Elder Care

BitterPill Book Jacket
In the New York Times Paula Span reviews A Bitter Pill: How the Medical System Is Failing the Elderly : John Sloan M.D.

“We do a rotten job in society, a terrible job, of looking after the frail elderly,” Dr. John Sloan says.

Dr. John Sloan, is a family physician who cares for elderly patients in their homes here in Vancouver, British Columbia.

After consulting with patients and their families, often at length, Dr. Sloan often finds that what works better is to make comfort the top priority. “They don’t want to be physically and mentally miserable,” Dr. Sloan said of his patients. “My answer is to take the emphasis off the high-tech, expensive, futile health care system, and be a little kinder.”

Here is someone who has taken a long hard look at how we should be treating the elderly. Who doesn’t see the sense in intervention when “comfort” and “function” should serve as a priority.

It occurs to me that Dr. Sloan is quite a unique physician, and those in his care are very fortunate. “House calls” are somewhat of a bygone era. Many elderly experiencing emergencies only have the option of trips to an ER dept. At a time of life when the advantage of a family physician or geriatrician who is aware of their history presents great advantages.

For each of us the time will come when we will be faced with such decisions. In our culture, accepting that all interventions to preserve life in the face of preventing death is not easy. We often hold on to just one more procedure or intervention which will save a life.

The ambiguity of aging makes family decisions more difficult. The challenge is how we should be focusing on the needs and comfort of the elder rather than on our own anguish.

This is one book that I am definitely going to add to my bookshelf.

Source: New York Times

Johann Hari writes an eloquent and impassioned summary of his grandmothers final years spent in care homes in Britain.

My grandmother did not believe in moaning about anything. So when I first visited her in that first home, and found her in a wheelchair staring into space, with a cold and foul pie in front of her, she said everything was fine. Although homes are supposed to lay on activities every day, I hardly ever saw any happening. There would be rows of people in metal chairs looking into the middle distance, and occasionally a surly member of staff would give them a balloon to pat to each other. Yet if you stopped and spoke to these people, they were lucid – and agonisingly bored

It gets worse:

She had been saying for months that it was far too painful, but the “carers” told her she wouldn’t get any food if she didn’t do it and it was “necessary”. “I’m not walking,” she said, crying. “It’s agony.” The staff were clucking and telling her she was “misbehaving”, as if she was a toddler.
This was so out of character that I immediately knew something was wrong, and I insisted they call a doctor. They hummed and hahed and only agreed when I got angry. She was finally taken to hospital and X-rayed. The doctors found that her legs could no longer support her weight – she was a big woman – and had suffered severe stress fractures and breakages that must have been there for months. They had been forcing her to walk on broken legs.

The shocking truth is that his grandmothers story is not unique.It terrifies me to think too much about the content of his article. What sort of society are we becoming when we treat our elderly so badly?  Johann nails it when he says:

we are punishing the people who saved the world from the Nazis. Didn’t my grandmother – and yours – deserve a better ending to her story than this?

And therin lies our own fates. Food for thought. Curious? Link to read this article in The Independent
Source: The Independent

Its an RSA focus this Friday, in his comment this morning Paul Allen addresses how the time bomb of an ageing population and a diminishing workforce coupled with the economic climate provides the new government with a difficult challenge.
Time is ticking on this potentially explosive situation. Paul Allen argues that swift, decisive and well thought out action is required to ensure the needs of our elderly population are met.

In 2009, the UK population numbered 62 million: 38 million of working age, 9.2 million between 50 and 65 years, and 11.3 million over current state pension age. The forecast for 2031 is a 58 per cent increase in the number of people aged over 65, but just a 16 per cent increase in those at working age. This creates a huge imbalance between those who are earning and those likely to need care. However, the funding available for elderly care has been shrinking for some time and many local authorities have slashed budgets up to 400 per cent, with some regions reducing sheltered housing provision from £40 to just £11.75 per week. link to continue reading

Source: RSA