On Sociology & Becoming a Patient

'The Subject matter of Sociology
& Becoming a Patient'

A primer for my picking up Hodges' model, or being pressed onboard, was early exposure to history and sociology. There was an understandable emphasis in the (then) school of nursing (registered mental nursing) on the role of society, social history, lunacy and the asylums, law, and attitude towards mental illnesses.

Continuing to sort books (inc. secondhand) and papers, there is:

Maclean, Una. (1974) Nursing in contemporary society. London: Routledge & Kegan Paul.

https://wellcomecollection.org/works/qhqc24fv

individual

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INTERPERSONAL : SCIENCES

humanistic -------------------------------------------  mechanistic

SOCIOLOGY : POLITICAL

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group-population

'The sociological viewpoint can be taken on many different subjects. Thus, political sociology has to do with people's voting behaviour and their reactions to the processes of government, while the sociology of education takes into account the influence of various social factors upon educational opportunities and achievements. In addition, social psychology, social psychiatry and social medicine are all related to medical sociology. These terms all imply the use of sociological methods and insights in different areas of human behaviour, and the divisions between them are a convenient way of dealing with what is a very wide territory. Such divisions may suggest that events and things in the real world are already separated in themselves, whereas the divisions are actually in the minds of the people who make them. It is easier to regard sociology generally as being the study of people's behaviour in groups, groups of all kinds, large and small, casual or permanent, groups of which people are very conscious as well as those of which they may scarcely be aware. Thus, much of sociology is concerned with the human family, a group whose form and composition varies from one part of the world to another and from one set of people to another but which does have common features and functions wherever it is studied. The family will be referred to repeatedly in this book, since not only does it affect all our lives but it profoundly influences the way in which people react in relation to illness.' pp.8-9.

Maclean pointed to the 'innumerable other human groupings' (p.9) and how these - family, schools, clubs, professional training, friendships, audiences, tourist crowds, customers, villager, hostel dweller; such groupings, some historic, temporary or transient - also differentiate into populations, that inform epidemiological and demographic studies. 

It is remarkable how societies have changed globally, since Maclean's 1974 text.

As if to presage the one-to-one encounters to follow, chapter 2 'Becoming a patient' after a brief history 'sickness' arrives at the work of the American sociologist Talcott Parsons.

I don't have the date but I remember making a note the four combined conditions at work for an individual to adopt the sick role. What stood out was how something we think is individually determined is social and so often a question of permission.

Maclean's text (with my emphasis) on these factors follows; and is then mapped to the domains of Hodges' model:

'In the first place, the illness must be outside the patient's control, in no sense his own fault. Second, the sick role will allow him exemption from his other roles. with their associated obligations and duties. For example, a man can legitimately give up work and leave his usual family 'responsibilities to his wife. But, third, the sick role requires that the patient should positively desire to get well, he should not relish the relinquishment of responsibility and, fourth, he has the obligation to seek competent medical help.' p.25.

individual

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INTERPERSONAL : SCIENCES

humanistic -------------------------------------------  mechanistic

SOCIOLOGY : POLITICAL

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group-population

the sick role requires that the patient should positively desire to get well	the illness must be outside the patient's control, in no sense his own fault.
the sick role will allow him exemption from his other roles. with their associated obligations and duties	he has the obligation to seek competent medical help

Again as an exercise you might care to reflect on this and our experiences since the millennium?

What is most remarkable is the need to view this as a 'future lesson' in terms of how societies must, will change to meet the challenges of tomorrow, and the day after that ...

Scholarship in Arnold Wesker's 'The Friends'

... n'just t'lethee know that's, scholrship up int North ...

'MANFRED. Our trouble, Crispin, us lot, the once-upon-a-time bright lads from up north, is that we've no scholarship. Bits and pieces of information, a charming earthiness intelligence and cheek, but-not scholarship. Look at these books here. (He picks up a pile and throws them round him.) Renan, Taine, Kirkegaarde, Wittgenstein, Spengler, Plato, Jung, Homer, Vico, Adorno, Lukacs, Heine, Bloch-you've not heard of half of them, have you? And half of them, two-thirds, I'll never read. Do you know, new knowledge disrupts me. Because there's no solid rock of learning in this thin, undernourished brain of mine, so each fresh discovery of a fact or an idea doesn't replace, it undermines the last; it's got no measurement by which to judge itself, no perspective by which to evaluate its truth or its worth; it can take no proper place in that lovely long view of history scalloped out by bloody scholarship, because each new concern renders the last one unimportant. No bloody scholarship, us. And when I sometimes get a feeling that two people in love or one man afraid of death might be a supreme consideration, along comes this man with his 'we are moving into phases of creative disorder' and his 'everywhere the lines are blurred' and I've no defence. He sounds so right, I think, and besides-he's got scholarship. What's 'silly loving' and 'banal dying' in all that? Evil? You want me to confess to the knowledge of evil? I confess it. I say it-evil! So? And what  shall I do with that bit of knowledge?' p.18.

