Remembering is in the air. Today marks the end of the ‘To Absent Friends Week ‘ which is an astonishingly creative and vibrant festival. The festival is based on the premise that people who have died remain a part of our lives – their stories are our stories, yet many Scottish traditions relating to the expression of loss and remembrance have faded over time.  To Absent Friends gives people across Scotland an excuse to remember, to tell stories, to celebrate and to reminisce about people we love who have died. To Absent Friends, a People’s Festival of Storytelling and Remembrance is an opportunity to revive lost traditions and create new ones.

But today is also a day which falls in the midst of Remembrance Week as we approach the  11^th November when at 11 am we engage in a very long tradition of acts of national remembrance for all those who have lost their lives in war. Even that process though will be very different this year with many public acts now not taking place because of Coronavirus.

Remembrance Day will provide many with the opportunity across the world to stop and in silence think of all who have died or been scarred by humanity’s inhumanity. It is a time for recollection and story, albeit that those with first-hand experience of the wars of the 20^th century are becoming fewer in number by the year.

For me Remembrance Day is indeed a day of story and recollection. A day when I especially remember my own grandfather who left his Skye village as a boy at the start of the First World War and returned years later a man.  But although he returned with a box of medals for his bravery, he also brought back the scars of encounters and experiences that would fragment his living and mark his heart until he died. I was young when he died, but I always felt an air of distant melancholy surrounded him, a sense of absence for those gone from his life.

Remembrance is many things to many people. It is both an act of literally ‘re-membering’, of putting back together the stories of a broken past but it is also about a resolve and a conviction that the lessons of that painful past need to be so real and so vital that the journey into darkness can never be repeated.

Many years ago, in Orkney I spent an afternoon on the week before Remembrance Day in the company of two men who had just recently got to know one another. They were unlikely friends but one thing, their experience of war and their desire not to talk about it, joined them into a life-long friendship. One was in his sixties and bore the literal scars of years of brutality and torture as a Japanese Prisoner of War. Every movement jarred his present with the pain of those days. But he was a man of astonishing positivity and optimism. He never talked about the war or his experiences. The other man was much younger, a soldier during the Falklands War when he would have been really young. He too had been forever changed by his days of battle. His scars were inside him. He spoke about never being able to have a night’s sleep without the sounds of crying and fear waking him into a sweat. Anxious and manic in movement and gesture he was continually agitated. But he too was silent about his suffering. For both men Remembrance Day was something they simply could not thole – they wanted not to remember but to forget.

But that afternoon and well into the evening something happened. I don’t know what it was. Maybe the sense of calm, or the warmth of the place, or the drinks that were shared. But they started to talk. At first slowly and with hesitation and reluctance but then freely and openly, almost with a need to expel the memories from inside, a catharsis of inner pain. They spoke and told their story and what I saw in the telling was a healing of wounds, a discovery of togetherness and the creating of a bond that would never break. They spoke that day but that was it; emptied of memory they never spoke about their experiences again, but they were changed, one with the other, a connection which brought a peace only they could understand.

Finding another to tell our story to, to be authentic, open and honest, to be who we really are without mask and pretence, is perhaps something we are all searching for. Those two men found each other that day and by the power that comes from togetherness, they upheld one another in the days and nights to come until one of them died. The story healed … it bound them … and once told it was enough.

Story has a real almost primordial power within it. It is not simply in the act of re-telling or re-membering our story that we are changed but in the way in which story enables us to be honest and real, raw and truthful. In the next few days it might be harder for many to find a face to face encounter, it might be hard to find the normal routes to tell our story and find connection, but there are so many ways to re-member and tell and talk. For it has never been more important to find space and place to tell our story even if it is to ourselves for the first time, even if it is into the silence of the day or the emptiness of the night. For in the telling there is healing.

This last year has brought so much pain and hurt for too many; lives lost to Covid19 before they had left their mark or finished their tale; hardness and heartache of those left behind, those who have spent themselves in care and giving; those anxious and worried, detached and separated. We need not just to remember but to use the energy of memory to create purpose to change, to do different and be better. That is what remembrance is for me – not an act of precision and poise, of stiffness and formality, but a movement of memory and re-making.

So as I go for a walk on Remembrance Day I will sit and ponder, reflect and remember, and I will allow my story to be told inside my heart, and like my two Orcadian friends I will seek to memorialise those who I have lost not in words but in action, in a commitment to be and to do better.

The bench

I look out at the sea

crying in the dark tonight,

shedding its tears on the shore;

washing down the face of the land,

hiding in the shadows,

yet never silent,

always roaming around

desperate for welcome and warmth.

 

and I close my eyes and think

who are you nameless one on whose seat

strangers come and settle in loving embrace;

your future folded forever

in slatted curves of wooden shape

overlooking the encroaching tide?

 

for here you rest in silence,

28 years old the plaque proclaims

but yet hushes the laughter,

tears and story of your days;

as your name nakedly

witnesses untold tales,

as gossip and truth mingle here.

 

how many of your lovers have forgotten

your touch and smell?

how many now strain to the memory of your

voice welcoming response?

how many come and sit

and weep at your going too soon?

 

I do not know

and can only close my eyes and imagine

 

for like the sea you are here

in season and out

taking tears and turning them tender

accepting brokenness and moulding forgiveness

sharing joy and directing hope

recognising fear and caressing sadness.

 

and like the sea you smuggle

love into my imagination,

washing away my anger

showing me that in death you rest in my living

and become my future.

 

Donald Macaskill

Perhaps it’s because I have the blood of generations of Gaels coursing through me that I have always been fascinated by Halloween, or should I say, Samhain. Samhain is the ancient Celtic festival which culturally we have by in large turned into Halloween, in turn whose connection with the Christian festival of All Hallows is probably lost to many. Samhain was believed to be a time when the veil between the real world and the other world of witches, the wee people and the departed was at its thinnest. In times gone by our forebears would leave an empty chair and food on the table to satisfy any passing ancestors. Traditionally celebrated on 31^stOctober -1^st November it marks the end of harvesting and the start of the ‘darker half’ of the year.

I am writing this in the early morning of a day which is dark beyond dawn, wild and wet with the threat of gale and damage in the air. The atmosphere could not be more apposite for the day. What holds my fascination for this time is not the monsters and ghouls, the ‘dooking’ for apples or the endless carving of turnips or pumpkins – but that the day offers an opportunity to celebrate the harvest of the earth and to prepare and reflect for the darkening of the season.

But this year everything is different. There will be no knocks on the door, questionable poetic renditions or feigned childish shyness. Restrictions have limited traditionality, the streets will be much quieter tonight. But probably more than in any other recent year the original purpose of the day is all the more necessary  – a time to reflect on the year and to carry hope into the dark days to come.

