Getting the Best Care

getting best careMargaret Fitzpatrick’s book Getting the Best Care: Rescue your loved one from the healthcare conveyor belt is a must read for every adult. Fitzpatrick is a nurse who’s written a great guide for everyone who need to get clarity on options for patients who’re at the end of life. The book contains lots of facts and options with examples of actual stories of people at the end of their lives.

As we age, particularly after age 65 every time we go to the hospital we’re likely to come out diminished. Hospital visits are particularly confusing and troubling as the average person doesn’t know what questions to ask or how to realistically evaluate the outcomes of various treatments. Fitzpatrick shows us how to talk about healthcare with older relatives and with healthcare workers. There are two different worlds, the hospital world and the world we live in, and there needs to be an adjustment in our view of what to ask and how to communicate so that older relatives and eventually ourselves have conversations that honor our wishes and don’t result in a lot of tests and treatments that do more harm than good.

Much of the book covers Fitzpatrick’s mother’s desire to never go into the hsopital. The mother of 9, who died after her  99th birthday, Fitzpatrick’s mother Alma. Alma never wanted to be hospitalized as she got older. As Fitzpatrick shows, that’s not a bad outlook as most of the elderly diminish in mental acuity and physical health with each hospitalization. While Alma did go to the hospital for a broken hip, because her daughter and other children understood Alma’s beliefs on autonomy and quality of life they were able to minimize the time spent in the hospital and able to see that she died as she wished, at home, in peace surrounded by loved ones after a rich life. In addition, Fitzpatrick uses stories of her patients, her brother and ex husband to provide context to how hospitalization effects older patients and how family or advocates can get better communicate to get the right kind of care and to manage expectations.

In a hospital patients are likely to be cared for by dozens of professionals and are often given several tests even when they have a diagnosis for a condition that has no cure anyway. Fitzpatrick’s book gave me the right way to ask the right questions. She also showed me that I should ask what the likely outcome can be, if there’s no cure or the treatment will cause more harm than good.

Chapters cover individual healthcare goals, codes in hospitals, setting realistic healthcare goals, testing, asking the right questions, advocating for loved ones with dementia, palliative care and hospice, nursing homes, and more. The book does not advocate against all hospitalization or to just cut grandma off from medical help, it just shows readers what they can do to better insure that loved one’s care is what they really want.

 

Madadayo

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Madadayo (1993) is the story of a high school German teacher in Japan in retirement and his devoted former students, who visit him, celebrate his birthday every year and who come to his aid when he’s in need is a slice of life film.

Unfortunately, the film dragged and got to sentimental for my taste. Lasting over 2 hours the film seemed much longer. I enjoyed seeing how devoted the former students were to their teacher and to each other, but that was the only good thing. The birthday parties and drinking parties got repetitive.

I suppose the climax of the film, which was written by Akira Kurosawa, was when the teacher and his wife lose their beloved stray cat, Nora. The students, now business men, do everything they can to find the cat as its loss has traumatized the teacher so much that he doesn’t bathe or eat. For a man who was supposed to be so philosophical and wise, I’d expect him to take a bath during the months the cat was gone.

There are better Japanese films. Watch something else.

More on Healthcare

I’ve just learned that when you enter the hospital, at least in Illinois, one of the forms you receive is for when you feel you’re being released too soon. You must fill this out before you get released. Then you have a chance at staying.

As I wrote, my aunt was released last Saturday and went to a poor-quality rehab center. On Monday she was readmitted to the hospital with a cracked rib. None of us know the story on that. Then we heard that she’d have a procedure done for her back on Tuesday. I went to the hospital Monday and she wasn’t in her room. She was getting the procedure done. That was rather worrying because:

  1. No one explained to the family what the procedure was or
  2. Why it was being done so fast

I was willing to wait, but if it was going to be hours, I’d come back later. Because of HIPPA, the US rules on privacy, the nurse couldn’t tell me when the procedure began or estimate how long it would take. She couldn’t answer specific questions, which was frustrating and no doubt an unintended consequence of a policy. Finally, I found she could answer, “If you were me, would you wait here?” She said no. Since my aunt was fine when I saw her yesterday, I’m satisfied. However, I also realize from talking to friends whose near and dear ones have been hospitalized, that the doctors and nurses are okay with people not visiting. The fewer witnesses the better? For them, that is.

She had a treatment where they drill holes in your back and insert a substance “like cement” to decompress the vertebrae. She said she felt better and the doctor said she wouldn’t call it surgery, as it’s not that bad. Still I’m shocked that they wanted to release my aunt yesterday, less than 24 hours after getting her back drilled into. What is wrong with American health professionals? Luckily, the new rehab center couldn’t take her till today. I just learned about this form so perhaps she can stay longer.

I really have decided I’d rather take my chances with the healthcare overseas. Not somewhere where they steal your organs of course, but somewhere where they don’t kick you out of the hospital so fast because, they want better productivity. (They can’t make money from people who’re just resting and not getting lots of tests and procedures.)