 WESKER, Arnold. The Friends. London: Jonathan Cape, (1970). Hardcover. First edition.

UK Higher Education Survey of Carers

From: Marie Moreau <marie_moreau AT HOTMAIL.COM>
Subject: UK HE survey of carers

Dear Colleagues

I am sharing this final call as we will be closing our survey of carers in UK HE at the end of the month.

Many thanks to those of you who have replied.

To be eligible, you need to be employed by a UK-based university and to be a carer (broadly understood, including as a parent, for a friend, a relative etc.). Here’s the link:

https://angliaruskin.onlinesurveys.ac.uk/national-carers-survey-uk

The outcomes will help us to better understand the experiences of carers in higher education and to provide recommendations to the sector.

We have received ethical approval for this project and are happy to address any question.

Warm wishes

Marie-Pierre Moreau
ARU, Cambridge, UK

My source (with some editing):

This message was issued to members of www.jiscmail.ac.uk/FREEDOM-OF-INFORMATION, a mailing list hosted by www.jiscmail.ac.uk, terms & conditions are available at https://www.jiscmail.ac.uk/policyandsecurity/

Tower blocks: Challenge young and older - Courtesy the Artist © Stephen Willats (Revisited)

LIVING WITH PRACTICAL REALITIES, 1978

"Stephen Willats aimed to explore the realities of living in a British tower block. The work centres on Mrs Moran, an elderly woman who lived at Skeffington Court in Hayes, West London. Willats photographed and interviewed Mrs Moran over the course of six months. The text in the work is based on these interviews. In his composition, Willats highlights the physical, social and economic constraints that she faced. Each panel also features a question. These invite the viewer to participate directly in Mrs Moran’s lived experiences."

Gallery label, September 2023

Tower blocks are an integral, defining structure in urban and city life. Governance, effective policy, accountability, high standards, public safety and duty of care must not be an after-thought. 

 Individual
  |

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

© Stephen Willats	© Stephen Willats
© Stephen Willats	Grenfell Tower Inquiry Housing policy Housing provision Housing market 'Mobility' Ownership Private, rented Housing Assoc. ... Tower Blocks Life chances - 'Health career'

Stephen Willats

My source: notebook, as with -

https://hodges-model.blogspot.com/2023/08/rational-concepts-dilworth-1977.html

Plus, a previous post:

https://hodges-model.blogspot.com/2014/03/living-with-practical-realities-1978.html

5th March at Tate Liverpool, the exhibition: "Keywords. Art, Society and Culture in 1980s Britain" from 28 Feb 2014 to 11 May 2014.

See also (listed in the bibliography):
Iris Lohja, Yves Demazeau, Christine Verdier. A multi-agent system approach to dynamic ridesharing for older people: State-of-the-art work and preliminary design. 18èmes Rencontres des Jeunes Chercheurs en Intelligence Artificielle, RJCIA’20, Jun 2020, Angers, France. pp.52-59. ⟨hal-02897446⟩

Brian E. Hodges (1942-2022) RIP Creator of Hodges' Health Career Model

The end of 2022 and start of 2023 brought loss, reflection and change in terms of family, friends and educational ties. My children said goodbye to their grandmothers in the space of two months. 

Brian E. Hodges c/o Family.

Then I was contacted by Brian Hodges’s daughter Sarah, with the news her father had died. November through to January saw me attend three consecutive funerals. I’m grateful I was able to visit Sheffield and say goodbye to Brian and meet his extended family.

Yes, it has taken a while to post this. For six months I have been sorting, clearing, rationalising books, papers with a house-sale now imminent, liaising with Brian's family too. 

It is fitting to share this sad news now and celebrate lives well-lived, cast in the promise of a new academic year. I think Brian would have liked this - the potential, and prospects for students in the semesters to follow, lecturers wrestling with how best to communicate and engage their students.