One of the things that we have probably largely lost in our modern celebrations is the sense in which Samhain and its Celtic successors was a collective and shared experience. It was a time when people recognised their binding into each other, their connection in community and belonging , their rootedness in the earth and to the soil on which they stood, all of which would be to them so important in the coming days of a hard winter. It was a time to celebrate togetherness and to re-commit to being concerned and committed to each other in the days of dark.

This past week has been a strange one. I have spoken and written enough about the Public Health Scotland report on the discharge of people from hospitals into care homes so I will not mention the substance of its contents here. What I do want to reflect on in is the reaction both in the media and within politics. I have to confess to a real sense of disappointment and dismay. One national newspaper used language and description which maligned frontline staff, debates I have heard have been heated and vexatious, argumentative and dismissive. Now I am no shrinking violet and have been as robust as the next person when I have seen injustice or behaviour which is unacceptable. But the level of blame, the point-scoring and the desire to apportion guilt has been quite shameful . The reason for my disappointment is that many seem to have too readily lost sight of the fact that behind every statistic and number, is a human person, is broken grief and heartfelt hurt.

In the spring when we experienced the first wave of the virus there was an amazing degree of political, media and societal togetherness. There was a real sense of solidarity. That all seems to have disappeared in the heat of the summer and to lie in tatters in the empty harvest fields around us. The days of ‘In It Together’, of rainbows on windows thanking staff and key workers, of clapping for carers, of a sense of mutual regard seem a distant dream away.

Solidarity is a wonderful concept. In its French original it’s definition means a   “communion of interests and responsibilities, mutual responsibility,” a sense of demonstrating real interdependency.

In the first wave of the pandemic there was a real sense that we had consciously put aside personal and political ambition and put on a mutual resolve to determine through common action our regard for one another, our desire not just to protect ourselves but those around whom we lived. I remember the scenes of neighbours helping one another, of strangers becoming friends, of unity across garden fences, and a real growth of community at its best. The harvest of those actions was a real literal suppression of the virus. We need to re-discover our solidarity in this coming season.

When I speak to folks around me, whether carers or families, workers or clinicians, there is a real and palpable fear and anxiety. Unlike the days of spring, we know about this virus, we know the pain and distress, the loss and grief it can cause. There is fear in knowing what we know. Unlike the first wave in a spring that reached out into the warmth of summer, we know this second wave is coming at us in a winter which at least in Scotland can sometimes feel as if it is never-ending. So, it is all the more important that we hold each other up, that we re-discover the solidarity of the spring, as we enter into the darkening days of winter.

This day teaches and tells us that darkness is always followed by the dawn, it reminds us that in the cold hard barren earth that seeds of growth and renewal are already dormant waiting to struggle into life. This day should show us that through collective action, mutual aid and support, that we do and will meet the struggle, and come through the other end. We will not do so by creating islands of self-interest or reverting to a narcissism in politics or social discourse, we can only do so by leaning on the humanity of each other, by bringing friend and stranger close into our company. This is the solidarity which alone will beat this virus.

So it is that we have to re-discover the sense that the only way we protect those who are most vulnerable is by our own individual action. IPC, PPE, testing and vaccines are all critical tools in the fight against this virus, but most important of all are the individual actions we all have control over. What I do impacts on my neighbour. We all of us need to be responsible for each other.

And that is where the hope really is. Because we know deep within our bones, that the fear never truly overwhelms, that the warmth and light of new beginnings will spring into being, and that constraint and restriction will be replaced by renewal and reconnecting.

So it is that through careful determination, by linking our arms in the solidarity of common interest and concern, that I am optimistic that all our sacrifices, that all the separation and loss, the pain and anxiety, the death and emptiness,  will bear a fruit of renewal. But only if we seek to be a community rather than a collection of individuals.

The night of Samhain  helped our forebears in their beliefs to glimpse the past and the present, to be in touch with meaning beyond understanding, so our actions in the coming days will show us the future of our being together, as individuals, as families and as a nation.

I leave you with some of the elegiac words of the American poet Annie Finch whose love of Scotland in all seasons comes through so much of her work:

Samhain

In the season leaves should love,

since it gives them leave to move

through the wind, towards the ground

they were watching while they hung,

legend says there is a seam

stitching darkness like a name.

 

Now when dying grasses veil

earth from the sky in one last pale

wave, as autumn dies to bring

winter back, and then the spring,

we who die ourselves can peel

back another kind of veil

 

that hangs among us like thick smoke.

Tonight at last I feel it shake.

I feel the nights stretching away

thousands long behind the days

till they reach the darkness where

all of me is ancestor.

 

I move my hand and feel a touch

move with me, and when I brush

my own mind across another,

I am with my mother’s mother.

Sure as footsteps in my waiting

self, I find her, and she brings

 

arms that carry answers for me,

intimate, a waiting bounty.

“Carry me.” She leaves this trail

through a shudder of the veil,

and leaves, like amber where she stays,

a gift for her perpetual gaze.

@ Annie Finch

 

Donald Macaskill

Heroes come in all shapes and sizes. At different stages of our life we probably most of us need heroes. For some they will be the celluloid stars of imagination, sporting greats or fashion and style icons. For many they are the famous and extraordinary, the remarkable and amazing. Our heroes will doubtless change over time but at the risk of exaggeration most of us need a few heroes in our hearts. They are the people who inspire and motivate us, who are exemplars of something we admire and whose lives push us to be someone we want to be. Regular readers of this blog will probably have guessed that most of my heroes are individuals who are not well known, many of them folks I have met along the way, but all of them people whose compassion and care, humanity and sensitivity have made them for me heroes of our humanity. That’s why during the first wave of the pandemic I spoke about ordinary frontline carers as being the real heroes of this year.

But in a more traditional way there are some people who have always inspired me and who have taught me something important about the essence of what matters. For most of my life I have found the story and example of Rosa Parks to be truly inspiring. Many of you will know her claim to fame and the heroism of her actions.

On December 1, 1955, in Montgomery, Alabama, Rosa Parks when travelling home from work on a bus refused to give up her seat in the “coloured section” to a white passenger after the whites-only section was filled. Bus segregation was part and parcel of the law at the time and was a physical embodiment of the race laws that existed in the United States. She was arrested for civil disobedience in violating Alabama’s segregation laws. Her quiet dignity led to many in the black community to boycott the Montgomery buses for over a year which became the first major direct-action campaign of the post-war civil rights movement. Eventually in November 1956 the courts decided that bus segregation was unconstitutional. She became in many senses the ‘mother of the civil rights movement’, spent her life thereafter fighting for equality and now even has a day named after her to commemorate her actions.

