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Deprecated: Return type of WP_Theme::offsetExists($offset) should either be compatible with ArrayAccess::offsetExists(mixed $offset): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-theme.php on line 554

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Deprecated: Return type of WP_Theme::offsetSet($offset, $value) should either be compatible with ArrayAccess::offsetSet(mixed $offset, mixed $value): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-theme.php on line 535

Deprecated: Return type of WP_Theme::offsetUnset($offset) should either be compatible with ArrayAccess::offsetUnset(mixed $offset): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-theme.php on line 544

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Deprecated: Return type of WP_REST_Request::offsetSet($offset, $value) should either be compatible with ArrayAccess::offsetSet(mixed $offset, mixed $value): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/rest-api/class-wp-rest-request.php on line 984

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Deprecated: Return type of WP_Block_List::next() should either be compatible with Iterator::next(): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 175

Deprecated: Return type of WP_Block_List::key() should either be compatible with Iterator::key(): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 164

Deprecated: Return type of WP_Block_List::valid() should either be compatible with Iterator::valid(): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 186

Deprecated: Return type of WP_Block_List::rewind() should either be compatible with Iterator::rewind(): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 138

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Deprecated: Return type of WP_Block_List::offsetGet($index) should either be compatible with ArrayAccess::offsetGet(mixed $offset): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 89

Deprecated: Return type of WP_Block_List::offsetSet($index, $value) should either be compatible with ArrayAccess::offsetSet(mixed $offset, mixed $value): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 110

Deprecated: Return type of WP_Block_List::offsetUnset($index) should either be compatible with ArrayAccess::offsetUnset(mixed $offset): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 127

Deprecated: Return type of WP_Block_List::count() should either be compatible with Countable::count(): int, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/1/s/speilvendt/www/wp-includes/class-wp-block-list.php on line 199

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Å leve som gammel i koronatider – Speilvendt
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Å leve som gammel i koronatider


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Tekst: Runar Bakken
Illustrasjon: Eivind Mo Andreassen

Fra skrivebordet mitt kan jeg se ut gjennom et vindu og ned på en gatestump og en parkeringsplass, og for en tid tilbake falt jeg hver dag i tanker om en gammel kvinne med rullator som kom til syne i synsfeltet. Til ulike tider beveget hun seg fra og til ulike gjøremål i byen. Det gikk sakte, men i all slags vær og sent og tidlig så jeg hvordan hun kjempet for å komme seg frem, kjempet for å greie seg selv. Nå ser jeg ikke henne mer.

Rent fysisk ligger ikke byens sykehjem langt unna mitt utkikkspunkt. Alle ligger innenfor en radius av rundt 1000 meter, men rent mentalt er livet innenfor veggene på sykehjemmene som et liv i en adskilt og parallell virkelighet. En av grunnene til at det er blitt slik, er at vi i humanismens navn – og spesielt etter den andre verdenskrig – systematisk har bygget opp institusjoner i et forsøk på å redusere den menneskelige smerte og lidelse; sykehus, sykehjem, hjemmetjenester, psykiatriske institusjoner og lignende. Vi får knapt tilgang til den for oss uvirkelige virkeligheten med mindre vi åpner dørene til disse institusjonene. Det har jeg gjort. I ulike perioder av livet har jeg vært innenfor som yrkesutøver, forsker, pårørende. Likevel tar det ikke lang tid etter å ha forlatt disse institusjonene før verden der inne lukkes ute og mer eller mindre forsvinner fra min bevissthet; ute av øye, ute av sinn. Men hver gang denne gamle damen med rullator kom inn i synsfeltet, ble erfaringene fra slike steder vekket til live igjen. For det meste var det løsrevne bilder næret av min egen frykt for en dag å bli løftet ut av gatene jeg ferdes i, ut av hjemmet jeg lever i, for så å balansere resten av livet på en eksistensiell knivsegg i overgangen mellom liv og død innenfor en eller annen institusjon.

«Krisetider tydeliggjør prioriteringene i helsevesenet: Alt
gjøres for å redde liv på sykehusene, i motsetning til hva som skjer i
sykehjemmene, hjemmesykepleien eller i omsorgsboligene.»

12. mars begrunnet statsministeren og helseministeren at nedstengingen av Norge var nødvendig for å opprettholde en forsvarlig kapasitet ved sykehusene, og for å beskytte de mest sårbare; gamle og andre utsatte grupper. Av de 62 menneskene som døde av covid-19 i løpet av påsken i Norge, døde 43 mennesker rundt om i sykehjem og omsorgsboliger; spesielt i sentrale strøk rundt større byer. Mens de som legges inn med covid-19-sykdommen på landets sykehus er smittet et sted ute i samfunnet, smittes gamle mennesker av ansatte på ulike institusjoner. Krisetider tydeliggjør prioriteringene i helsevesenet: Alt gjøres for å redde liv på sykehusene, i motsetning til hva som skjer i sykehjemmene, hjemmesykepleien eller i omsorgsboligene. Krisetider tydeliggjør en vel dokumentert strukturell og systemisk diskriminering av gamle mennesker på kommunale institusjoner, med den følge at stadig flere gamle dør. Dette står i grell kontrast til en av hensiktene med nedstengningen; «….for å beskytte de mest sårbare; gamle og andre utsatte grupper.»