I first met Brian in 1987 when he was a Senior Lecturer at Manchester Polytechnic - which is now Manchester Metropolitan University. Brian taught on the ENB 911 Care of the Mentally Ill in the Community Certificate course. On the course Brian explained his eponymous model. This was more than a decade before Project 2000 made nursing an undergraduate programme. Brian created the model as a response to this. Brian’s qualification in Learning Disability Nursing is key to the inclusion of individual, group (carers) and the POLITICAL domain.

The model contributed to our assessment on the course, which required we complete a case study applying the model to a client/patient on a placement which was conducted with another service. Seconded from Chorley my placement experience was at Bolton. I still have my case study and a set of Brian’s original lecture notes.

Straight away I knew there was something special about Brian’s model. I suspect I’d been primed after watching Tony Buzan’s TV programmes in the 1970s, ‘Use Your Head’ and related books on mind-mapping. By the time I joined the Internet-age it was 1997. I’d written some microcomputer programs on the ZX81 and BBC Micro ‘B’: Nursing Process, Computer Aided Patient Assessment; HAEM; and Shades of Grey. Several were published by Open Software Library (no longer operating).

An ongoing interest developed in nursing theory and models of care, from reading about the nursing process. An early thought about creating a computer program about Hodges’ model crystallised in March 1997 when I came across the Nursing Development Site. This was hosted by the University of Alberta, Canada. Seeing that Hodges’ model was not listed, I contacted the site’s administrator. The response was: “Why don’t you create something and let us know.” Brian was very patient and offered his thoughts via email exchanges (saved, but in Turnpike format). In 1998 I finally got in touch with Alberta and they added a link.

The notes below are from the resulting website (1998-2015 now archived). The product of an interview with Brian at Manchester Polytechnic and my interpretation of model:

“Brian thought up HCM on the then British Rail train service, commuting between Sheffield and Manchester in 1983. He was stimulated by the need to impose structure on a curriculum for a BSc Nursing Studies course. Having defined the model in 1983 a scheduled teacher was unable to take a class, providing an opportunity for Brian to share the model and his thoughts with students. Despite this impromptu start, within a short time academic colleagues recognized the value of HCM in curriculum design and development, in addition to clinical practice.

 
A problem for practitioners has always been ensuring a comprehensive assessment has been made. The HCM facilitates that process, as an aide-mémoire, especially critical when faced with child care / abuse assessment and care evaluations. HCM was adopted as a tool for use by students on courses. Not surprisingly a key area of application is Health Visiting. Other nursing fields includes the use of case studies in post-basic education - Community Psychiatry Nursing Certificate; community and mental handicap - now learning disabilities.

 
Key phases in development

 
The main development work following initial conception, was up to 1987. Due to illness in 1990 Brian has been unable to engage in in-depth development work with the HCM. Hence Brian's bemused surprise at my contacting him. Despite this there are many educators, clinicians and no doubt health care managers who having been exposed to HCM carry it, like myself, as part of their mental toolkit. So if you have taught or used HCM in the past, or (even better) use it currently Brian and I would be delighted to hear from you. Given the duration of courses at Manchester then of course many colleagues in other parts of the north west of England have heard of HCM, used the HCM, or possess a college set of notes on HCM. Do you?” . . .

<> 

Sarah and family have kindly forwarded the eulogy which includes:

“Dad was born on 30th January 1942 to Vera and Gilbert Hodges, he was the eldest of three with a sister, Rita and younger brother Philip. He grew up in Kingswood, a suburb of Bristol and attended the local Grammar school. He loved being a Scout and was a member of the YMCA.

When he left school, he went to work for Boots the Chemist, telling us often about his’ behind the counter’ days. However, a conversation with a colleague led him to rethink his career and he applied to train as a nurse at a hospital for patients with learning difficulties. Being a male nurse in the 1960’s was quite ground-breaking, and so typical of Dad who was always pushing boundaries and taking the ‘road less travelled’.

Dad realised that he enjoyed teaching the students and became determined to raise the profile of nursing those with learning difficulties. This led to him to taking a year’s teacher training at Bolton College and with his new qualification he was determined to make an impact on nursing. In 1972 this lead to the move to Sheffield to set up a nurse training course at Sheffield Polytechnic and Middlewood hospital. He loved this job and the impact he could have on training nurses, alongside this he embarked on an Open University Degree and also developed the Hodges Health career model for nursing, which facilitated integrated care, person centredness, reflective practice and helped to bridge the theory and practice gap. He was very proud of this work, and it remains in use. 

