A healthcare insider’s look at the healthcare debate from a social point of view.

5 reasons we will never actually pass a national healthcare plan.

Reason #1.
You, the patient, are offered three medical treatment choices:
Option #1 costs $10,000 and works very well with very few side effects.
Option #2 costs $1000 and will also work very well but will have a few more side effects.
Option #3 costs $300 but only works some of the time with lots of side effects.
Which will you choose?

Most people will say, “I don’t want a chance for more side effects or one that only works some of the time, I want the best, Option #1.” Or people might say, “Well it is okay for someone else to choose the 2nd or 3rd option, but I have a right to good healthcare.” And what they mean by “good” healthcare is really great healthcare. For national healthcare to work, we need people to be willing to accept and to choose the second best choice sometimes which may come with a few more side effects. The system can’t afford the best all of the time. To make this happen, we have to adjust the rules doctors live by which brings me to reason number two.

Reason #2.
Doctors must give informed consent which means people have to be given enough meaningful information so they can make a good decision regarding what treatment to choose. This information would include being told about the first, second and third best options. Who is going to say, “No, doctor, really it is fine with me. Give me second best option.” We are starting to see this problem for certain hospitals that statistically provide second rate care and therefore may eventually need to disclose to patients, “You may be better off going somewhere else.” So if doctors need to tell the whole truth, the system will break down. Informed consent will have to be limited to those treatments allowed under the national health plan.

Reason #3.
The other problem doctors will have is that they will still be held legally liable for providing good healthcare. If you don’t get better or you get extra side effects, you will sue the doctor. Why is this doctor’s fault when the system says he has to give you option #2 or #3? Our malpractice system will have to change to protect doctors who are only following the rules set up by the national healthcare system.

Reason #4.
National healthcare will mean a more equal distribution of medical resources. What that really means is that many of us will have to accept a little less for everyone else to receive a little more. Now, you may say you want this but how many people really act in an unselfish way? I know lots of people who say they care about the poor and underprivileged, but I don’t see them sending a poor family half of their paycheck. We want the government to take care of everyone while we still get everything we want. But we can’t get everything we want with national healthcare. It just isn’t possible. But, everyone could get reasonably good care.

So, we are part of the problem. We are selfish. Our selfishness is a deeply imbedded societal belief about what our obligations are to others. This country was built on individualism and watching out for your own best interest. We are not a country which cares more about others above ourselves. And those of you who just said in your mind, “Well I care.” Then do something significant to prove me wrong.

Reason #5.
The last reason things won’t change is that our politicians are not interested in voting for national healthcare. Right now they are receiving a substantial amount of money from insurance companies and pharmaceutical companies. Why would they want to stop getting all this money? They don’t. And you wouldn’t either if you were in their place. Politicians talk a good story but when it comes to action, nothing gets done. How many politicians said they are for national healthcare during their campaigns? Most, but still nothing will happen. It is about money.

But we, as individuals have power. If the politician gets voted out of office they will lose their financial kickbacks. So, we have to tell them that if they want to stay in office, they have to give us national healthcare. And if they don’t vote it in this time, we must vote them out of office. We are not helpless. If we truly care, and I hope we do, we need to speak up, speak out and vote responsibly. Contact all of your local and national politicians to vote for national healthcare. And contact them over and over again. They won’t take us seriously unless we get serious about caring for all Americans.

For a look at the money issues in the healthcare debate, go to https://kindethics.com/2009/09/an-healthcare-insiders-look-at-the-healtcare-debate-from-a-money-point-of-view/

Have a kind and respectful day.

Rescheduled: Date TBD, Interview with Peter Lichtenburg Ph.D. on blogtalkradio.com/kindethic

Peter A. Lichtenberg, Ph.D., is the Director of the IOG and Professor of Psychology, Psychiatry and Behavioral Neuroscience & Physical Medicine & Rehabilitation at Wayne State University. Dr. Lichtenberg received his Ph.D. in Clinical Psychology at Purdue University, where he also minored in aging. Dr. Lichtenberg will be discussing dementia, Alzheimer’s and the work of the Institute of Gerentology at Wayne State University, including the work of the Healthier Black Elders Center.

www.iog.wayne.edu — blog
www.dementiacoalition.org
http://www.mcuaaar.wayne.edu/events.php — Healthier Black Elders Center

Director of the IOG since 1999, Lichtenberg has led this research and education unit to record levels of funding (annual totals for the past 8 years are a 300-400% increase from previous highs), to an expansion of research focus by recruiting faculty in the area of cognitive neuroscience, and the leadership of several highly successful training and mentoring grants (See below for details on the Predoctoral and Postdoctoral Training and on the Michigan Center for Urban African American Aging Research). Dr. Lichtenberg also created the first IOG-funded development Board of Visitors which in its first 4 ½ years raised over $2.25 Million dollars.

