don’t ask!!). As part of my study I interviewed the consultant oncology staff I worked with, about their attitude towards death. I found interesting results. A lot of the clinicians held various views on life and death and this influenced their approach to treatment offered to patients, some would go to the last possible course of treatment in an attempt to rescue the patient but one in particular stood out for me, he stated that he would only go for one round, possibly 2 but after that finish treatment as he believed we “come from dust and will return to dust” but the question remains is the attitude towards rescuing patients. Is offering treatment an attempt to preserve life at all costs worthwhile, if the quality of life remaining is poor? A lot of clinicians felt they had failed if the patient died, despite all treatment offered.

I was admitted via A&E when I first had my stroke. I was kept on an acute admissions ward for observation, with a view to a further transfer to a rehabilitation unit. However, I deteriorated and was transferred to Addenbrokes Hospital for neurosurgery to open my skull and drain the bleed. It is now a thought of mine that I was subject to life saving procedures but sometimes wonder if it would have been better if they let me go.

There is a piece circulating, via Facebook, describing a new indicator for stroke recognition emphasising the need for urgency to get the patient to hospital to make every opportunity for survival and a good recovery. The article then makes the point that those who might survive, when perhaps intervention has been too late might be severely disabled and become “hopeless and helpless”. This might be true but reading this as a so called “stroke Survivor” (I don’t like being labelled in this way!). It does not really inspire or motivate me now that I have survived. This articles comment makes me feel especially angry as I, for one, intend to have hope and do as much as possible towards my recovery.

I hope I have been honest in this blog and even more so, I hope it opens up a dialogue about this very difficult subject. It has resonance for me. I hope you feel able to comment on this subject and open up a discussion in the comment section below. I look forward to that.

For more about Peter and his recovery, please follow his blog, https://mystrokejourney.health.blog/

On October 1, we celebrate the International Day of Older Persons. Although not as well known as Mothers Day, Fathers Day, Women’s Day or Youth Day, we should never overlook or downplay the contribution of older people in our society.

Why?

They’ve lived longer
Well, the obvious reason is that they’ve lived a lot longer, so they have more experience of life. While that doesn’t automatically make them wiser, scientific tests have proved that older people are often more patient and have a deeper understanding of, and empathy for, others.

Different world
They grew up in a different world. Hard to believe that 50 years ago there was no Internet, mobile phones, personal computers, hand held calculators or ATM machines!

Today’s retirees have lived through the third industrial revolution, as well as the so called Industry 4.0 – the fourth Industrial Revolution which we are currently experiencing.

If nothing else, this has made them extremely adaptable and downright interesting to talk to! Kids today may be astonished at how many older men and women can add, subtract and multiply in their heads! And come up with the correct answer faster than a calculator.

Acknowledge their contributions
One of the saddest things about getting older is becoming invisible … even disposable in the eyes of the younger generation. This is particularly hurtful for older people who have held positions of importance and value during their lives, such as doctors, teachers, pilots or company directors.

Although our brains may work more slowly as we age, knowledge and experience more than makes up for this, and older people’s thoughts and opinions offer valuable insight.

Social values
Older people exhibit high levels of social values and behaviours. We just have to look at our Meals on Wheels volunteers – many of whom are themselves well into their sixties – to witness their willingness to help and care for others and the environment. Older adults are more likely to be tolerant of people who are different and to endorse equal treatment for all.

Role models
Older men and women are great role models for children. Kids who spent a lot of time with their grandparents usually have well developed values and an enhanced sense of security and confidence. They may also develop into more compassionate, thoughtful adults, as they learn that granny or grandpa needs help with certain activities.

Grandparents also offer a link to a child’s cultural heritage and family history. Children understand more of who they are and where they come from through their connection with their grandparents.

Honour the Aged
Why not show your support by wearing one of Taft’s purple heart stickers on October 1. Stickers are available at just R10 each from Kemmy Leigh Moodley. Call 031 332 3721 or email idpr@trafta.org.za

When a friend loses a loved one, one of the first things you might do is send a bouquet of flowers to let them know you are thinking of them during this sad and difficult time.