After years of struggling to achieve justice , after her retirement, Parks wrote her autobiography and continued to insist that the struggle was not over and there was more work to be done. In her final years, she lived with dementia and spoke and wrote with passion about the rights of older people and those with dementia.

Today is the 15^th anniversary of the death of Rosa Parks in 2005. It is with a real synchronicity of time that today is also the 75^th anniversary of the founding of the United Nations.

On October 24, 1945, 51 countries came together to create the United Nations. Its purpose was to promote peace and cooperation around the world.

The 75^th anniversary is happening at a time of massive upheaval and uncertainty for the world living as we are through the  global health crisis which is the COVID-19 pandemic. The pandemic is resulting in severe economic and social turmoil. But as the UN has said this week it is also a reminder that times of struggle can become an opportunity for positive change and transformation. It is at such times that we learn what is intrinsic to life, why collective action and inter-national co-operation are so important, and perhaps why most of all peace is what remains the aspiration at the heart of the founding Charter of the UN.

There may be occasions when we can be tempted to forget the way in which the actions of others impact on our own story, but the global pandemic has shone a light on the way in which we are all inter-connected, one with the other, co-existing in our humanity and on our planet.

The COVID-19 pandemic for many of us has become a watershed. Even as we now respond to a second wave and no doubt prepare for future waves of the virus; even as we accept the reality that pandemics will become part of the pattern of our future, we are now being presented with opportunities to do better and be different.  These are the times when the lessons of our heroes can come off the page of our imagination and be written into action and response.

So, it is on this United Nations Day and in recognition of those who have stood up to injustice that I want to argue that Scotland needs to urgently decide to commit to creating the role of an Older Peoples Commissioner.

There has been much debate over the years about whether or not the time is right for Scotland to join Wales and Northern Ireland in the UK, and many other countries across the world in appointing an Older People’s Commissioner. I would argue that the time for such debate is over and that the pandemic response requires such a role to be created.

Ageism has been at the heart of so much of what has been the experience of older people during this pandemic. Whether it has been the suggestion that Covid19 was a ‘baby boomer harvest’ and only affected the old, all the way through to comments in the media this past week about the requirement to ‘segregate the old and vulnerable’ in order to protect and safeguard them. Throughout the pandemic there has been an obscene , conscious and at times unconscious, ageism at the centre of much social and media commentary. In practical actions, from a questionable ethical Guidance document which used age as a proxy for decision making, through to the inappropriate use of DNACPRs, to unequal treatment of older people in terms of access to social care packages, to the lack of agency and voice to those who receive care at the table of decisions – this pandemic has been a shameful enactment of profound age discrimination right across Scotland.  It is time for that to change. It is time for Government and political leadership across the parties in Scotland to take older age seriously and create a post for a Commissioner.

Scotland does indeed have a Minister for Older People but that is not enough – that is part of the structures of government, an Older People’s Commissioner is someone who is appointed by a parliament, responsible both to it but primarily to the older people of a nation, and who is enabled to speak and act with independence, able to hold those who rule and decide to account for responsible human rights based actions. She/he becomes an advocate for older age.

In the last few months I have had the privilege to work alongside Helena Herklots and Eddie Lynch, the Older People’s Commissioners in Wales and Northern Ireland respectively. Their ability to champion the voice of older people, to challenge and remind, to articulate and to speak out has been inspiring. Scotland needs such a voice to hold all of us to account, to remind all of us of our responsibilities. The election in 2021 should offer us that as a legacy to all who with older age have struggled in these last few months. I recognise  the creation of such a post is in itself no panacea but it is the first step in a journey to equality regardless of age. As a people, as communities and as a nation we must challenge the pernicious acceptance and allowance of age discrimination.

Growing up I was very aware that others had heroes who sat alongside those I held important. It felt to me that every night in my teenage years that I feel asleep to the sounds of the music of Bob Marley, the undoubted super-hero of my older brothers’ world. Over time – perhaps with sleep appreciation – I have grown to appreciate the awesome power of Marley’s words. One verse in particular resonates today as I remember those who have stood up for equality, justice and peace throughout the 75 years of the United Nations, including Rosa Parks who literally refused to move, and as I continue to work with others to create for Scotland an Older Peoples’ Commissioner.

Get up, stand up, stand up for your rights
Get up, stand up, stand up for your rights
Get up, stand up, stand up for your rights
Get up, stand up, don’t give up the fight

 

Donald Macaskill

 

 

In the week that has passed one thing has dominated my conversation and consideration – care home visiting. On Monday the Cabinet Secretary published Guidance which amongst other things extended the potential of outdoor visiting to include up to 6 people, indoor visiting was enhanced to enable the possibility of physical touch (with PPE), longer visits (up to four hours) and involvement in activity with residents. In addition, there was permission given to allow children, pets, and hairdressers into care homes.

In the hours and days after the announcement I have held and heard many conversations with individual family members, providers, managers and staff. The conversations have sharply illustrated the degree of disagreement both about the visiting guidance but indeed about the risks and opportunities around visiting altogether.

I am writing on this subject this week to partly reflect the variety of views but also to attempt to identify steps that might be taken in the weeks ahead to give greater reassurance, and most critically to argue that unless we all of us work collectively over the next few weeks then the winter we are about to face will be a very dark one indeed.

There can be no doubt about a point of overwhelming agreement and consensus – namely that everyone involved in care homes both recognises the importance of restoring a more normal and natural family and resident relationship, and that there is growing evidence of the physical, emotional and psychological harm that is resulting from the enforced and extensive separation that has occurred over the last seven months. There can also be little grounds to dispute the knowledge that the risks of Coronavirus upon those who are our very old, frail and elderly are immense and considerable. No one wants to see a return to the devastation which brought such heartache and sadness to all our lives in the spring and early summer. But there are also points of real tension beyond agreement.

I have heard this week from providers, care home managers and staff who are deeply concerned and very fearful indeed about the measures which were announced on Monday. The grounds for their concern are numerous but chiefly they feel that the timing of the announcement and the start of increased visiting is miscalculated. They argue that at a time when cases of the virus are increasing in the community, when hospitals are beginning to fill up and when large parts of society are facing increased restrictions in order to protect, then this is not the time to extend visiting and increase the risk of transmission from the community into care homes. They further argue that the safeguards which we have been operating over the summer months are now at a state of real fragility, this is especially the case with care home testing where the experience of many is that delays in the UK Portal mean that some staff are having to wait for test results for a period of up to and beyond a week. They express further concern that without the testing of visitors that there will be real harm to residents from the risk of asymptomatic individuals coming into the care homes. They state that they have a duty of care not just to individual residents but to all residents and staff. They have also highlighted the huge pressure extending visiting places upon already stretched and exhausted care staff and managers at a time when they should be focussing on keeping people alive.

