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Thursday, October 6, 2016

There's thinking you know about your future and...

Reading "Being Mortal" which has more information than I expected.

Ah, having worked with elder people doesn't give me any extra insight into how to be one.

This is one book that I think everyone should read, young and old.  It points out a huge hole in our culture, one where every one of us will eventually slide.  That of the final infirmities and lack of good models of care for us.  The current treatment is once you have infirmities of the body, you need to be in a regimented nursing home, where you suddenly lose all your independence and become just one more cog to be given treatments like scheduled medication, bathing, toileting, and feeding.  There may be some better options for those who have a lot of funds.  There is still a dirth of  good care for all the rest of us.

And yes, the author gives great examples of how geriatric care is different than regular medical treatment.  Do you know how? (I hate to say it, read the book!)

Not enough geriatricians are being developed...physicians who specialize in care for the elderly and dying.  There isn't any incentive.  They are paid less, have fewer courses of study, and don't have any incentive to work with the population which will be increasing exponentially in the next decade.

The author of "Being Mortal," Atul Gawade, quotes Chad Boult, the geriatrics professor... 
"In a year, fewer than three hundred doctors will complete geriatrics training in the United States, not nearly enough to replace the geriatricians going into retirement, let alone meet the needs of the next decade.  Geriatric psychiatrists, nurses, and social workers are equally needed, and in no better supply.  The situation in countries outside the United States appears to be little different.  In many, it is worse.
He goes on to say
"another strategy: he (Boult) would direct geriatricians toward training all primary care doctors and nurses in caring for the very old, instead of providing the care themselves.  Even this is a tall order - 97 percent of medical students take no course in geriatrics, and the strategy requires that the nation pay geriatric specialists to teach rather than to provide patient care.
Boult concludes
"We've got to do something, Life for older people can be better than it is today."
There is a very thorough bibliography, and I think the quotes above come from
University of Minnesota; C. Boult et al., "A Randomized Clinical Trial of outpatient Geriatric Evaluation and Management," Journal of the American Geriatrics Society (2001)
as well as
The American board of Medical Specialties, American Board of Psychiatry and Neurology; L.E. Garcez-Leme et al., "Geriatrics in Brazil: A Big Country with Big Opportunities," Journal of the American Geriatrics Society (2005)

Norma made a fairy house in clay

I enjoyed reading about Driving Miss Norma on Facebook recently.  A dying 91 year old woman spent her last year with her son and daughter-in-law driving in an RV around the country, where she experienced everything she wanted to.  She took her last breath September 30, 2016. I didn't discover her posts until after she was gone, but it is interesting to look at what her family posted.  This is a use of social media that I like.  And again, this is a woman who had resources with which to have such a wonderful experience in her last months.


In being with dying, we arrive at a natural crucible of what it means to love and be loved. And we can ask ourselves this: Knowing that death is inevitable, what is most precious today? Roshi Joan Halifax

1 comment:

  1. Ours is a youth obsessed culture and ignores the elderly, will it change????


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