Alongside his work interests Dad decided that he would learn to sail, and not only how to sail, but also how to build a boat. The boat started life in the hallway of the house in Meadow Grove Road, and whilst it amused me and Sarah, there must have been a moment where Mum asked him to move it somewhere more suitable. He successfully built the boat and taught us all how to sail.

Back to his work life he was offered a job as a lecturer at Manchester University and later became Head of Nursing Studies there. He loved his job and invested a lot of time in encouraging his students with his indomitable wit and zest for life. Always wanting to learn more, he also studied for an MSc in Health Education, which meant he travelled to London and loved to tell us about his walks around Chelsea.

Life changed dramatically in 1990 when aged only 48 Dad had a severe stroke which led to a left side paralysis; and a medical assessment that he would not walk again. His sheer determination meant that he did in fact walk, although never regained use of his left arm, which made a lot of day to day tasks very difficult. He had no hesitation about asking strangers to help on his trips to London in his electric wheelchair.

Although Dad returned to work a year after the stroke, he found he could no longer do the job the way he wanted to and took early retirement. Being Dad, he did not stop working and continued to do some teaching, and travelled to other education centres as an external examiner. He also took up a number of volunteering activities which could make use of his skills. He became really involved in health care improvement through service user input and ultimately Chair of Shop Mobility in Sheffield.

One volunteering opportunity led to many and he took up a number of positions in both Sheffield and London. He loved to travel to London on his own on the train, where after his meetings, he would meet Sarah for dinner. He always said ‘focus on what you can do’ so that is what he did. After the stroke he learned to swim again and joined his grandchildren in the pool at Centre-parcs, and played badminton on one of his much loved family holidays.

He did not let the stroke stop him travelling at all and visited France, Florida, Barbados and even St Petersburg in his wheelchair. He also loved trips to Chatsworth for ice cream.

He loved listening to jazz music and rock, had learned to paint and draw. He loved the theatre and bird watching and was an avid reader. In fact, he was interested in everything, knew so much on any topic you could choose, and always more up to date than those around him, often much younger, on all the latest thinking or technology.

His philosophy of life meant that even after the catastrophic event of the stroke, it did not mean an end to living and he found other opportunities which he grasped enthusiastically.

So many people were amazed and inspired by Dad for what he achieved. He was one of life’s cheerleaders always encouraging and supporting others to fulfil their ambitions and this is what we will take with us. When we are not sure in our lives going forward we know we will think ‘What would Brian / Dad / Grandad say’. He had many sayings which we will remember and whenever anyone was facing difficulties or challenges, he would say ‘You will be alright’, and we will be alright because he has have taught us to be so.

Above all he will be remembered for his sense of humour, his huge sense of purpose and service to others and for the determination to live life to the full and never be stopped by anything or anyone. He was so proud of his family and all they have achieved. He was an inspiration and encouragement to everyone he met.

This is the final page of Dad’s life, but it is not the end. Everyone who’s life Dad touched, and all the people present here today carries a little bit of him with them, his humour, his smile, his sayings, his tenacity. So, he will live on with all of us, it is a fond farewell and not a goodbye.”

<> 

Train ticket 28/05/97 (also from 1st website)

Since the Community Psychiatric Nursing (Cert.) course in the 1980s and our initial interview 28th May 1997, Brian and I met on about ten occasions. As noted above, Brian enjoyed rail travel and in the interview I had this image of a train with thought bubbles - Brian's reflections with the model taking shape.

Image from 1st archived site

Brian’s passing and his family's observations prompted recollection of a trip to London in 1996; to an IEE Colloquium on Thinking with Diagrams (Digest No: 1996/010).

https://ieeexplore.ieee.org/xpl/conhome/5214/proceeding

I’m sure Brian met me there, demonstrating his independence, motivation and enthusiasm. I need to check but I’m fairly sure, even imagining he said he was meeting Sarah afterwards? My father accompanied me, we stayed with an aunt who lived near London Bridge back then. Happy memories for me too.

Brian knew of several sites across the UK, that used or took an interest in Hodges’ model. When the website went live in 1998, I’d hoped people with notes, insights, examples of application, pros and cons would come forward. Sadly this did not happen except for a few instances.

I’m so pleased to have met Brian and being able to carry his model forward. Even semi-retired, I rejoice in the freedom I have as a practitioner. As I believe Brian came up against many academic barriers in trying to validate, publicise and disseminate the model. There was no expressed cynicism in this however, but political realism about how the world – academia works. A lesson I know very well in trying to publish work.

