While diligently trying to improve care for frail elders, often by filling gaps in the care system, even our most innovative programs tend to work within the constraints that created those gaps in the first place. Dr. Joanne Lynn, Director of the Center for Elder Care and Advanced Illness (CECAI), has been visiting and often […]
Posted on behalf of Dr. Joanne Lynn Patients and policy makers must require that clinicians communicate effectively with patients and families, not only to plan for death but also to develop a care plan that guides healthcare services through to end of life. Discussing clinical circumstances and their probable course, understanding the patient’s goals and […]
Family caregivers are the infrastructure upon which the lives and well-being of millions of frail elders rest. Without their presence, and without their filling in healthcare gaps to coordinate and manage care for their loved ones, whole segments of the healthcare industry would simply collapse. Although caregivers can find the experience of helping others to be […]
Despite surveys that indicate our overwhelming preference to grow old and die in our own home, those among us who grow old and frail are more likely to live in many different settings. The likelihood that we will face old age encumbered by multiple complex health conditions makes it very likely that we will, at […]
The worlds of frailty, caregiving, and geriatrics tend to be a women’s world—men grow old, but women grow even older. Although more men are now acting as family caregivers, the high-touch, hands-on work continues to land mostly on women. The eldercare workforce teams with women, from direct care workers to geriatricians. For all that we […]
The MediCaring team of healthcare providers must reflect and address the array of medical and social services frail elders need. However one labels the team– multidisciplinary, interdisciplinary or trans-disciplinary—its key focus must be to deliver an integrative approach based on a care plan developed in collaboration and with the elder and her family. Such a […]
As millions of Americans reach old age, millions will experience the frailty that accompanies that time phase of life. And that price, really, can be a sticker shock when writ large over the lives of millions. People over the age of 65 account for a fair amount of the nation’s healthcare costs. For example, 13% […]
Health planning has been a long-running theme in American health policy, dating back to the 1940s. Seen by its advocates as a movement, such planning aimed to make widely available coordinated health facilities and services, especially hospitals. It also aimed to foster the orderly and efficient development of hospitals in order to meet each community’s […]
In 1980, American business discovered W. Edwards Deming and his quality improvement work in the Japanese automotive industry. In fact, that work helped to launch the application of Total Quality Management (TQM) strategies in the American healthcare system.In his final book, The New Economics, Deming outlined a way of seeing, a lens for looking at […]
Medicare coverage for services shortly after hospitalization includes a great deal of waste, low-value care, and services that stretch Medicare coverage rules. If reforms save a great deal of money in “post-acute” care, where should those savings go? A recent Institute of Medicine (IOM) report showed tremendous variation in “post-acute” care, and the U.S. Department […]