A beautiful bouquet of someone’s favorite flowers, or a surprise home-delivered arrangement, often says more than a card or message could ever do. But these beautiful bouquets don’t just bring pleasant sights and smells to a person’s life on a difficult day. Flowers have been scientifically proven to have a positive impact on happiness and health.

For example, certain blooms can:

• Improve physical health: According to a study published in HortTechnology, hospital patients who recovered in rooms with flowers needed less pain medication and had lower blood pressure and heart rates than those with no flowers in their rooms. Having flowers in your home will improve the humidity in the air, which in turn helps alleviate dry skin and sore throats, and makes it easier to breathe.
• Reduce stress: The scent of flowers is known to aid relaxation – just think how you feel when you visit a beautiful garden. Specific flowers like chrysanthemums, lavender and gerbera are well known for their calm-inducing qualities and are ideal for both work spaces and around the home.
• Purify the air: Airborne germs and toxins may be circulating unnoticed in the air you’re breathing. Certain flowers like chrysanthemums (or mums for short) actually help remove toxins such as ammonia, benzene, formaldehyde, and xylene from the air around us.
• Enhance mood: At the most basic level, receiving flowers from someone helps lift your mood because it means someone cares. But even if you buy or pick your own flowers, they still help improve your mood because they look nice and smell good. Research indicates that flowers have powerful emotional effects, helping people feel less depressed, less emotional and happier. During sad times, flowers bring the message of hope and signify compassion, love and warmth.
• Boost memory: Because flowers are fragrant and smell is so strongly linked with memories, flowers have the potential to activate and exercise the parts of the brain associated with memory. Plus they help oxygenate the air, which also improves memory and concentration.
• Help us sleep: Lavender has long been believed to be a great, natural aid to sleep. But other fragrant flowers such as jasmine and gardenia have also been shown to calm nerves, so we sleep well and wake up feeling rested and energetic in the morning.

So the next time you send a friend or family member a bunch of flowers, know they are doing so much more than just making them smile.

With jobs in South Africa being shed at unprecedented rates – unemployment is projected to reach 50% by the end of the year – the majority of South Africans are about to get a lot poorer. And it’s going to impact not only on our lives today, but on the kind of lives we planned for the future.

If your employer is struggling to keep the company afloat and has had to reduce your salary, your retirement fund contribution (usually a percentage of your salary) will be less too. Some employers have even applied for temporary relief from the obligations placed on them by the Pension Funds Act which, if granted, means that they may not be paying anything into the fund on your behalf.

If you have been retrenched, you may be forced to cash in your retirement savings in order to continue paying the bills and keeping food on the table. This can have a catastrophic effect on your ability to retire comfortably when the time comes.

On the whole, South Africans are notoriously bad at saving for retirement, with only 6% having accumulated sufficient savings to retire comfortably.

Even before the pandemic struck, less than 9% of earners preserved their retirement savings when they changed jobs. Younger people, in particular, tend to job hop frequently, and cash in their savings each time they leave a company, only waking up much later in life to the importance of saving for retirement. By then, it’s virtually impossible to catch up.

But it’s not just the young and thoughtless who may be wishing they’d saved more or started saving earlier. Even those who have prepared well could be in trouble.

Since March 2020, the central bank has cut the key repro rate by a total of 300bps. Or, in other words, interest rates have dropped from 6.25% to the current 3.5%. While this is good news for borrowers, retired people living on the interest earned on their savings will have considerably less money each month than they bargained for.

So what can you do if you’re struggling to make ends meet right now?

First and foremost, resist taking on any more debt, especially ‘bad’ debt (that used to buy consumables or items that decline in value). If you’re maintaining your previous lifestyle by racking up more credit card debt, you’re heading for disaster. When the President speaks about austerity measures and belt tightening, he is referring to all of us. We need to seriously evaluate how we spend our money and eliminate non-essentials.