I keep fretting about not completing the ‘new’ website, but perhaps I’m following Brian’s advice after all: “focus on what you can do”. Despite its limitations the blog is helping to spread awareness of Hodges’ model; learning each year of new publications citing the model. Hodges’ model isn’t just another 2x2 matrix—business/management consultancy style thinking tool.

The key is the model’s full title:

Hodges' Health Career - Care Domains - Model

‘Health career’ refers to ‘life chances’ and this was central to Brian’s values of person-centredness, advocacy, and ‘seeing’ the political in health, social care and his own educational development and health career. 

The work remains to take Hodges’ model forward, to pass on this ‘+’ shaped baton. I will reflect further, especially as I was initially determined to ensure that Hodges' model was not just left on the shelf. For me, Brian’s legacy is the increasing relevance of his eponymous model since its creation. Consider since the late 1980s developments in human rights, consent, mental capacity, safeguarding, protection of liberty, mental health act, prison health. Brian's model readily encompasses the person and the State - nationally and globally, access and provision to health services, primary care, sustainable development goals, the determinants of health. How do we switch from illness-directed to preventive, health educational services?

In addition, Hodges' model can conceptually represent all these - across time as a series of frames. Brian's model remains a gift to his students and today's learners; including, patients, carers, mental health and general nurses, district nurses, learning disability and health visitors. As suggested here - Brian's effort and work has proved a great gift to me (as friends, family and many student nurses on placement, mentored, signed-off will attest). Brian's model is not a be all and end all, he knew this. It is one of many tools, models and theories, but it can and must also help future generations: from self care, health care, to global health and planetary care.

Thank you Brian. RIP.

What is Population Health? c/o The King's Fund

individual - self - person - citizen

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INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

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other - family - community - population

Mental Health & Well-being	Physical Health & Well-being
	Local & National Government, Services

Related posts W2tQ:
https://hodges-model.blogspot.com/search?q=%22population+health%22


Source:
@HICLancaster and @TheKingsFund

Barber's model of hairdressing - "Care in the Community"?

Through the 1980s and 90s when models of nursing and nursing theory were flavour of the month, I remember a conversation that being so numerous, there was no doubt a "Model of Hairdressing" too. This is not to denigrate hairdressing in anyway (not at all Sis!).  I've actually considered this as a demonstration of the scope of Hodges' model. This post even prompted me to check the previous 2379 to see if I've been here before on W2tQ, but it appears not. (I do have an article somewhere - a parody on 'models of care'.)

There is a developmental tale here though, that is itself interesting. The story runs from the late 90s early 2000s thinking about hair, its qualities, scalp problems, nits (and diplomacy), health and safety at work, the equipment, the pictures displayed - advertising, ingredients, person-centredness, position - comfort and mobility, safety with some preparations and processes, gender and cultural aspects, the history of barbers and of the other 'services': ("Something for the weekend sir?"). So clearly hairdressing like all employment can be complex and rewarding. In addition: there are hosts of medical conditions and psychological factors (for example, self neglect*, phobias, children's reactions) that can affect the hair; its care, management, loss and compensating for this (with specialist help) as needed.

The social event that a visit to the hairdressers / barbers invites, was apparent as a child recalling my mother's former visits and the local 'news' that followed afterwards. In the later 2000's the need for dementia friendly communities was a further development. Business owners can see changes in their regular customers too. Many businesses seek to sustain this awareness and sensitivity in their approach and business. On my visits, the whole process is very relaxing. A further invitation as we shift from the sinks to the chair and mirror. There we are reflected in a before and after. The banter may also include the aspirations and educational options as students work through part-time work. As you may also have heard, over the past few years the actual and potential role of barber's in mental health has been more formally recognised:

https://www.thelionsbarbercollective.com/about-us/

https://www.independent.co.uk/life-style/hairdresser-suicide-prevention-mental-health-tom-chapman-safe-space-torquay-a7644021.html

Recognised also in the arts:

individual - SELF

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INTERPERSONAL : SCIENCES

talk - HUMANISTIC - chat ----------------------------------------------- snip - MECHANISTIC - buzz..

SOCIOLOGY : POLITICAL

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OTHERS - population

Mental health	Physical health
	Public mental health policy

*What are the thresholds that pertain here - no doubt there are several - compounded?