Dr. Lichtenberg is the author of five books, including the highly acclaimed Handbook of Dementia (2003, Handbook of Assessment in Clinical Gerontology (Wiley press, 1999) and A Guide to Psychological Practice in Geriatric Long Term Care (Haworth Press 1994). In addition, Dr. Lichtenberg has edited a four volume series for the organization Medical Psychotherapy, and has published over 125 peer reviewed scientific articles. His particular areas of research include mental health in long term care, geriatric depression, geriatric psychology and
medical rehabilitation and the early detection and management of Alzheimer’s Disease.

Dr. Lichtenberg has been awarded many distinctions including the 1996 Early Career Award in Rehabilitation Psychology, Fellowship in the Gerontological Society of America and the American Psychological Association, the Outstanding Contribution Award for Psychologists in Long Term Care, and both the 2001 Distinguished Faculty Award and Outstanding Mentor Award at Wayne State University. In 2002, he was the first educator to be given the Alzheimer’s Advocate Award. In 2004, on behalf of the IOG, he accepted community honors from the Area Agency on Aging 1C and Wayne County. In 2006 he was awarded the Harry Kelly Award for outstanding leadership in Gerontology

Dr. Lichtenberg is a leader in many national and community organizations in Detroit and the State of Michigan including chair of the http://www.dementiacoalition.org/>Michigan Dementia Coalition, past-chair of the Central City Aging Services Consortium, and Board member for the Area Agency on Aging 1-B Advisory Board. Nationally, Dr. Lichtenberg was the Chair of the
Behavioral and Social Sciences Section of the Gerontological Society of America (2007), Chair of the APA Committee on Aging (2008) and a member of the APA Presidential Task Force on Integrated Care for an Aging Population.

The Institute of Gerontology at Wayne State University brings together science and service to advance the cause of aging research. Its multidisciplinary faculty, post-doctoral fellows, and pre-doctoral trainees focus on the social and behavioral aspects of lifespan health and cognitive development. Dedicated to promoting successful aging, the Institute of Gerontology is where research and outreach combine to make life better in Detroit and beyond.

Improving Bedside Manner While Managing Your Time

Your bedside manner will affect the medical outcome of the patient. Here are some easy tips you can do in your office. The first thing you want to do is to briefly review the chart before you walk in the room. Usually physicians will start looking at the chart once they’ve entered the room and will be so busy reading the chart, that they missed the opportunity for a warm greeting and good eye contact. So while you’re in the hallway, before you open the door, do two things. Review the chart quickly and check in with yourself. You want to check in with yourself that you’re ready to go in and be present with this particular patient. Even if your mind has been thinking about other patients in the office or the hospital, or if you’re thinking about your kid’s soccer game, stop and redirect your focus. Then when you walk in the room, the patient will feel like you are there for them and that you are paying attention. As you walk, greet the patient warmly and use culturally appropriate nonverbal skills. Don’t assume that the patient hasn’t minded waiting for you, they do mind. Apologize if you are late.

Please don’t sit behind a desk. The desk can be cold and distancing. The patient will feel more comfortable if you sit with them in the exam room. If you can, please talk to patients with their clothes on as patients can be very uncomfortable sitting in a small gown or with just a drape covering them up. If you’re using electronic medical records and are just now getting used to doing the patient interview in front of a computer screen, please remember to look up from the screen and to make sure you stay connected to the patient. I know the new technology takes some getting used to, but you can’t afford to have the patient feel like you don’t care. You also want to make sure that you don’t make the patient a third-party patient. This is when you talk to their caregiver and ignore the patient. Even if the patient doesn’t have full capacity, keep them included in the conversation.

Remember that the conversation should be a dialogue, not a monologue. Leave plenty of time for listening, especially at the beginning of the conversation. If you do want to connect with the patient on a personal level, don’t make the mistake that many doctors do. Doctors will begin to tell the patient about their own hobbies or interests. Don’t tell the patient more about you, instead you want to listen more to discover things about them. You also want to look for moments of caring where you can reach out and give the patient and family the needed reassurance. Don’t just focus on the symptoms the patient is reporting. Make sure you ask the important questions about how their lifestyle or culture may be contributing to their illness.

These are just a few tips I teach doctors when we talk about bedside manners and how to improve medical outcomes.

Have a kind and respectful day.

Viki Kind interviews Allan Hager, “Right at Home” on Sept. 8th, 9AM pacific on blogtalkradio.com/kindethics

Interview with Allen Hager and Right at Home. Right at Home is a national in home care and assistance agency. They provide trained, insured and bonded caregivers for a variety of elder care services. Whether it’s for extra assistance after a stay in the hospital, an aging parent who needs extra help or companionship to remain in their own home, or as a respite for a husband or wife who cares for an ailing spouse, Right at Home can help with home health care needs.