In addition, I have heard from family members who have written and spoken to me who are alarmed at the extension of visiting and see this as posing a risk to their family members. They have stated that they are the silent majority who are either happy with the level of visiting as it exists or simply fear for the extensions on similar grounds to those I have already mentioned. I know of families where some visit and others refuse to do so.

Then there are other voices, and I have spoken directly to many including representatives of the Care Home Relatives Scotland Group who I met alongside some providers and managers on Thursday evening. They have long campaigned for a normalisation of visiting and have broadly welcomed the new enhanced Guidance. Their case is simple, that it is a human right for an individual to be able to be with their family; that care homes are not prisons and that we have to respect and listen to the desires and will of those who are residents. They point to the research evidence from SAGE and others that the risk of transmission of the virus into care homes is very low, almost absent, with the appropriate use of PPE and certainly lower than other associated risks. They point to research which shows the level of deterioration and decline being experienced by care home residents devoid of contact and encouragement, presence and family love – they point out that no matter how good the quality of paid care is in a care home it can never replicate the love and touch of husband and wife, son and daughter and family in general.

I think it is important to state that everyone involved in this discussion and debate is starting from a point of real sincerity and desire to protect, keep safe and enhance the quality of life of residents in our care homes. The way that is to be achieved are the points of disagreement.

Even though the First Minister has made clear that guidance will not be mandated it is critical we work collectively together to move issues forward. I do not think this is the best place to go into the various individual elements of some of the debate, but I do think there are several actions which can be taken to improve things on the ground.

Firstly, we need to get to a working Covid testing system as a matter of urgency, one that can give as much assurance as possible to staff working in care homes. The current UK system is not working and the sooner there can be transfer to a robust NHS Scotland system the better.

Secondly, we need to develop a mechanism which will enable family members to either become part of the standard staffing testing system or much more desirable to introduce either in every care home or on a local community basis a rapid testing system that would enable them to be tested and get their results quickly, recognising their critical role in the care and support of their relatives.

Thirdly, the Scottish Government and COSLA need to make very clear that additional costs which result from enabling visiting to happen will be speedily met so that providers of all sizes are able to be sustained.

Fourth, we should collectively work to develop a system whereby the sheer managing of visiting (in these current circumstances) becomes the focus of one individual in each care home, whether volunteer or not, because we cannot over-burden existing staff who are already tired, exhausted and focussed on keeping life going and maximising health and wellbeing.

Fifthly, it is time to develop a National Care Home Visiting Action Plan and Statement where we bring together all the diverse voices and commit to how we will move forward into the spring. This is as important an area as any of the other realms of winter planning and will itself be no doubt impacted by other threats such as the growth of seasonal respiratory conditions, the flu and Brexit fall-out.

Sixthly, we need a degree of consistency around decisions taken by Public Health officials over when visiting is restricted due to community transmission. Explicitly we need all of us to know not only when this happens but also why. So why is it in some parts of the country that even window visits are being restricted but in other parts they are allowed? Why do we exclude visiting for 28 days in instances that a staff member tests positive and is not at work? This seems disproportionate and risks closure to visits becoming a rolling reality for some homes.

Seven, it is increasingly clear that we need more localism in the implementation of decisions. We need to find a better balance that avoids blanket positions being adopted and which enables individual care homes in specific parts of the country to work together with their stakeholders and family members to take decisions locally which reflect the risks in the local area. We are losing the ability to trust our care professionals.

Eight, as was shown in an open letter from some of our leading Infection Practice and Control experts in yesterday’s Nursing Times, we have to urgently develop a way of understanding infection practice in our care homes which is not simply the adoption of what works in acute health settings. Care homes and their residents are not equivalent or the same as hospital wards and their patients. One is an institutional setting, a care home is not; it is a home of friends and companions, who interact, mingle and mix. As we move into winter the ‘IPC fundamentalism’ which has been adopted around infection control practices needs to be replaced by an understanding of the imperatives of infection prevention which work for a different context.

Lastly, we must all of us get better at communicating and consulting. There will be many times when decisions have to be taken which are hard and challenging. It is especially important at such times that all involved both understand reasons and feel involved in the taking of these decisions, where it is possible to be so involved. It is equally important that when any new future Guidance is developed and issued that those most impacted are the first and not the last to know.

At the heart of all the debate and discussion I have held in the last week, one thing has continually struck me, and that is the need for us all to work together. At a time at which wider society is obscenely chattering about the possibility of segregating the old and most at risk, in some pretence of humanity, it is incumbent on all who are committed and concerned about care in care homes and in the wider community, to be united rather than divided.

It is not always easy to see the perspective of the other, especially when the urgency of action, the desire to protect, the passionate need to be present with loved ones, the fear of failure and blame, the terror of the virus, dominates our thoughts, But we can achieve very little without working alongside others.

The next few weeks and months will be ones of challenge for all who care. The nights are already growing longer and the evening sets earlier with each day. I have always been more at ease in the draughts of winter than the rays of a summer sun, but one thing I have discovered is that you cannot rest for long in winter, you have to keep moving on to the hope which spring beckons, bringing a new start and new beginnings. We cannot simply settle content with the ways things are at the moment – we need to work together to make sure contact with family is enhanced and safety of residents is deepened.

One of the poems I read this week is an old favourite. It is ‘Stopping By The Woods on a Snowy Evening’ and is one of Robert Frost’s earlier poems. It describes the woods as a place of beautiful silence and peace, but it is also a place that exists alongside danger, stress and activity, amidst obligation and responsibility. For me it is a reminder that we all have promises to keep, not just to keep going, but to be better, to restore, and to re-build. That is the essence of care wherever it is delivered. We cannot stand still in the winter peace – we have to move forward. “I have promises to keep, And miles to go before I sleep.”

As we move into winter it is critical beyond the obvious to state that we must find ways of being open in our dialogue, working together and making sure that we maximise the protection of folks from the virus but at the same time increase the alongsideness of family presence. I believe we can do this but not in our own defensive and reactive siloes. We owe it to those we love to work together with a responsiveness and mutual regard which is at the centre of all good care.

“Whose woods these are I think I know.

His house is in the village though;

He will not see me stopping here

To watch his woods fill up with snow.

 

My little horse must think it queer

To stop without a farmhouse near

Between the woods and frozen lake

The darkest evening of the year.

 

He gives his harness bells a shake

To ask if there is some mistake.

The only other sound’s the sweep

Of easy wind and downy flake.

