As I’ve thought more about this important article, I think we need to put Jan in charge of ALL long-term care. She could hire the people needed to work with patients/residents the way she worked with/encouraged her parents. The cost would easily be covered by the decreased medical costs of those patients—fewer meds, fewer physician and hospital visits, fewer weird dietary needs, decreased need for help with ADL’s, etc., etc., etc. And all this coupled with a vastly increased quality of life for the patient and all of his or her “Ohana” (“family” unit). This would also empower the families and loved ones to get more involved. I vote for Jan!!
It is also true that care is so fragmented that when a patient sees their outpatient doctor, the only way they can learn what happened during their long stay at hospital and rehab except through the patient and their advocate. Even if they use the same computerized record, that record has hundreds of pages. And the discharge “summary” is largely computer generated and prepared by the doctor who saw them during their last three days in the hospital. Usually there is no meaningful narrative of what happened during their stay.
If you are an advocate, come to that appointment prepared to provide what information you can, and bring all of the pills in their original bottles, or the doctor will have no idea what the patient is taking.
As a doctor myself I can tell you that the system is broken.
When my 86-year old uncle was hospitalized, I never left him alone in the hospital without someone there to monitor what was going on. This was years ago, but even then, I understood that patients need an advocate. But I had not extended the need for an advocate beyond the hospital. Your wonderful post has widened my understanding of the need for advocates. Living in a profoundly rural part of the U.S. (2 people per square mile), there are many elderly farmers living and often actually farming well into their 80s. I have come to realize that's because they do have advocates in their neighbors. it's hard for those unfamiliar with rural America to understand what a profound effect the support of lifelong neighbors and their families can have on the quality of life for older people.
I love how Jan perfectly modeled the 5th commandment to honor her father and mother! What a beautiful example of a patient advocate that far too many don’t have but desperately need! I have often told family members they are their loved one’s best advocate, and to never be apologize for that!
You correctly described the deliberately planned state of U.S. Medical "Care" available to middle class Americans and below with this irrefutably true statement:
"There’s a swelling tsunami of individuals who have no one to argue for the care they need when they are ill."
The deliberate abandonment of those individuals has absolutely nothing to do with "modern illness" and everything to do with a medical system that, unlike the medical systems in other industrialized countries, has decided that Social Darwinsim is more profitable than Matthew 7:12.
Here are the FACTS:
COVID Deaths per Million and Life Expectancy Decline in our greed corrupted country:
Doctor Leap, I know you are part of the solution, but ignoring the core cause of this increase in inadequate health care caused misery (and consequent decrease in longevity) for 80 million PLUS Americans, cynically "priced out" of Matthew 7:12 based Medicine, will not help solve this evil.
As I’ve thought more about this important article, I think we need to put Jan in charge of ALL long-term care. She could hire the people needed to work with patients/residents the way she worked with/encouraged her parents. The cost would easily be covered by the decreased medical costs of those patients—fewer meds, fewer physician and hospital visits, fewer weird dietary needs, decreased need for help with ADL’s, etc., etc., etc. And all this coupled with a vastly increased quality of life for the patient and all of his or her “Ohana” (“family” unit). This would also empower the families and loved ones to get more involved. I vote for Jan!!
Excellent piece Ed and kudos to Jan. We see these truths so often in palliative care as well.
How very true.
It is also true that care is so fragmented that when a patient sees their outpatient doctor, the only way they can learn what happened during their long stay at hospital and rehab except through the patient and their advocate. Even if they use the same computerized record, that record has hundreds of pages. And the discharge “summary” is largely computer generated and prepared by the doctor who saw them during their last three days in the hospital. Usually there is no meaningful narrative of what happened during their stay.
If you are an advocate, come to that appointment prepared to provide what information you can, and bring all of the pills in their original bottles, or the doctor will have no idea what the patient is taking.
As a doctor myself I can tell you that the system is broken.
When my 86-year old uncle was hospitalized, I never left him alone in the hospital without someone there to monitor what was going on. This was years ago, but even then, I understood that patients need an advocate. But I had not extended the need for an advocate beyond the hospital. Your wonderful post has widened my understanding of the need for advocates. Living in a profoundly rural part of the U.S. (2 people per square mile), there are many elderly farmers living and often actually farming well into their 80s. I have come to realize that's because they do have advocates in their neighbors. it's hard for those unfamiliar with rural America to understand what a profound effect the support of lifelong neighbors and their families can have on the quality of life for older people.
Amen & Amen! Jan is a living example of love and service!
I love how Jan perfectly modeled the 5th commandment to honor her father and mother! What a beautiful example of a patient advocate that far too many don’t have but desperately need! I have often told family members they are their loved one’s best advocate, and to never be apologize for that!
You correctly described the deliberately planned state of U.S. Medical "Care" available to middle class Americans and below with this irrefutably true statement:
"There’s a swelling tsunami of individuals who have no one to argue for the care they need when they are ill."
The deliberate abandonment of those individuals has absolutely nothing to do with "modern illness" and everything to do with a medical system that, unlike the medical systems in other industrialized countries, has decided that Social Darwinsim is more profitable than Matthew 7:12.
Here are the FACTS:
COVID Deaths per Million and Life Expectancy Decline in our greed corrupted country:
https://www.counterpunch.org/wp-content/uploads/2023/09/a-graph-of-covid-19-deaths-per-million-descriptio.png
https://www.counterpunch.org/wp-content/uploads/2023/09/a-graph-showing-the-difference-between-the-u-s-a.png
The above is the DIRECT RESULT of the inequality fostering U.S. Corporate greed rampage:
https://inequality.comm.ccsu.edu/wp-content/uploads/2014/09/wealthdistribution-1024x675.jpg
Doctor Leap, I know you are part of the solution, but ignoring the core cause of this increase in inadequate health care caused misery (and consequent decrease in longevity) for 80 million PLUS Americans, cynically "priced out" of Matthew 7:12 based Medicine, will not help solve this evil.