Got a new TV! After my hospice preceptorship ended early on Wednesday, I stopped by Douglass Loop to see if the new noodle place, The Pink Door, was open for lunch (it wasn't, so I went to Lemongrass instead). I wandered into a consignment shop nearby and found a 27" TV for $69. We've been sort of looking for a new TV for a while -- all we have are two 20" ones left over from college, but we definitely can't afford a brand new TV -- the LCDs and plasmas are obviously too expensive, and it doesn't seem like a good idea to sink $200-300 into a tube TV, even if it has a nice flat screen, when it's just dead technology. So we picked up the thrift store TV yesterday and it looks great in our new living room.
New living room? That's right, we rearranged on Thursday night. The couch used to face the bedroom, away from the kitchen, and that was good for watching TV, but guests never sat on it because they were blocked off from the rest of the goings-on. Now the couch faces the window, so people sitting there can be open to the kitchen if they want. We moved the wardrobe into the office (it was just a storage closet anyway) and now there's enough room in the living room for the Poang chair again, too. I really like the new setup.
And I really liked hospice, too. I went around with a CNA, which is one of the lowest health-care positions you can have, but arguably one of the most important, as well. Someone has to wipe dirty butts and give people baths, after all. Anyway, we made two home visits and I got to meet some very nice families and see what hospice is all about. I like the hospice philosophy and hope I get to work with hospice in some capacity during my career. Or, if I can't be blessed with dying a quick, tragic death at the age of 80, I'll definitely participate in hospice as a 99-year-old instead.
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I realized I never wrote about our second Broadway show, Dirty Rotten Scoundrels, which we saw at the beginning of November. It was a lot of fun -- I've never seen the movie before, so I wasn't familiar with the plot, so it was a real treat. The guy who played Freddy was probably the best, I thought, and I really liked the score, especially "Great Big Stuff" and "All About Ruprecht." The craziest part of the show were the lyrics -- really tawdry, base, tasteless stuff, like "fresh-shaved testicles on Christmas Day." Also a couple nice political sneers, including, "The Bushes of Tex/were nervous wrecks/because their son was dim./But look what happened to him." Go see it if you can. Up next: 12 Angry Men in January.
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I don't remember what I was listening to - TV or NPR - but they were promo-ing a program on how medical science hasn't kept up with quality of life issues - that we are allowing people to live longer but don't know what to do with the very old who suffer from lingering chronic, but non-fatal conditions. I didn't hear or see the actual program, but it got me thinking.
It's very true. Prior to the age of modern medicine, people died quickly and unexpectedly, mostly of infectious disease. Medicine focused on caring and comfort and most healthcare occurred at home. In North America, we developed an attitude that death was something to be fought against. We value youth and independence and don't value family or interdependent caring. We fight aggressively against illness and death and try to prolong life at all costs. We see death as the enemy and feel we've failed if we can't cure. In this transition, we moved birth and death to hospitals, where families weren't allowed to stay for long periods of time and health professionals took over for their care. The result is that today, we actually don't cure people of too many diseases. Instead, people live longer with chronic diseases and stave off death. In fact, less than 10% of people die a sudden, quick death, from something like a fatal heart attack or car accident. More than 90% of people have protracted, life-threatening illnesses, characterized either by a slow, steady decline with a short "terminal phase," like cancer, or by a slow decline punctuated by periodic crises, such as with congestive heart failure, emphysema, or Alzheimer's. Even hospice is seen as "giving up," something to turn to when there's no hope left for a cure, when in fact death is a very natural process and there's no reason it should be seen as giving up.
All of that, except the first sentence, is from our hospice lecture. People can be treated and live for a very long time but it doesn't mean there's any good care being provided. Best case scenario is you get to stay home with your family; worst-case scenario is you get dumped in a nursing home and hope people come to visit you during "visiting hours." Pretty depressing.
No kidding. This is the main point of discussion with many of the seniors I talk to every day too. They want a quality option for staying at home and receiving quality care. We're trying to make some changes in PA, but its obviously very slow at best.
Brian J
I highly recommend hospice. They have an interdisciplinary philosophy, so you're visited by a CNA, RN, MD, and chaplain at regular intervals, and other team members also as needed. If your family can stay with you at home, then you can live at home. If your caretaker has a personal crisis (needs to go to the hospital him/herself, for instance), then they can move you into the hospice in-patient facility on a temporary basis until your home situation becomes stable again. I think some hospice patients can utilize hospice in nursing homes, too, depending on the nursing home -- you may be treated by visiting hospice healthcare providers or the nursing home may subscribe to the hospice philosophy. (Also, not all hospice patients are elderly; there's pediatric hospice (sad) and any other terminally ill patients can be in hospice also.)
I definitely recommend that you call your local hospice and see if you can shadow for a day. I'm sure they'd love to have you, since you work on senior healthcare issues. That might help you identify some of the problems non-hospice patients face and how they might be addressed. Plus it's fun to go around visiting people.
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