Knife crime: treat as a 'disease'.. (in Hodges' model!)

individual

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INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

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group

Individual Human Rights  Self - IDENTITY Vulnerability - Influence of others?  Motivation, Anger, Impulsivity Schools - bag searches public MENTAL health Character; Values Self-esteem, responsibility, resilience 'Kids with attitude' (great)? 'Kids with attitude' (problem)?	D   disease models  A                           T                    Public Health  A             Violence: stabbing, slashing  T        Access to weapons inc. kitchen knives  R            Weapon concealment on person  A                            Metal detectors  C    of individuals
peer GANGS groups belonging social cohesion - social integration Family structures 'Friends and Family' 'Friends as Family' Social services: housing, education, community centers, community workers 'Moral Panics'? Victim's family - aftermath COMMUNITY	K    and groups  I                   Youth Services - Funding  N               'Global' action - All Together  G                          Chicago - Glasgow "STOP & SEARCH"           Public Health approach to policing violence School (exclusion, impact of) Knife crime: Policy, Home Secretary   'Strong ENFORCEMENT' Strategy - Early Intervention  POLICING           legal advocates

See also:

BBC Radio 4 - Moral Maze 13 March 'Moral Panics'

My source:

Various including: @rydermc "Not a sticking plaster" on https://www.tortoisemedia.com/

 https://twitter.com/rydermc/status/1104706208630489089

David Gillanders

Book: With the End in Mind

individual

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INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

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group

With the End in Mind
"It's the listening. It's the imagination. It's the ingenuity. Oh, and it's the price. Mannix clearly loves her job. They all love their jobs. But you don't watch young children lose their parents and not pay some kind of price. Mannix talks of being "rewounded in the light of duty".  And every day, they go back." p.31.

My source:
Patterson, C. (2017) A better way to die, Culture, The Sunday Times, 31 December, pp.30-31.

George Monbiot & Ewan McLennan - Breaking the Spell of Loneliness

individual

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INTERPERSONAL : SCIENCES

humanistic -------------------------------------------  mechanistic

SOCIOLOGY : POLITICAL

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group-population

My source: BBC 2 or C4?

Goodbye to David McKendrick an 'old' friend and personal reflections

The past three years have been quite challenging both personally and professionally.

Professionally as an IT secondment came to an end in 2007 and brought with it positive and negative changes. The positive of moving back to clinical practice, the negative the vagaries of clinical banding and the Knowledge and Skills Framework which many health sector organisations are still attempting to fully implement. On a personal level, I am now also divorced. Working on the community for so many years - just over the border of my clinical patch - was a gift of convenience in terms of the children's schooling and playing taxi driver.

While there was a very objective interview panel I feel I owe having my current job to my friend David McKendrick. This fact now scares me witless that this was back in 1985 when my eldest son was born. I was so wrapped up in this life-changing event that the secretary phoned to ask if I did want the job. The organisation I still work for has changed its title and status umpteenth times it seems and I have had several roles over the years, including research and service development projects. The truth is though that when it comes to work, this journey began at Chorley with David and that is essentially where I am still at.

I was really shocked then when Sue, David's wife phoned with the news that David had died earlier this month. I'd kept in touch with David through the years. Due to my new domestic circumstances I moved back to Ashton-in-Makerfield - living not far from David and Sue - in July last year. David was so helpful, patient and supportive as I have progressed through the divorce.

We both worked at Winwick Hospital, Warrington, UK and I am pleased I went along this summer to a reunion and saw David in his element with friends, Sue and a pint. I also managed to take quite a few photos which will now be extra memorable for so many of us. Although I didn't work with David at Winwick, as already suggested he was my boss on the community mental health team at Chorley, Lancashire from October 1985 through to his early retirement due to illness.

We shared a love of IT and coding as enthusiasts. In the early 80s David called to my parents home when I'd bought a BBC micro, an upgrade from a Sinclair ZX81. David contributed so much to health IT, through his work with Open Software Library, computer aided learning and his pioneering bulletin board. David was also a co-organiser of a computer based training conference at Keele University 1987-88. Open Software Library distributed several computer programs I wrote on the BBC micro. One thing that makes me smile is the way in the late 80s early 90s I got my underpants into a bit of a twist over the copyright. Now reflecting back, David was a real Gent in how he handled that, my concerns to which he listened, accepted and explained. There was a lesson there also in terms of Hodges' model and Brian Hodges' worries over the same. Where might the model be now, we often pondered, if it had been driven hard from the outset!

