Shelfari: Book reviews on your book blog

A Readmission to the Hospital for My Aging Father

The Hospitalist System Redux

A recent article in The New York Times praising the advent of hospital doctors known as “hospitalists” has stirred a small controversy among readers of The Times New Old Age blog.   Many, but not all, of the medical people who weighed in point out the many potential advantages of the system.  One advantage is that there is an actual doctor in the hospital available to respond to patient emergencies.  (This is apparently not true in all hospitals, however, as one commenter from Venice, FL. attests.  Check to see if your hospitalist is an MD or a Physician Assistant.)

There are other theoretical advantages outlined in The Times report.  One of the important ones is the idea that hospitalist doctors reduce the incidence of expensive hospital readmissions.  The Times tells us that avoidable readmissions …

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A Desperate Caregiving Moment

The New York Times recently published an article extolling the virtues of a new kind of medical specialty, the hospitalist.  This “new breed” of doctors works exclusively in hospitals with hospitalized patients.  The hospitalists with whom I have had contact are members of a group practice that contracts with the hospital to provide medical coverage throughout the facility.

One supposed advantage of this system is ease of oversight of all the patient population freeing up primary care physicians to focus on their outpatient practice so that they are not inefficiently dividing their time between hospital and clinic.  In theory, hospital doctors are more available to patients than their primary care doctor might be.  Studies show that under this system hospital stays are reduced by 17 to 30 percent and medical costs by 13 to 20 …

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Who’s in Charge? Caregiver? Aging Patient? Physician? Nursing Staff? Aunt Sally?

I have some experience with caregiving done badly and the emotional fallout for survivors.  In my view, a huge problem for caregivers of elderly parents and other ill family members is a fragmented patient care system that has no one tracking the patient’s condition on a regular basis.  In my father’s case there seemed to be little communication between specialists and none with me.  There was no formal rehabilitation plan and little apparent concern for my father’s future welfare.

My sense is that he was seen as old, dying, and thus of little concern.  I did not see him that way at  all as he led a rich life until the heart attack, and I wanted him to resume that life as much as possible.  What I did not do was take charge of …

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Trying to Take Care of The Elderly Without Really Knowing How

I’ve been reading novelist Sue Miller’s memoir of her father’s decline and death (The Story of My Father: A Memoir,Alfred A. Knopf, 2003).  After her mother’s sudden death, she and her father saw a lot of each other.  She writes of a dawning realization that something odd is going on with him.  He is different:  sadder, untidy, forgetful.

She knows something is wrong.  But what?   He is not responsive to her questions about his health and wellbeing.  Is it because he can’t talk to her or is it because he won’t?  Is he too proud or simply confused?

I am completely familiar with that feeling of bafflement.  Can’t he or won’t he?  We often ask ourselves this question about Frank.  Why doesn’t he shave every day as he used to do?  Why doesn’t he clip …

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