GlassHospital

Demystifying Medicine One Month at a Time

Tag: aging

A Guide to Caregiving from NPR

How to Age Better: Live somewhere that combats Loneliness, Helplessness, and Boredom

At GlassHospital we strive to bring you interesting ideas about improving health and health care from places far and wide:

An article in the Saskatoon (Saskatchewan) StarPhoenix features Suellen Beatty, CEO of the Sherbrooke Community Centre in Canada.

Sherbrooke is a community centre, but it also is home to more than 250 residents — the kind of place we might call a ‘nursing home’ in the U.S. I love that in Canada they’re called Community Centres. That’s what any facility or neighborhood should strive for.

Suellen Beatty rejects the idea that nursing homes are places where people go to await death. Her team’s philosophy is to make old age more fun. Sherbrooke readily acknowledges the big three elements that compound the infirmities of aging: Loneliness, helplessness, and BOREDOM.

By loading up the day with activities, by listening to their residents and families, and by hosting hundreds of volunteers who see their job as providing fun and emotional sustenance to resident and day-visitor elders, Sherbrooke attracts visitors from all over the world who marvel at its success.

It reminds me a of a piece we ran a few years ago about a pretty special elder care facility in Arizona–one that put its residents’ happiness and comfort above all else — even when it means deviating from ‘standard’ protocols of elder care like eating bland food.

Take a look at what’s going on in Saskatchewan. We can all learn.

Marching for Science

Another piece I recommend: This time from Vox, in their First Person section.

It’s an essay by someone close to me who appreciates the scientific advancements which will help her survive the breast cancer she’s just been diagnosed with.

“It’s their dying; not yours.”

Ever heard of a doula?

Doula is an ancient Greek word that translates as “woman who serves.” Specifically, it’s come to mean someone who serves as a birth attendant, a person trained in childbirth who acts in support of a birthing mother. A doula provides knowledge, comfort, and an extra pair of hands — whether it’s to provide nourishment or massage, or help a mother find a comfortable position.

doula1As you may imagine, the modern “doula movement” started as a reaction to over-medicalization of the birth process in the U.S. Too much hospital, too many medical interventions, too much ‘invasiveness’ of what should be a joyous and miraculous time in a family’s life. The ‘movement’ began in the early 1970s. The interesting thing about doulas is that they have achieved widespread acceptance from the skeptical medical profession — there’s strong science showing that labor attended by doulas results in better outcomes — e.g. less use of epidural anesthesia, fewer c-sections, and improved infant mother bonding (i.e. successful initiation of breastfeeding).

One of my mentors in medical school, Dr. John Kennell, was instrumental in doing the research that showed how doulas make a positive impact.

My wife and I were lucky to have the births of both of our children attended by doulas, one near Boston and one in Chicago. Both doulas even came to our home after birth to check in on us and see what we needed.

Recently I was surprised to see the term doula used in conjunciton with the other end of life — death. A recent piece in the NY Times business section, in the “Shortcuts” column, discussed the emergence of doulas helping those that are dying ease the process.

It’s quite logical, really. Most of us are afraid of death — the article chronicles a few for whom there was little in the way of family or friend support. A person experienced in listening, attending, and just being present is a wonderful gift to anyone, but especially someone who knows they will die soon.

Some of the doulas mentioned in the piece come from the hospice world, others from the birthing side of life who wish to use their skills elsewhere. The article gives details on the financial considerations if one were to hire a doula (it’s in the Business section, after all) — but trust me, no one is profiteering in this type of work. These are folks in it for the meaning.

Doctor Yenta Redux

The following post first appeared in 2010. I’m reprising it because I like it and I’m heading off the grid for a few days.

————————————————-

god-versus-science-time-magazine-coverAs a doctor, I’m trained to do things:

I listen. I ask.

I examine, order, and test.

And then I assess.

I certainly try to treat. All too often, this includes prescribing.

What frequently gets lost in this paradigm is that on many occasions, the listening part is often enough.

Take Gene, for instance. He’s a retired biochemist. When I met him for the first time as a patient, I took a standard social history: I asked about employment, hobbies, and habits.

“I’m emeritus,” he explained, sitting hunched forward in the chair, looking out from Harry Caray spectacles.

“What does that actually mean?” I pushed.

He told me about his walks, his weekly lunches, his mail, his invitations, his memoirs. “Do you still do experiments?” I wondered.

“I dream about them every night,” he replied.

Pause.