 

The woods are lovely, dark and deep,

But I have promises to keep,

And miles to go before I sleep,

And miles to go before I sleep.”

Robert Frost

 

Donald Macaskill

When the story of the pandemic is finally written I hope that one of the chapters in that tome will be the recounting of how as individuals and as a society we have dealt with death and dying. Today is World Hospice and Palliative Care Day which provides an annual opportunity to reflect on the importance and significance of palliative care in societies across the world. Scotland is blessed by having a level of palliative care provision and excellence rarely matched elsewhere, even if we have fallen short of our aim that by 2021 all who need and require palliative care would achieve its easy access. But what can we say of palliative care during the pandemic?

“Without the skill and quiet professionalism of the palliative care nurse none of us would have got through what we have just experienced.”

Those were the words of a care home nurse at the height of the first wave of the pandemic. They mirrored the experience of dozens more. There was and still is a real sense of palliative professionals wrapping their arms of support around social care and health colleagues in care homes across Scotland. Where others talked, they walked in and worked in honest care partnership. It was my privilege to take part in weekly then less frequent virtual calls with palliative care colleagues from across Scotland and I can lay testament to the truth that some of the real unsung heroes of the last few months have been the women and men who work in palliative care and palliative medicine in both our hospitals and in the community. Their lack of recognition is perhaps itself illustrative of the discomfort of wider society in relating to issues of death and dying.

Today is an opportunity to reflect upon the criticality of palliative and end of life care to thousands upon thousands of people across our society. For me personally it underlines the importance of recognising that access to good palliative care should be considered as a fundamental human right in much the same way as we recognise that access to health in general is a human right. Last year I argued this case in a session at the Scottish Parliament stating that the way in which we care for and support those who are dying is as important as the way in which we care for and support those who will go on to recover and live through any illness. I’m not at all convinced we are there yet!

If we are able to prepare for our own death, then we engage upon the most person-centred activity we will ever undertake. Being in the presence of those who are dying teaches us that every death is unique and individual and that the art of such presence is to learn to mould your care to the needs and wishes of the person who is dying. It is to learn the lesson that silence speaks more than sound, that touch teaches more than restraint, that our hearts cradle hope. There is no textbook on the last days and hours of life albeit that we recognise the signs and symptoms of life ebbing away as the body shuts down and breath departs. Every death is unique and the care of those who are dying requires skills of empathy, compassion and alongsideness which are nurtured over many years.

If it is an overstated truism to say that death encourages us to live our lives to the full then it should also be transparent that we all of us need to learn how to die well. Palliative care is not just about the last few moments of breath but the times in which we are supported and cared for in the days, weeks and months before we die.

But of course, as a society we have never really been comfortable with talking about never mind planning for death. Death is always something that happens to someone else and we let it into our head only when the death of those we love, or a person of our own age reminds us of our own fragile mortality.

It is too early to say what the pandemic experience will mean for our collective understanding of death and our ability to be more skilled at living in the face of our own dying. For some undeniably the experience has been one of acute pain where we have been prevented from being at the bedsides of loved ones, have been unable to say goodbye and be present with touch and tear. For some it has been an experience which has robbed them of precious time to spend with others and do all that was planned as they have lived with terminal illness in a world locked down on loving and togetherness.

There are many things we need to learn to do better and differently. There should never be any excuse or reason for denying the presence of family and loved ones (properly protected) in the days before and at the moments of death. There can be no justification for allowing people to die without those they love and want beside them – even with the caring professionalism of strangers beside them – for that is a loneliness we can never end. We have to do better at recognising that end of life care in care home or hospital is not just in the final hours when someone has lost so much of the spark that is their self but, in the days, and weeks before. We have to get better at balancing risk with love, presence with absence, quality of life with quantity of life.

But over all of this the pandemic and its daily echo of mortality as numbers of lives lost etch themselves into our hearts, should also teach us the essential truth of palliative care. We all of us should be better at preparing and planning for our dying and the last days of our living. That is what anticipatory care planning is all about. It is the recognition that if we are able, planning our own death is as important as the plans we make for the birth of new life into the world. Tragically the abuse of Do Not Resuscitate forms and their indiscriminate, ageist application by some during the pandemic, has damaged the concept of planning around dying. But the ground must be recovered because a life which does the work of death before the moment of dying is one that is undeniably more settled and peaceful for both the person and those around them.

I am reminded of this truth whenever I read the words of those who are dying. Now lest anyone accuse me of simplistic naivety I have been around death long enough to know that moments of quietist peace are balanced by times of angry fear and raw rage. Death can be terrible and terrifying in equal measure to its ability to be peaceful and calm. But as possibly one of the most important things we will anyone of us do then we owe it to ourselves and those we love to be prepared.

I have seen over the years that dying can create new life and family restoration, it can bring about healing and forgiveness. Past experiences are seen through a new prism of priority and what truly matters. Dying moments can be our best time, they can gather up the story of our living and loving into a gift of touch and solidarity that nothing can equal. That’s why we owe it to all to be present at times of death. That’s why we owe it to all to give time in the weeks and days before death. Honesty grows slowly in ground which has been fallow but its fruit is a memory whose taste remains forever. That is what good palliative care is all about.

Over the years as I grew up, I came to love the acidic and wise wit of the Australian Clive James. After being diagnosed with leukaemia and emphysema in 2010, James said that his terminal diagnosis led him to “start saying goodbye” through his poetry.

He captured the pain and agony of departure, of planning and preparation in his usual witty style in a poem called Japanese Maple, which is about a tree given to him by his daughter. In it James adores the tree’s soft presence in the back garden of his home, yearning to live until autumn in order to see its leaves “turn to flame”.

Japanese Maple

Your death, near now, is of an easy sort.
So slow a fading out brings no real pain.
Breath growing short
Is just uncomfortable. You feel the drain
Of energy, but thought and sight remain:

Enhanced, in fact. When did you ever see
So much sweet beauty as when fine rain falls
On that small tree
And saturates your brick back garden walls,
So many Amber Rooms and mirror halls?

Ever more lavish as the dusk descends
This glistening illuminates the air.
It never ends.
Whenever the rain comes it will be there,
Beyond my time, but now I take my share.

My daughter’s choice, the maple tree is new.
Come autumn and its leaves will turn to flame.
What I must do
Is live to see that.That will end the game
For me, though life continues all the same:

Filling the double doors to bathe my eyes,
A final flood of colors will live on
As my mind dies,
Burned by my vision of a world that shone
So brightly at the last, and then was gone.