Right at Home’s home care services cater to a variety of in home care needs ranging from companion services to personal care to light skilled nursing.
Companion & Homemaker Services:

• Caring Companionship
• Medication Reminders
• Meal Preparation
• Shopping & Errand Services
• Light Housekeeping
• Laundry Services
• Bathing Assistance
• Family Respite Care
• Recreational Activities
• Personal Hygiene & Dressing Guidance
• Incoming Mail Organization
• Review with Family
• 24-Hour Emergency Response Personal Care Services:

• Bathing
• Walking Assistance
• Posture Positioning
• Continence Care
• Oral Hygiene
• Special Diet/Meal Preparation
• Eating Assistance
• Toileting Assistance

Right at Home care services are highly personalized and flexible. Right at Home caregivers can provide in home care from a little as a few hours a day to 24 hours a day. Whether it’s for extra assistance after a stay in the hospital, or to provide respite to a caregiving spouse, home care may be the solution for you. They’ll do everything they can to make sure you and your loved one are completely satisfied. Furthermore, they take great pride in making sure they fit the right caregiver with the right client.

No regrets. Spend quality time with loved ones today.

It is important to spend time with our loved ones. It is especially important that we spend time with those who have lost their ability to drive. Tell your loved one that you have saved the afternoon for them and you are willing to drive them where they want to go. We lose so much of our freedom as we get older and more dependent. Instead of you choosing the activity or the restaurant, let them be in charge. So, if they want to go to the local hardware store and wander around like they used to when they were young, go with them. If they like to get out in nature, even if they have physical limitations, find a local park that is disability friendly.

And of course bring your attention. If you are busy on your cell phone or distracted, it won’t count as quality time. We have to stop and truly be present with our loved ones. And that means turning down the technology and turning up our caring attitude.

One thing I regret is that I didn’t take the time to take my dad to the places he wanted to go. I took him where he needed to go like the doctor’s office, but then I would run out of time to do the little extras. I wish he was still here so we could just stop for an ice cream or take a drive around the old neighborhood. The time we spend counts and is remembered forever.

Have a kind and respectful day.

Interview with Cristina Chamberlain, “Assistive Technology for the Deaf and Hearing Impaired” on Sept. 2nd, 3PM pacific

Cristina Chamberlain, “Assistive Technology for the Deaf and Hearing Impaired” on Sept. 2nd, 3PM pacific. blogtalkradio.com/kindethics. Call in with your questions about dealing with a new hearing loss or finding the right technology to help those who are already hearing impaired.

Christina Chamberlain is the Deaf and Hard of Hearing Services Coordinator at the Three Rivers Center for Independent Living. Christina is part of the Assistive Technology Department. The Three Rivers Center is one of many Centers for Independent Living in the US. Their goal is to help people with disabilities live independently in the community setting of their choice by providing consumer controlled supports and services. Their services include Advocacy, Assistive Technology, Waiver programs, Housing, Deaf and Hard of Hearing services, Nursing Home Transition, Peer Support, Skills Training, Personal Assistance and Transitioning. The website is www.trcil.org

Other resources include:

Harris Communications www.harriscomm.com A good starting point for assistive devices for the Deaf/Hard of Hearing.

ASL Expo www.aslexpo.com

http://en.wikipedia.org/wiki/Deaf_culture A good starting point for information on Deaf Culture
Hearing Loss Association of America http://www.hearingloss.org/

http://www.virtualcil.net/cils/ This site will direct people to a Center for Independent Living near them.

The Pennsylvania Initiative for Assistive Technology (PIAT) http://disabilities.temple.edu/programs/assistive/piat/

PIAT Assistive Technology Lending Library http://disabilities.temple.edu/news/newsletterAT/
Pennsylvania Telecommunications Device Distribution Program (TDDP) http://disabilities.temple.edu/programs/assistive/tddp/

Pennsylvania Assistive Technology Foundation (PATF) www.patf.us

Have a kind and respectful day.

Why wouldn’t my doctor or the nurse listen to me?

Dear Viki,

I was having a terrible allergic reaction to a new medicine and the nurse at the doctor’s office wouldn’t take me seriously. My skin was turning red and was burning and my lips were stinging and swelling. It took me days before anybody took me seriously. I called over and over again for three days. And then when I finally talked to the doctor, she said I should keep taking the medicine because it was important for my heart. Eventually I got an appointment with another doctor and when I stopped the new medicine, all the symptoms went away. What could I have done to get their attention?

I am so sorry this happened to you. First thing, if you are having a terrible reaction to a medication, go to the emergency room. Some allergic reactions can become fatal. Regarding your doctor and the nurse, you have a problem. This is an office that isn’t taking your complaints seriously. Either they didn’t believe you or they didn’t realize it was serious. Either way you are in trouble.