His wistful admission pierced me. I felt helpless; there was nothing I could do about his loss. I ruminated on it for some time. Then I had a dream. An epiphany of sorts: Emeritus came to me to mean lonely.

I knew another emeritus: my rabbi. He, too, struggled to find the right balance between activity and restfulness in retirement. Why not bring them together to see what could happen?

Gene: an octogenarian Jew-turned-atheist; scientist; discoverer; and Renaissance man, passionate about music and art.

A.J.: an octogenarian rabblerousing Rabbi; social justice crusader; scholar; also a ‘fiend for culture’ (and his beloved White Sox!).

They were the same age. Of similar backgrounds. Neighbors for thirty years, though they’d never met.

I proposed a series of conversations. Interviews, really, in which I’d ask them about their lives. I wanted to understand their hopes, their dreams, their experiences through the tumult of the twentieth century. Gene was worried the rabbi would try to bring him back into the fold. When I obtained assurances of no proselytizing, the dates were set.

We met for a semester every Thursday on a quiet corner of campus. I brought the questions and the tape recorder. Thursdays with Gene & A.J., we jokingly called it.

I tried to hit the big themes: work, accomplishments; family; their philosophies, politics, faith, and philanthropy.

I’m not sure why I did it. I think I felt each man’s loneliness, and I hoped to lessen it by providing them companionship–with each other, and with me.

I also think I felt my own need for role models of well-lived lives. I hoped to nurture my non-medical self, by tapping into sprightly minds encased in enfeebled bodies and revealing their accrued wisdom.

It worked. A patient came to me with a problem and I did something: I helped him make a new friend.

Doctor Yenta

GlassHospital has been featured in a publication produced down the road at FancyHospital.

I’m delighted to share with you the recently published issue No. 8 of Atrium, available free for download by clicking on the link here.

Many readers know of my ‘wisdom’ project in which I brought together a retired biochemist and a retired rabbi for a year to discuss ‘big issues’ in life from the viewpoint of two eighty year-old wise men.

The essay below was a featured Snapshot, on the theme of “Happy.”

*                    *                    *                    *

As an internist, I’m trained to do things:

I listen.  I ask.

I examine, order, and test.

And then I assess.

I certainly try to treat.  All too often, this includes prescribing.

What frequently gets lost in this paradigm is that on many occasions, the listening part is often enough.

Take Gene, for instance.  He’s a retired biochemist.  When I met him for the first time as a patient, I took a standard social history:  I asked about employment, hobbies, and habits.

“I’m emeritus,” he explained, sitting hunched forward in the chair, looking out from Harry Caray spectacles.

“What does that actually mean?” I pushed.

He told me about his walks, his weekly lunches, his mail, his invitations, his memoirs.  “Do you still do experiments?” I wondered.

“I dream about them every night,” he replied.

Pause.

His wistful admission pierced me.  I felt helpless; there was nothing I could do about his loss.  I ruminated on it for some time. Then I had a dream.  An epiphany of sorts: Emeritus came to me to mean lonely.

I knew another emeritus: my rabbi.  He, too, struggled to find the right balance between activity and restfulness in retirement. Why not bring them together to see what could happen?

Gene: an octogenarian Jew-turned-atheist; scientist; discoverer; and Renaissance man, passionate about music and art.

A.J.: an octogenarian rabblerousing Rabbi; social justice crusader; scholar; also a ‘fiend for culture’ (and his beloved White Sox!).

They were the same age.  Of similar backgrounds.  Neighbors for thirty years, though they’d never met.

I proposed a series of conversations.  Interviews, really, in which I’d ask them about their lives.  I wanted to understand their hopes, their dreams, their experiences through the tumult of the twentieth century. Gene was worried the rabbi would try to bring him back into the fold.  When I obtained assurances of no proselytizing, the dates were set.

We met for a semester every Thursday on a quiet corner of campus.  I brought the questions and the tape recorder.  Thursdays with Gene & A.J., we jokingly called it.

I tried to hit the big themes: work, accomplishments; family; their philosophies, politics, faith, and philanthropy.

I’m not sure why I did it.  I think I felt each man’s loneliness, and I hoped to lessen it by providing them companionship–with each other, and with me.

I also think I felt my own need for role models of well-lived lives. I hoped to nurture my non-medical self, by tapping into sprightly minds encased in enfeebled bodies and revealing their accrued wisdom.

It worked. A patient came to me with a problem and I did something: I helped him make a new friend.

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