© Clive James, 2014

Donald Macaskill

 

 

If the weather allows this weekend I will hopefully escape the house and get into the garden to start to prepare the soil for the seasonal planting of bulbs. I’ve always loved gardening and open spaces, perhaps it’s me getting in touch with the Hebridean genes of ancestors who farmed the land, even without their skill and ability. Even when I have been in a place without a garden I have always wanted green life in my space. This time of year, in particular, is one that gives me a sense of the natural rhythm of existence, as planting bulbs kindles my inner hope for renewal and rebirth after the anticipation of the deadening and bleakness of winter. But of course, as any gardener knows only too well the quality of the resurrection of vibrancy in the spring, the depth of colour and vigour of harvest, is always conditioned by the soil and its preparation. You cannot sow hope in rotten soil.

On Wednesday along with colleagues I will be starting a three-day ‘Homecare Festival. It is an attempt to focus on the astonishing work of care and support that happens in the heart of our communities. On any one day of the week there are tens of thousands more people being cared for and supported in our communities than in our care homes and hospitals combined. They are being supported to play their part as full citizens of their communities. It is a care and support that gives them independence and freedom, meaning and purpsoe, contribution and value. Yet the homecare sector is one which is often ignored and rarely recognised. Never has that been more true than during the last few months of Covid19. Despite attempts it has been rare for the media to tell that story or focus on what has been happening in our communities. Perhaps understandably but no less inexcusably our focus in society has been on events in care homes and hospitals, and not in the homes beside our living. This needs to change.

In the last few days as I have prepared for the Scottish Care Homecare Festival, I have read report after report detailing the silent and invisible pandemic which has been affecting our old and disabled in communities right across Scotland.

At the start of the pandemic tens of thousands of packages of support were withdrawn – in part by local authorities seeking to prioritise resource and in part by families who feared that staff going from home to home would bring in the virus. The effect of these interventions is only now becoming clear. A couple of weeks ago a homecare worker wrote to me and detailed some of what she was witnessing and seeing. She spoke of older folks she had known for a long time showing visible signs of decline and deterioration; of a gripping sense of isolation and loneliness because with restrictions some people living with disabilities were cut off from friends and family; she recounted the growth in cases of body sores because folks had become immobile without exercise and unable to go out into the community; and most worryingly she told of the dozens she knew whose mental health had been shattered by lockdown. The stories of thousands of individuals who receive homecare supports will not often be heard or told but their pain during the pandemic is no less real for the lack of telling.

We stripped away thousands of packages of support and it is clear as we start the possibility of yet more restrictions moving into autumn and winter that many of these have not been restored. Some undeniably because family are still caring because their work has not re-started. But I fear that many more have not been re-started because of a decision to save money and a presumption that if people coped during the pandemic then they can cope now. I have heard such folly voiced and foolishness it is indeed. If for no other reason we have to reckon in that calculation the truth which tells of a 25% increase in ‘excess deaths’ in our communtiies of people living with dementia, diabetes and orher conditions.

Even before the pandemic homecare in Scotland was in crisis, it was rooted in a rotten soil. That rottenness was for many reasons. Chief amongst them was because we have failed to embed ground-breaking legislation which gave citizens control and choice of their care, instead the ‘system’ has held on to its power and resource by refusing to inform, to give people control over their budgets, and to really empower people to take control of their lives. The system has played the game of ‘self-directed support’ but not released its spirit, vested interest has cut off the shoots of real change before they could flourish.

Even before the pandemic we witnessed the perversity which comes from presuming that care can be delivered in fragments of time. Across the country there are packages of care counted out in 15 or 30 minutes created by number checking commissioners of care without regard to the urgent need for people to be treated as human beings rather than coins in a machine. There is no way one can deliver dignified, rights-based care and foster and nourish relationships in slivers of time.

Even before the pandemic we treated our frontline care workforce shamefully. Local authorities whilst boasting of their own Living Wage Employer and Fair Work practices bought care on the cheap by drawing up contracts with care companies knowing that their allocation of resources prevented those organisations from delivering fair terms. And to add insult to injury the same authorities introduced electronic monitoring systems to effectively ‘tag’ frontline carers so that they could be stalked and controlled.

The pre-pandemic state of homecare in Scotland – and therefore by volume – social care as a whole was shameful, pathetic and rotten. And it still is. Radical change is needed. If we are to flourish and come to a spring of renewal the soil needs to change and the system needs to be overhauled.

So, at the Homecare Festival I hope we will hear of a vision which will be about giving control and power to the citizen who is supported and who uses care rather than to commissioners and bean-counters. I hope we will hear of a vision where workers are trusted and given autonomy, not clocked and checked at every turn. Where terms and conditions are resourced for equality and fairness rather than a two-tier system where local authorities look after their own first and others get the fag-end of attention and support. I hope we will hear a vision where prevention rather than reaction is at the heart of the packages of support we create. And most of all I hope we hear of a vision which adequately resources the care of people in their own home rather than seeks to buy care on the cheap. All of this would show we care about care rather than empty slogans.

At the heart of all this – as we enter a Covid autumn and winter, I hope that when we plan, we remember that many of the thousands of family carers who took over care or carried on care without support are absolutely on their knees. Families are exhausted, the act of 24/7 caring has spent and drained them. They urgently need support especially where traditional day services and respite opportunities have been stripped away during the pandemic. We need to critically re-prioritise homecare and seek to invest more not less.

Across Scotland today there are thousands of people in urgent need of support to rehabilitate their physical bodies after months of decline, there are hundreds in need of psychological and emotional support after isolation and emptiness; there are yet more in need of being made to feel that they matter, that they are noticed, that they are valued.

There is much talk of winter planning –but if we do not plan to tackle this pandemic in our communities and in the homes of those who require support and care then we will reap a terrible harvest of regret in the spring. We need to renew the soil, replace the rotten practices of the past with refreshed vision and humanity. We can only sow hope and healing in conditions that allow it to grow.

The great Irish poet Derek Mahon died on Thursday night. He was a poet of his time asking uncomfortable questions to those who would rather not hear. I think homecare asks us the same. We can go through the next few months choosing to ignore the silent pandemic in our streets, in the homes around which we settle our living, or we can open our eyes to create a vision of a better way of caring for and upholding one another. We can collude with the ‘old conspiracy’ of staying as we are, settling for the soil we have or we can create a fresh hope for spring because the truth of homecare around us should surely ‘exact more interest than casual pity.’ Mahon says it all in his brilliant poem  ‘Spring in Belfast’ and its last stanza in particular.

 

“Walking among my own this windy morning

In a tide of sunlight between shower and shower,

I resume my old conspiracy with the wet

Stone and the unwieldy images of the squinting heart.

Once more, as before, I remember not to forget.

 

There is a perverse pride in being on the side

Of the fallen angels and refusing to get up.