Be thankful you have found out now that this doctor isn’t a good fit for you. This doesn’t mean this is a bad doctor, just not the right doctor for you. For some reason, they wouldn’t believe you and you can’t take the chance that this might happen in the future. This could be dangerous to your health.

Even it wasn’t the doctor who made the mistake, the doctor has a nurse working for her that doesn’t respect what the patient says or doesn’t pass on the messages appropriately. You can not take that risk. What if it is truly life threatening the next time? I highly recommend that you take this as a warning and find a different office. Sometimes in life we get the gift of knowledge. Use this experience to protect yourself and get an doctor’s office that will listen to you.

Have a kind and respectful day.

Sign up for free, “Kindness Reminders” – Remember to connect with your loved ones.

The “Kindness Reminder” is a brief weekly email to remind you to connect with your aging parent or other loved ones. The reminder is full of touching and fun ways to reach out and connect.

A colleague said to me, “I love my grandmother but I keep forgetting to call her.  Can you send me an email once a week to remind me to call her and can you include some ideas of things I can do for her?”  When he asked me to create these reminders for him, I realized I have been doing this type of thing all my life. I used to call my brothers and remind them to call our dad. It wasn’t that they didn’t care; it was just that like all of us, we get caught up in our own lives.

People think I am amazing because I remember to call on birthdays or to call in once a week to check on my elders. I am not amazing, I am organized. I pre-book recurring appointments in my calendar so I it sends me reminders to call, write or show I care. Otherwise, it would slip my mind and weeks would go by before I would make the effort.

These email reminders will give you a number of ways to show that you care. I will also give you ideas on how to thank those who are taking care of your loved one when you are either far away or unable to be there. The more you show appreciation for those who take care of your loved one, the better care they will get.

Just sign up in the box in the upper right section of my blog at KindEthics.com. Thanks for helping me make the world a kinder place. Please let others know about this free service.

Have a kind and respectful day.

Nighttime Day Cares for People with Dementia and Alzheimers

In my recent interview with the author of Becoming Dead Right: A hospice volunteer in urban nursing homes, Frances Shani Parker told me about a new concept that is spreading across the nation. Nighttime Day Care Facilities for people with dementia and Alzheimers. Instead of giving the caregiver a break during the workday, the caregiver gets a good night sleep. This is exceptionally helpful because people with dementia tend to be up and night and want to be entertained. No wonder so many caregivers are exhausted if they are up all night taking care of their loved one. Not only is this a great idea for the caregiver, the person with dementia gets the interaction and attention they need. They feel less frustrated, less isolated and more content.

You can start out with one or two times a week and add more as necessary. There will be a period of adjustment but most people really enjoy getting out and spending time at these day or night cares. Frances also said that this can be a good option for people who will eventually need to go to a care facility full time. Going to day or night day care will help the person transition more easily when the time comes.

This is also good for business because now the day care can cater to a whole new group of customers. The night time crowd.

If you would like to listen to the interview about what we can do to improve nursing homes and the recent regulatory changes mandating these changes, click on http://tinyurl.com/lrjj8c. You can listen on line or download it through itunes.

Have a kind and respectful day.

A Good Death – The Patient Gets to Decide

A good death is what the patient tells us it should be. No one can define what would make a good death for another person. We have to ask.

There is a famous bioethics case of a lady who needed to have her leg amputated. She didn’t want to have her leg cut off even though it meant she would die. The doctor argued with her again and again. He would ask, “Don’t you want to be alive to see your grandkids grow up? Don’t you want to spend time with them?” Finally the woman said to the doctor, “I hate my grandkids.” He was shocked. But she went on to explain that the only thing that brought her joy was working in her garden. And if her leg was cut off, then she couldn’t do that anymore. The doctor had thought that what would be valuable for him would be valuable for her. He was mistaken.

We have to ask the patient what they would want and then respect their answers. We have to respect the person. It is their life and their death.

I know it is difficult to accept when people want things we don’t understand. For instance, for some people suffering has meaning. If I understand this, I can understand when the patient doesn’t want to take their pain pills. Or if they want to trade a little bit of pain control for increased consciousness, then I will understand if the patient will only take a little of their pain meds. It is their death. We need to listen to them.

When I work as a hospice volunteer, I have lots of ideas for things people might want to do to create a legacy for their family but that is only if the person wants to. But I don’t assume that what other people want is what I would want. I ask. If someone wants to record their life history on an audio or a video tape, I will help them. Or perhaps they will want to write love letters for their family to open after they are gone. And some people want to write an “ethical will” outlining what values and beliefs they would like to pass on. Or if they would rather avoid thinking about dying, then I honor that. It is their decision to make. They get to choose what makes a good death for them, so I listen.

Have a kind and respectful day.

« Previous Page — Next Page »