Consider ‘downsizing’ your home or car. The status that comes from living in a mansion and driving a luxury motor vehicle is important to some people, but it’s not worth the financial stress that comes from struggling to maintain an unaffordable lifestyle.

“We saved over R2000 a month on car repayments,” says Mrs M, “just by trading in my husband’s big SUV and buying a smaller car. Everything about the new car is cheaper – from filling the tank to servicing, and replacing tyres. It still gets us from A to B in comfort. And it’s much easier to park!”

Making the decision to sell your home is a little trickier. It’s a buyer’s market right now and you may not be able to achieve your selling price, especially on a property in the higher price bracket. If you’ve owned your home for a while and your bond has been partially paid off, consider approaching your bank to negotiate an extension on the loan period to bring down the monthly repayments.

Selling your home and using the proceeds to rent elsewhere, can only be a short term solution. You never want to be in a position where you are using your capital to fund monthly living expenses. However, in some circumstances, it may be the only option until the situation improves.

If the bills are piling up and you are unable to meet your commitments, don’t just ignore the situation and hope for the best. Speak to your creditors to let them know of your difficulties and negotiate a more affordable repayment plan. If you need more help, consider applying for debt counselling.

This is a formal plan introduced by the National Credit Act to assist over-indebted consumers. You’ll be placed under Debt Review and protected from legal action by your creditors. Your debts will be restructured and you will pay a single, reduced monthly amount that you can afford. This repayment plan becomes a legally enforceable court order.

During the period that you are under debt rescue you cannot incur any additional debt. You will also receive advice on how to budget and make better spending decisions once you are debt free.

Such is the paradox of Covid-19.

To avoid passing on the disease we are urged to stay at home. If we do venture out, we must practice social distancing and wear masks that hide our smiles. Under these conditions, meaningful contact with others is pretty much impossible; even communicating with the person at the till is difficult, when words are muffled by masks and barriers of shiny perspex.

The feeling of being cut off from everyone else is almost surreal. And because we humans are social beings, this feeling of isolation sparks other feelings of depression, hopelessness and sadness.

But then, the worst happens. We actually get Covid-19. And suddenly we find that we aren’t alone at all.
We are swamped with phone calls and WhatsApp messages from friends expressing concern, offering prayers and volunteering to do whatever they can to help. We may feel like we are more connected, to a wider circle of people than ever before.

This is what happened to an elderly lady at Tafta Lodge recently. When she tested positive for Covid-19, she was made aware as never before of the kinship shared by all the residents of the building.

Just like family, they rallied round to offer support and practical help … anything she needed … as well as assurances that she was in their thoughts and prayers. It was an outpouring of love, intended to uplift and sustain a fellow being in her hour of need. Above all, it gave Mrs E the comfort of knowing that she was not in this alone.

As she battled the disease, and eventually recovered from it, Mrs E was constantly amazed by the kindness and support she received. So much so that she said it had given her a new outlook on life, experiencing the humanity and care that still exists in the world.

Being a Tafta resident, she was well aware of the huge responsibility we have to so many other people. This made her even more overwhelmed and grateful for the personal, compassionate attention she received. It made her feel important and valued, and helped give her the will to overcome the debilitating virus.

Mrs E never felt that she had to battle the disease on her own. Even while she was in isolation, she was touched by the patience, understanding and encouragement of our social worker and staff. Her condition was closely monitored by the building supervisor, who checked on her regularly. Fellow residents also rallied round to offer assistance.

“I urge you to continue your great work for it is never in vain,” she said.

We will never know why our world has been afflicted by the Coronavirus pandemic. Some feel it is a wake up call to curb our exploitation of the animal world, or some sort of pay back for all the damage inflicted by the human race.

But perhaps, the lesson it has to teach us is that we are not alone – and that caring for our fellow human beings is the most important thing we can do.