Category Archives: Opinion

Elder-Care Crisis: Early Screening For Dementia, Increased Preventative Primary-Care Are Needed

From a Wall Street Journal Opinion article (Feb 10, 2020):

How to address the elder-care crisis? Ideally, doctors would screen older patients for dementia. An early diagnosis helps patients understand treatment options, plan for the future and receive appropriate care in the hospital. 

Costs of Long-Term Elderly Care Kaiser Infographic

Other steps include: more preventive care, changes to Medicare’s rehabilitation policies, adopting new reimbursement methods, and developing new measures of success. Primary-care offices can prevent hospital visits, but Americans seeking primary care face an average wait time of 24 days. This might not be a problem for a patient in need of an annual physical, but conditions like chest pain or infections require prompt treatment. Primary-care offices that offer same-day sick visits, home visits for bed-bound older adults, or at-home monitoring of conditions could reduce emergency department volumes.

Read full article by Elizabeth Goldberg MD

Healthcare System: “There’s No Dignity In Hospital Gowns” (BMJ)

From a The BMJ Views and Reviews article by David Oliver (February 5, 2020):

David Oliver There's No Dignity in Hospital Gowns The BMJ February 5 2020Last year the Lancet published a paper on the impact of wearing gowns, surveying 928 adult patients and carrying out structured interviews with 10 patients. Over half (58%) reported wearing the gown despite feeling uncertain that it was a medical necessity. Gown design was considered inadequate, with 61% reporting that they struggled to put it on or required assistance and 67% reporting that it didn’t fit. Most worryingly, 72% felt exposed, 60% felt self-conscious, and 57% felt uncomfortable wearing the gown.

I’ve often wondered why on earth we routinely put so many patients into hospital gowns within minutes of their arrival at hospital.

Sometimes referred to as “dignity gowns,” such dignity as they afford is only in comparison to being stark naked. They don’t come in a wide range of sizes or lengths, and they’re open along the back. You tend to get what you’re given and make do. The effect is to leave patients with lots of exposed flesh, with underwear or buttocks intermittently displayed and a feeling of extreme vulnerability, not to mention being cold if they have no other layers to wear.

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