When David retired it wasn't the same. Of course you know the job changes constantly, but there was a real loss of impetus: from warp to impulse drive. David was much liked and respected as a boss and colleague. If you were professional in your approach put the clients, carers and families first then he left you to get on with the job. That said his recognition for accountability and governance was communicated and shared by the team. He used an Amstrad micro to produce statistics on the number of home visits, injections and many other details. David was ahead of the informatics game in recognising the value of information for service planning, development and improvement. When David was off a while I kept this effort going for a short while until duties dragged me elsewhere. David's early IT work was published in the Community Psychiatric Nursing Association journal, an association (now the MHNA) which he helped established initially.

I can see us all walking from the team office at Eaves Lane hospital (long gone now), up through the tunnel to the main hospital for the regular team meeting. That was a golden age of sorts, when all the community nurses came together. David was always keen on that. You were a member of a team and everyone was valued and had a role to play.

David recognised my interest (and yes skill -- thanks David!) in computing and sent me on a health care computing conference held in Manchester 1986. I wrote a report and have attended and presented at the HC-XXXX series on several occasions since. We often shared books, papers and plans around technology developments and when to build or buy that next PC.

I really, really can't believe David has gone. He was (very) widely read and we loved knocking ideas around always wondering about what sort of clinical / nursing application might have a future. I only learned since his passing of his excellence as a student nurse. When he qualified as a Registered Mental Nurse (RMN) he was awarded the Gold Medal. He was always keen to read my writing efforts and discuss the same. I remain really impressed with his website on Winwick Hospital - Winwick Remembered. While there is much in the old institutions to say good riddance to and never again this IS social history and as BBC R4's In the Mind featured there is much to record and document. In 2006 David got in touch with a query regarding relatives of patients from Winwick trying to trace details of their family members. I posted his inquiry on the psychiatric nursing list.

Over the past year or so, we met a few times at Tom & Gerry's the local pub with David riding there on his bike: magic!! Sitting at that usual table (near the plug) sad, but lots of smiles too.

I arrived late to politics and I much admire his involvement in community work, the Three Sisters Recreation area project in Ashton. While I enthused over 'community informatics' David was practicing it, engaging with others. I'm sure I don't appreciate the extent of his efforts, the youth club - helping make IT available to youngsters, environmental projects, and the community forum.

I am truly thankful for having met David, for his friendship, support and guidance over the past 18 months and the years before. If I've three regrets:

1. I never did take my guitar around; as I realise now how good David was - McKendrick's Moonshiners no less - I clearly missed a lick there!
2. Also never did find and show David the old photos from Winwick hospital - the show we put on as students.
3. Being able to explore Ashton Heath, the types of heather and the bees there.

Regular readers here know of the hyperbole over the new website, well now if I ever do create the new website - maybe we'll know why...

David - I'll miss you pal and miss you already!
As the new decade begins bless you, Sue and your family and friends...

Peter

===================================
From: Richard Lakeman, richard.lakeman at dcu.ie
To: Peter Jones h2cmng at yahoo.co.uk
Sent: Mon, 14 December, 2009 14:40:27
RE: [PSYCHIATRIC-NURSING] David McKendrick - CPN - CPN Manager, Winwick & Chorley, UK

I’m sorry to hear about David, Peter. Thanks for letting us know. I never met David, but he marketed some software I wrote for some years and He was a pleasure to deal with.

Regards
Richard

Elderly Care: "Follow me please" along the gangway

It goes with the job, seeing people in residential care and nursing homes. The past few weeks walking through several care facilities - corridor-lounge-corridor - you pass a series of open doors, an invite to gaze that way. (People do ask to have their doors left open and visitors should not be able to walk past open doors if privacy and dignity are at risk?) Walking along - a smile, nod of the head, wave of the hand it's like a gangway.

Recently, though it was a case of 1, 2, 3 and counting: residents sat in their rooms; chair, wheel chair, special chair bound.

A gallery of still-life studies. So many heads bowed, cast as life and world-weary statues. So many aged variations of The Thinker.

The homes and their staff do the best they can, some employ people dedicated to 'activities'. Despite this, it's not easy for many new carers to appreciate the value in engaging people who are disoriented for TI:ME, PLACE and PERSON in chit-chat or a group activity when five minutes later they have forgotten all about it. People are referred to mental health services because they have a mental health 'problem' and yet in many cases their bags are packed and they are ready to take you on a journey: if you care to listen.