We could all be saved by keeping an eye on the hill

At the top of every street, for there it is,

Eternally, if irrelevantly, visible —

 

But yield instead to the humorous formulae,

The spurious mystery in the knowing nod;

Or we keep sullen silence in light and shade,

Rehearsing our astute salvations under

The cold gaze of a sanctimonious God.

 

One part of my mind must learn to know its place.

The things that happen in the kitchen houses

And echoing back streets of this desperate city

Should engage more than my casual interest,

Exact more interest than my casual pity.”

 

Donald Macaskill

To find out more about the Homecare Festival from Wed 7^th to Friday 9^th  see https://scottishcare.org/cah-conference-2020-2/

Today the 1^st October marks the 30th Anniversary of the International Day of Older Persons. It is a United Nations event which focusses on continued age discrimination across the world and which this year, also the “Year of the Nurse and Midwife”, seeks to highlight the role of the health care workforce in contributing to the health of older persons. In doing so it seeks to give special recognition to the nursing profession and to give a primary focus to the role of women in health and care.

When these themes were decided some time ago no one could have imagined that we would have faced the traumatic year that we have had and are still experiencing. It has been a year which has underlined the need to focus on older people not least because of the appalling truth that the majority of the million people who have died as a result of the Coronavirus pandemic have been aged over 75.  At different points over the last few months we have had occasion to reflect on the existence of unequal treatment of those who are old in the way in which society has responded to the pandemic. At the start we had casual careless talk describing Covid19 as a ‘baby-boomer harvest’, then we had questionable ethical frameworks which envisaged age to be the main criteria to use in any decision to withhold treatment should resources become restricted, and most recently we have heard of suggestions that we should ‘lockdown the old’ in order to let the rest of society get on with life.

Our attitudes to older age, whether positive or negative, are, I believe deeply influenced and shaped by our experience of older age in our early years and upbringing. It is those experiences which will to a greater or lesser extent embed within us a belief that older age is something that continues to have value and offers contribution, or alternatively that we associate older age with deterioration, incapacity and a lack of creativity.

I have mentioned before in this blog my Aunt Effie from Skye. When I think of age, and older age, I think of her. She was a character who stood physically tall and strong, intellectually robust and rooted, at one and the same time melancholic and reflective, fun and frivolous. I marvelled at her daily consumption into her nineties of the written word from novel to textbook, from newspaper to magazine. I was left enthralled by her forensic ability to trace her family tree back three hundred years, a feat achieved in the pre-internet age through telephone and letter – and all at the age of 95. So, for me age has always been a chronological clock that granted the individual free expression, space and time, that blossomed creativity and insight. That is not to deny my own personal awareness and family truth of those who have been limited and imprisoned by dementia and decline, whose lives have been shortened by the lostness of disease and whose living has spoken of sadness and confusion. But overwhelmingly older age is for me a positive characteristic.

So it is that I have always been very fond of the brilliant iconoclastic poem ‘Warning’ by Jenny Joseph which at one stage was the most popular poem in the UK. You might know it: –

“When I am an old woman I shall wear purple
With a red hat which doesn’t go, and doesn’t suit me.
And I shall spend my pension on brandy and summer gloves
And satin sandals, and say we’ve no money for butter.
I shall sit down on the pavement when I’m tired
And gobble up samples in shops and press alarm bells
And run my stick along the public railings
And make up for the sobriety of my youth.
I shall go out in my slippers in the rain
And pick flowers in other people’s gardens
And learn to spit.

You can wear terrible shirts and grow more fat
And eat three pounds of sausages at a go
Or only bread and pickle for a week
And hoard pens and pencils and beermats and things in boxes.

But now we must have clothes that keep us dry
And pay our rent and not swear in the street
And set a good example for the children.
We must have friends to dinner and read the papers.

But maybe I ought to practise a little now?
So people who know me are not too shocked and surprised
When suddenly I am old, and start to wear purple.”

There is a delicious irony in that when she grew older Jenny Joseph was asked if she would start wearing purple anytime soon, to which she replied, “I can’t stand purple. It doesn’t suit me.”

Today as we reflect on what active and healthy ageing is all about – even in the midst of a pandemic which threatens older age – I think it is time for us all to start to wear purple. It is time to turn upside down the conventional assumptions about age and challenge the prejudice which devalues older age and puts youth on a pedestal. It is time to shout down and decry the subconscious discriminatory presumption that the old are incapable of individual choice and decision, of creative contribution and radical change.

On too many occasions during our pandemic response we have treated those who are old with an obscene paternalism and syrupy protectionism which ignores their intelligence and capacity, their autonomy and energy. We have talked about corralling residents in care homes into units to protect them; we have failed to ask and give voice to those whose lives we have restricted and whose capacity for consent we have removed; we have done to rather than working with. Even today we see this paternalism in the desire of some politicians and commentators to rush to become the jailers of the elderly on the pretence that we must protect those most at risk.

The old are not passive passengers in life but they are the living witnesses of years of hard knocks and experience. Age enables in many the ability to nurture the humility that comes from error and failure and from that ground to grow an honesty and sensitivity to others. We ignore that insight at our peril as we repeat the mistakes of the past in every passing moment.

Stepping into the future with our older citizens, wherever they live in our communities, whether alone or with others, is about making a commitment that no one will be left behind, no voice will be unheard because it has lost its strength, no contribution will be dismissed because it is articulated by age.

To be valued, to find a place, to be able to give, to contribute, to participate are fundamental to our health and well-being. Healthy ageing is not about keeping simply the body and the frame of skeleton alive, it is about enabling the passion and power of age to express itself in the whole of our lives and communities. So, as we all grow older in Scotland, I hope we can also tap the potential of every individual in order to maximise the health benefits which come from feeling you can still make a difference.

So, in your place of home, in your place of work, in your place of relaxation, think today about how you can include all the generations, and value especially the gifts, abilities, capacities of those who are older. Think not just about how we protect and keep safe but about how we listen to, learn from, allow to grow and critically allow older age to disrupt and contradict.

Let us all therefore work together to step into a future where every older person can find their place to give, share and be. Let us all  wear a red hat that doesn’t suit and learn to kick over the traces of conformity! It is time for all of us to start to practise for the days of purple.

Donald Macaskill

 

 

On Monday it will be 200 days since March 12^th/13^th when the majority of Scotland’s care homes shut down in order to protect residents from the emerging threat of coronavirus. It is a point in time which comes as the seasons change from a late summer into the shortened days of autumn beckoning in the coldness of winter. Spring and summer have been and gone and the world as we knew it at the start of the year is unrecognisable. These have been days of real pain and emptiness for thousands, and of waiting and yearning for countless more.

