The landmark United States Supreme Court decision that same-sex marriage is a fundamental right guaranteed by the Fourteenth Amendment to the U. S. Constitution has important implications regarding the health and care of older Americans.
Studies show that denying same-sex couples the right to marry has a negative impact on their mental health, according to a 2006 report by Herdt & Kertzner. And a growing body of evidence suggests that policies conferring protections to same-sex couples are linked to lower health care and mental health care utilization, as well as to decreased health care spending.
There also are numerous studies confirming the health benefits of marriage for older heterosexual couples. “Married persons, on the whole, tend to have lower rates of fatal and nonfatal diseases, physical functioning problems, and disability compared to all other marital status groups,” reported Amy M. Pienta et al. in Health Consequences of Marriage for the Retirement Years, published in the Journal of Family Issues in 2000.
This week we offer a poignant story of one physician’s struggle to understand what he could do to help his aging and ailing new patient. Written by Dr. Mitch Kaminski, and originally posted on Pulse, a leading narrative medicine website, this true tale makes the point that if we don’t understand a person’s own personal health goal, we are unlikely to achieve it.
We are unlikely to help them.
The John A. Hartford Foundation is deeply committed to aligning care by all health care providers to address the goals of older patients. As people age and become much more medically complex and frail, well-intended treatments may not help with pain or function. The treatment may create new problems and burdens.
For two decades, the John A. Hartford Foundation has invested in the development and spread of the Hospital at Home model of care, which provides safe, high-quality, hospital-level care to older adults with select conditions in the comfort of their own home.
Over those years, studies have consistently shown that the model delivers improved care and outcomes at lower costs. But adoption has been limited, leading us to conclude that Hospital at Home was ahead of its time.
Amy Berman prepares for her image guided radiation therapy.
I live with stage IV cancer—cancer that has spread to the far reaches of my body, an incurable disease, a terminal diagnosis. But if you saw me—if our carts randomly bumped into each other in the supermarket—you would never think I live with serious illness.
And let me add that I feel as well as I look, just great.
Funders share information on investments in palliative care at the recent convening spearheaded by the Hartford Foundation.
Palliative care is an essential component of care for the seriously ill. Yet, the term is often misunderstood by policymakers, the public, health care providers, and, no surprise, even those in philanthropy.
The John A. Hartford Foundation has been a longtime supporter of the spread of high-quality palliative care through its funding of the Center to Advance Palliative Care (CAPC), led by Diane Meier, MD (see Celebrating CAPC and Our 500th Blog Post!). Dr. Meier often refers to palliative care as an “extra layer of support” for the seriously ill and their families.
Jessie Gruman, founding president of the Center for Advancing Health, died on July 14 after a fifth bout with cancer. Jessie was a hero to patients, families, and health care providers for her selfless work to help people better understand their role and responsibilities in supporting their own health.
The latest cohort of fellows in Sigma Theta Tau International’s Geriatric Nursing Leadership Academy pose for a group photo with their leadership mentors, faculty, and representatives of Sigma Theta Tau and the Hartford Foundation.
The Geriatric Nursing Leadership Academy aims to prepare and position geriatric-expert nurses as leaders within the interprofessional health care delivery environment. The fellows I had the honor of meeting expressed an unwavering commitment to developing their influence and impact in hospitals, nursing homes, and home health to benefit vulnerable elders.
Amy Berman speaks at TEDMED’s Great Challenges in Health Care in 2013.
Editor’s Note: In this post, originally published on Health Affairs Blog, Amy Berman shares more of her story as a person living with stage IV cancer who has chosen a palliative care approach.
She contributes regularly to Health AGEnda about her experiences and how they relate to the John A. Hartford Foundation’s support for palliative care for older adults facing serious illness. In March 2014, the Hartford Foundation awarded a new grant to the Center to Advance Palliative Care (CAPC) to build on the successful spread of hospital-based palliative care and move these services into care settings outside the hospital.
Gary Oftedahl, MD, Chief Knowledge Officer for the Institute for Clinical Systems Improvement, speaks at the CaRe Align initiative launch in Dallas.
Older adults who typically live with many chronic conditions see, on average, two primary care providers and five specialists per year in four different medical practices. Such fragmentation and logistical complexities are problematic for providers and patients.
For a hypothetical primary care practice consisting of 30 percent Medicare patients, each of whom has four or more chronic conditions, the physician must coordinate with 86 other providers in 36 practices over a year’s time.
Adult children and spouses are the primary caregivers of our nation’s older adults. They provide critically important assistance that helps frail elders remain at home, from meal preparation to such complex medical/nursing tasks as medication management, wound care, and care coordination.