«Strukturell og systemisk diskriminering», kan synes som en følelsesdrevet populistisk påstand uten substans. Skal det være dekning for påstanden, må det kunne henvises til et konkret innhold. Forbundslederen for Sykepleierforbundet har uttrykt det i en setning: «Covid-19-krisen kommer på toppen av en allerede eksisterende kapasitets- og kompetansekrise». Denne kapasitets- og kompetansekritiske situasjonen kommer konkret til uttrykk ved at det er for få ansatte med kompetanse med små stillingsbrøker, i forhold til omfanget og det faglig krevende arbeidet de settes til å utføre. Til sammenligning: På intensivavdelinger er det én spesialsykepleier pr. covid-19-syk pasient. Når det i tillegg er opp til ansatte selv å vurdere om de er bærere av koronaviruset, er egget lagt. 

Det å forstå og i praksis være i stand til å bryte smitteveier, er ikke noe for amatører. Derfor fikk pårørende tidlig besøksforbud. Det å ikke  smitte andre og selv ikke bli smittet, er en egen spesialgren som bare de som arbeider på smittevernsavdelinger behersker til fulle. Smittevern krever kunnskaper, langvarig trening og evne til å vurdere og omsette disse kunnskapene i konkrete situasjoner. At mange leger og sykepleiere dør i Italia i arbeidet med å redde liv, viser hvor krevende dette arbeidet er. I storbyer som Oslo er cirka 30 % av de ansatte i pleie- og omsorgstjenestene uten utdanning, og de arbeider ofte i så små stillinger at de må jobbe på flere institusjoner for å kunne tjene til livets opphold. I helger og høytider som påske, øker bruken av ufaglærte i små stillinger. Denne kombinasjonen har jeg tidligere omtalt som en potensielt dødelig miks med tanke på  å unngå å smitte de gamle hjelpetrengende. Når det i tillegg mangler smittevernsutstyr og kompetanse til å bruke det, så trenger en ikke være smittevernsekspert for å kunne fastslå at den strukturelle og systemiske diskriminering av gamle mennesker på kommunale institusjoner dreper stadig flere gamle: 1. april døde 43,6 % på kommunale institusjoner, mens 48,7% døde på sykehus. 17.april døde 57,8 % på kommunale institusjon, mens 39,1 % døde på sykehus. 

Helsedirektoratet beklager at så mange gamle smittes av koronaviruset og dør på de kommunale institusjonene, men deres oppmerksomhet er nesten utelukkende rettet mot sykehusenes kapasitet når de gir råd om først nedstengning og nå gradvis å lette på restriksjonene; sykehusene må ikke overbelastes. Assisterende helsedirektør Espen Nakstad – den sympatiske og kunnskapsrike «sykehusmannen» – uttrykte tidlig i forløpet av pandemien: «De fleste som dør som følge av covid-19, er gamle mennesker med underliggende sykdommer som uansett ville vært døde om kort tid.» Det som var én av to begrunnelser for å stenge ned Norge for å hindre ukontrollert smittespredning, er blitt redusert til ett hensyn : hensynet til sykehusenes kapasitet. Hensynet til gamle sårbare mennesker på kommunale institusjoner har i realiteten aldri blitt prioritert. 

«Over hele Europa og USA meldes det nå om grufulle tilstander
rundt om på sykehjemmene, og dødstallene er langt høyere
enn det som kommer til uttrykk i statistikkene over covid-19-døde.»

Ja, gamle mennesker som er avhengig av bistand, for å kunne leve litt videre, lever prinsipielt sett i overgangen mellom liv og død. Det er «lønnsomt» at alt settes inn for at de som legges inn på sykehus med covid-19, skal bli friske og kunne vende tilbake til arbeidslivet, familielivet, kjærlighetslivet; få hjulene i gang igjen. Det er «ulønnsomt» å investere mye for at gamle mennesker på sykehjem skal leve best mulig til siste slutt. Det må være grunnen til at gamle som først er smittet av ansatte, ikke blir fraktet til nærmeste sykehus, for å få kompetent lindrende behandling, til tross for at kapasiteten til å ta imot er til stede. Den strukturelle diskriminering ikke bare dreper, men den viser her sitt sanne, inhumane ansikt. Men Norge står ikke i en særstilling. Over hele Europa og USA meldes det nå om grufulle tilstander rundt om på sykehjemmene, og dødstallene er langt høyere enn det som kommer til uttrykk i statistikkene over covid-19-døde. Men en dag kommer – og dagen, den vil komme – når Høie, Solberg og Nakstad skal få smake sin egen medisin. 

Fra skrivebordet mitt faller jeg fremdeles i tanker. Jeg ser fremdeles etter om den gamle damen med rullator kommer til å dukke opp i synsfeltet. Jeg undrer meg på hvor hun befinner seg; om hun bare er hjemme eller på sykehjemmet. En nabo avklarte den gamles skjebne her en dag da jeg møtte ham tilfeldig ute på gaten: «Nei, hun er så heldig å ha fått fast plass på et av byens sykehjem.» Jeg skulle ønske jeg også kunne se det på den måten.   

Runar Bakken er sykepleier og dosent ved Universitetet i Sørøst-Norge ved Fakultet for helse- og sosialvitenskap der han også er del av forskningsgruppen USN EldreForsk. Han har utgitt flere bøker om alderdom og hvordan eldre i samfunnet behandles blant annet Frykten for alderdommen og Alle vil leve lenge – men ingen vil bli gamle. Bakken er også skribent og samfunnsdebattant med innlegg i blant annet Morgenbladet og Klassekampen. 


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