I feel it is an anniversary of time which needs to be marked and which should cause us to pause and reflect on how we should be planning and preparing, both practically and psychologically, for the seasons and days to come.

Since the first days of spring when Coronavirus started to reap its harvest, we have lost countless thousands across the country to this virus. We have learnt many lessons taught us in a school of pain and cruelty, sadly some have come too late for the knowing and others have been appreciated too slowly. The daily statistics have become like an inexorable tick of a clock with numbers increasing every day, yet their regular recounting hiding the true story of thousands whose lives have been changed for ever.

As we remember 200 days, we know that there are too many who have lost their lives before their time, too early for parting, too soon for absence. We know that there are thousands who have not been able to be present, to sit alongside loved ones to say goodbye, to hold a hand and caress a face, to wipe a tear and simply to be silent before endings. We know that there are thousands who have not been able to celebrate lives well lived, to spark memories with others and laugh and cry together in funeral and farewell. This has been the unbearable cost of these days.

During those 200 days there have also been those struck down by the virus who have recovered, both in care home and community, but who are marked by the legacy of the disease in a way that has forever altered their living. What has become known as ‘long Covid’ is a set of conditions and a legacy of illness, that we are only now beginning to appreciate, and which will result in extensive need for rehabilitation and recovery for countless years.

So, there has been no shortage of emptiness drained from life and community in the last 200 days. The emptiness of grieving, of lostness and aloneness. There has been the emptiness felt by those who have struggled with the full reality of lockdown, whose mental health and self-esteem have been shattered and diminished; whose hopes and aspirations for their lives have been set aside; whose businesses and careers have been wrecked or abandoned. This has been six-months of real desolation for too many – and yet for so many it has been pain endured in silence, in absence, in hiddenness and on the edge of noticing.

These have also been days of waiting. Waiting to return to normal only to learn the language of a new normal; waiting for life to re-start and living to re-open only to discover a reality unfamiliar and unrecognisable; waiting for exam results and university to start only to experience the pain of anxiety and a strange new beginning; waiting for furlough to end only to be told of redundancy and loss of role; waiting to be re-connected, for shielding to end and encounter to start; waiting for a tomorrow which feels more like our past.

200 days which have changed us all. 200 days which have brought out the best of humanity, have shone a light on the exhaustion of love and giving, but have also witnessed the predictability of ambition, selfishness and frustration.

So, what of the future. As we sense a slipping back into the inevitability of more restrictions, the fear of a return to a pain which is now one that we know all too well, a diminishing of the loss of hope – what now?

I have held many conversations over the last 200 days and in the midst of sadness and emptiness, the characteristics and emotions that have struck me the most, whether on the part of carer, manager, family member, supported person or care home resident, has been a sense of determination and hope, of energy and commitment of care to the other given to the point of exhaustion, of a deep yearning to survive and do better in the midst of the waiting and the absence.

So, the next 200 days can and must be better even though they may be harder – for if we do not believe that, then the sacrifices and loss of the former would be too much to bear.

We need to plan and prepare to a degree and extent which we have never before attempted. Of course, I am not naïve. I do not imagine that even with the best precaution and best planning that we can prevent yet more pain and yet more damage from this virus. But whether it be by getting a testing system that really works rather than promises and fails to deliver, whether it be through robust practice in terms of infection control in our communities and care homes, whether it be through supporting those on the edge of despair and hopelessness in our communities, whether it be through simple acts of neighbourly kindness,  then we can build on what we have done to prepare better for tomorrow.

And some of my personal hope would be:

That we recognise that we have to create opportunities for family members to better re-connect with their loved ones in care homes. We know the desolation and emptiness; we have heard the cries of lostness and have seen the signs of deterioration and decline caused by enforced absence and the loss of touch and contact. Whether it be through extending the time for visits, better resourcing care homes to have additional staff and volunteers to support visiting, by the use of testing to protect visitor and resident, we are all of us determined to learn and improve. We all of us need to make the next 200 days better and more connected.

That we really accept that we need to start to prioritise what happens in our communities as much as in our care homes. There is a growing awareness of all those who have lost their lives in our communities both to Covid and more significantly to other conditions in the last 200 days. We need to make sure we do not remove the homecare and supports which are the lifeline of so many as we face challenge of resource and workforce into the winter. We need to recognise that we have depended on family carers who are now exhausted and drained and cannot face the future without respite and recovery.

That we recognise that just as it was in March, so it is in October, that the first line of defence against this virus is the individual action and responsibility of every citizen. We need to rediscover a collective solidarity which strengthens us to sacrifice our freedom and intention in the service of and for the protection of others who need our loving and caring to be seen in our actions.

That we develop a testing system to protect all whether young person or old, whether care home resident or worker, whether schoolteacher or student, homecare worker or NHS staff member. The imperative of using testing as a protection has never been louder but so too is the importance of recognising that it is not a panacea merely a critical tool in the battle we are engaged in.

That all who can will take up the opportunity to be vaccinated for the flu recognising the real risks of overwhelming care and health systems in the weeks ahead.

That we recognise that there are thousands of staff in care home, community and hospital who are not simply weary but drained and exhausted, and that we do not just speak of support but show it in actions both large and small to alleviate, recognise and reward.

That we do not lose hope and that we continue to feed and foster our yearning for a better tomorrow, a brighter spring and a healed summer.

For even in the last 200 days life has won through against all the death and destruction. At 103 John fought off this pernicious disease and now sits laughing and story-telling with his fellow care home residents. At 38 Jane was able to come through weeks of intensive care and rehabilitation and is now able to hold her child and laugh at the small things of unimportance. At 17 and in a strange university experience there are students falling in and out of love with equal measure in the predictable rhythm of life; that in ceremonies across the country there are lovers committing to a future of togetherness; that in creative ingenuity ideas are being born out of hard work and reflection; that there are artists painting a future of purpose and poets ploughing the depths of emotion; that there is even in the midst of autumn a renewal which overcomes the decay and despair.

The next 200 days will undoubtedly be hard and there will be times of barren emptiness and pain but one lesson the last 200 has taught me is that we cannot make the journey onwards alone, but must all walk through into our future together, without casting casual blame, scoring points, asserting ego but upholding one another and speaking love into emptiness.

We pull ourselves forward together through our yearning. In the words of Seamus Heaney in ‘The Cure at Troy.’

“No poem or play or song
Can fully right a wrong
Inflicted and endured.…

History says, don’t hope
On this side of the grave.
But then, once in a lifetime
The longed-for tidal wave
Of justice can rise up,
And hope and history rhyme.

…

Believe that further shore
Is reachable from here.
Believe in miracle
And cures and healing wells.”

 

Donald Macaskill