We seem to focus on the cognitive value of the things we do, but is this a variation of task orientation that delivers a concrete output (PROCESS vs PURPOSE again)? What about the emotional value of the things we do and the possible benefits, whether visible or intangible? ALL work and the effort it requires carries a price and despite the forgetting, the emotional engagement and safe social contact can still make a real positive difference to people. The price paid by residents in being engaged in conversation, can reduce any sense of alienation, loneliness and the aggression and agitation that can follow.

What do I mean 'safe' social contact? Many people in care are disinhibited; they say things to their fellows and staff that are very personal and upsetting. Cognitive decline is a fact of life, but even for people diagnosed with dementia, the damage done varies from person to person. For many they are profoundly impaired and yet their personality flickers through and with it sensitivity to things said by their peers. Remember those anxious moments in the play ground? Social mores are deeply ingrained in us. Maybe this is why for youngsters the current spate of e-bullying is having such a impact. Bodies may be battered and worn, but INTRA - interPERSONAL and SOCIAL exercise mediated by carers (and relatives!) can pay longer term dividends.

In between care needs that also demand quiet, rest and sleep and our need to be realistic and objective; personal and group engagement can I'm sure make a real difference. It depends on the resources + the right attitudes to make it happen. To see the person not the statue.

Even if only for a few moments
bringing statues back to life is real magic.
Walking the gangway is one thing,
but residential care should not be the gangplank
as it is so often portrayed for residents or staff.
Converse-2-conserve.

Rodin image original source: http://users.ox.ac.uk/~ball0888/oxfordopen/Rodin.htm

Well-being: a great place to be!

Working in mental health you certainly don't take mood, mental state and that nebulous notion of well-being for granted.

Depression is a terrible thing and given the thin red line that we all walk in terms of mental health, it's a place no one wants to venture.

There's a lot of emphasis being placed on well-being (happiness!) at present. The usual retinue of number of this and that measures count for little if at the end of the day well-being or the individual's happiness is not improved, or perhaps more accurately 'satisfied'.

Watching Glastonbury it's all about music and well-being amid lots of mud.

Well-being is taken for granted like so many things in life. Take it away and it's noticed - very quickly.

They say that the best lessons are those we learn for ourselves. Being lost and finding your way is another pivotal lesson. At key times and places this journey can be a rite of passage no less.

In order for health promotion to deliver, people need to understand well-being, that is the many ingredients that contribute to that feeling, that sense, that inner magic that lights us up and those around us...

Hodges' model can help people with that journey, especially at a time when a fellow traveller may be needed.

Health and social care services are so often about signposting these days.

Hodges' model can help people signpost for themselves...

Photo: BBC

Ecotherapy: Hey Surf's Up - Better grab your sunbed

Having an eye for 'therapy-this' and 'that-therapy', a report on ecotherapy has appeared on the MIND website, blogs and other media. It's not new really, although the researched approach is very welcome. The mental health benefits of volunteering and the great outdoors have been recognised for countless years.

This summer - August in fact, there's an opportunity to do something different that also has an outdoor theme. It means putting that surf board down and getting the sun bed out: after midnight. Now is the time to do some networking and planning - at that time of night of course you must be safe and this is an experience to share with people you know and trust.

This is 'astrotherapy' which is connected to ecotherapy because venturing out you realise how light it is at night - where is the night sky!

Why go out and find dark skies? It's the PERSEID meteor shower and this summer with maximum the 12-13 August there is no full moon.

You can also check on whether the International Space Station (AND Space Shuttle on this occasion!) will pass within sight for your location.

When you can and do look at the stars it's quite a trip. If you are feeling depressed or lacking in self-esteem, if you let the view work its magic - it sure can make you feel insignificant and yet so very special. Gifted: to look the infinite in the eye...

Mind - Go green to beat the blues - Executive Summary
Some obvious tips: If travelling somewhere even with others check the site during the day. If needed: get permission - tell someone; take extra clothes and a hat - midges, mozzies. If you've a torch cover it with a transparent red film (red hanky even) so it doesn't mess your (and others!) night vision as much. Support your neck properly, you can't stand and crane your neck for hours - besides you'll look daft the next day walking into work - hey I know. If you are in the back garden and see a meteor don't shout out. The buckets of water will fly. Give yourself a good 10-15 minutes to light-dark adapt. Don't forget the flask! Be patient and I'm sure you'll be rewarded...