Looking after elderly in all our interest

HEART BEAT: Rose early, that is early in my present life, around 7am. The sun was shining and the sky was almost clear

HEART BEAT: Rose early, that is early in my present life, around 7am. The sun was shining and the sky was almost clear. It was full tide and the water was flat calm, mirroring the hills and the occasional passing cloud.

The grass in the meadow was unruffled and a cock pheasant poked unhurriedly around the margins. A disorderly mob of siskins, greenfinches and chaffinches pushed and jostled at the bird table and feeders.

The earliest swallows were abroad and our robin in residence worked the ground under the feeders. Rabbits abounded on the drive and in the meadow. It was a genuinely "good to be alive" morning with the promise of a nice day.

I am ashamed to say that my purpose in being abroad at this early hour was not to enjoy the beauties of nature. Rather I was about to transform myself into a couch potato for the next two hours while I watched the Lions play Taranaki.

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I am further ashamed to say that this necessitated drawing the blinds thus excluding the wonderful world of light outside. But there you are; we all have our secret vices. Solitary peace for the next two hours and I was free to advise the referee without the disapproval of my sons, all of whom know much more about rugby than I do. Come to think of it, they know much more about everything than I do.

The Lord of the Rings and now the Lions tour revive my interest in returning to New Zealand which I had only briefly visited before. I did not feel at all guilty as I returned to the real world. I had, however, to solve some major problems. Would I have a swim? Maybe this evening when the tide would have come in over the warm sand. Would I play golf? No, not after the catastrophes of the previous few days, this caused God and I to be no longer on speaking terms. I will have to sneak up unannounced on golf and take it by surprise. How then do I get my moderate exercise?

I was presented recently with a pedometer by my good wife. The ostensible purpose was to record my mileage or lack of same during the day but I harbour the suspicion that she really wanted me out from under her feet.

I was told that the basic requirement just to stay alive was approximately 7,000 steps (3.5 miles) per day and that if you wanted to be more ambitious than that, eg to get slightly fit, you needed 10,000 steps. It is a simple inexpensive device and has proved reasonably accurate. There are deluxe models which give information about calories and things but such are really only for true believers.

Trouble is the bloody thing is making me obsessive. Late at night I look at the display, 9,719 steps. Off I go again around the garden or the house and lo! 10411 steps. Goal attained. Then I press the button to translate into miles, 5.81, well, clearly you want to even this up to six miles, so off again.

I can now identify and measure various walks in Dublin and Kerry to fit the shortfalls. If anybody should see me walking about aimlessly at night, they will now know that I have a hidden agenda.

On golf days I have no trouble with numbers - 15,000 to 20,000 steps being common achievements. I should point out that my golf and that of my usual partners would not be exactly tee to green and a certain amount of exploring or indeed orienteering is customarily part of the game.

Other days you may have to make a big effort, particularly in bad weather or more often when you are simply feeling lazy. Nonetheless it has changed my attitude, stairs instead of lifts, walk to shops, etc. This can only be good and I am already entertaining the delusion that I am feeling fitter.

Sloth is appealing and pernicious and so it is very important to keep muscles and joints exercised when possible and thus prolong active life. Sleep and appetite are beneficiaries and more importantly so is peace of mind. Get up you fat slobs and start moving. If I can do it, anybody can.

This is of course age-related. I am talking of activity levels that many people of my generation aspire to, not those gaunt figures that inhabit gymnasiums and run real marathons. I would be more comfortable with the mini-marathon group progressing gently around Dublin raising money for some worthy cause. Exercise is clearly good for you and common sense and peer group example are your best guides as to how much.

This isn't about living forever, but it is about retaining your mobility and with it, hopefully, your independence for as long as possible.

The Prime Time programme on RTÉ recently drew everybody's attention to the problem areas of caring for the elderly in our society. I think many knew there was a problem but sadly it always seems to be somebody else's problem. At least acknowledging that a problem exists is the first step to fixing it. Like all health issues it is complex and not amenable to "one size fits all" solutions.

We are dealing with different groups of people with different needs, the wholly well, those with physical restraints, those with psychiatric illness and those with dementia. These groups all pose different problems and require different levels of care and nursing.

Clearly in some instances they have not been cared for correctly to state it at its least offensive.

As usual our dysfunctional health service was found wanting. The prattle about the public-private mix had again been found wanting and I personally feel it has little to offer in the delivery of health which must be dedicated to the patient and not to the pursuit of profit. An awful lot of us are going to live to the age where we may require such services and if it is only for self interest, let the service not be found wanting. I hope we care for more altruistic reasons.

Maurice Neligan is a cardiac surgeon.