If you follow our blog, you know that the John A. Hartford Foundation is now spending our time and money putting geriatrics research and knowledge into practice to change health care delivery for older adults. We are able to do this because for decades we’ve funded outstanding scientific investigators in the aging field through scholars and fellows programs, most of which continue today.
Scholars who attended the recent Dennis W. Jahnigen Career Development Award and T. Franklin Williams Scholars retreat or the Paul Beeson Scholars annual convening, had the privilege of hearing Dr. Stephanie Studenski, a renowned geriatrics researcher, deliver a powerful presentation about the need for senior academic leaders to make room for the next generation. Stephanie—a professor of medicine and director of research at the University of Pittsburgh’s Division of Geriatric Medicine and program director of the Pittsburgh Pepper Center—has an inspiring message and one that is not typically shared.
Dr. Wes Ely tests a patient for ICU delirium. Click on the photo to listen to or read a Nashville NPR report on Dr. Ely’s study on ICUs and delirium.
Going to the hospital can be scary, especially if it’s for a critical illness. Unfortunately, it turns out we have even more to be worried about — long-term cognitive problems.
An important study was published earlier this month showing that going to the intensive care unit ICU) can do new and lasting damage to the brain. And delirium, a potentially preventable state of confusion that too often occurs in the hospital, plays a major role in having worse outcomes.
Two years ago, I wrote a blog titled Confused About Post-Operative Confusion about my father’s experience with post-op delirium after he had triple bypass surgery. It obviously struck a chord with many.
Even now, it consistently remains one of the most-visited pages on our website, and has drawn 26 comments from people who are caregivers themselves and whose relatives experienced symptoms of delirium similar to my father. And more comments continue to be posted even after two years. Usually our blogs receive comments from grantees/policy people, professionals, etc. It is less common that our blogs reach caregivers.
What we’ve discovered is that there are many caregivers and others faced with similar circumstances who are hungry for information on post-op delirium and are finding my blog post through various internet search engines.
Dr. William Dale, author of “Geriatrics Saved His Life!” The story took top prize in this year’s John A. Hartford Foundation Heroes of Geriatric Care Story Contest.
Too often when older adults enter the health care system, we hear stories about them not receiving recommended care, such as medications reviews, fall prevention assessments, and depression screenings. Older adults also experience too many adverse events in the hospital, poor handoffs between care settings, and preventable hospital readmissions.
And too many times, they enter this system lacking the advocates who can expertly provide or coordinate their often complex care.
David Solomon, MD, was a pioneer of geriatric medicine.
Last week, the world lost one of the giants of American medicine and a founder of modern geriatrics, Dr. David Solomon, who passed away on July 9 at the age of 90.
“Lost,” however, is not really the right word. While I never had the honor of meeting Dr. Solomon, I can say with certainty that his legacy lives on through the people he mentored, the field he helped build, and the vision of care for older adults that continues to guide much of what we and our grantees do.
Arthur, with his beloved Yorkshire Terrier Charlie, from the story “Man’s Best Friend.”
The John A. Hartford Foundation is pleased to announce the winners of its first annual Heroes of Geriatric Care story contest. Back at the end of January, we started publicizing the contest particularly seeking “stories that convey how a person with geriatric expertise (in any profession and discipline) can save the day when those without couldn’t get the job done; where special knowledge and hard-won skill in geriatric training programs make a difference in peoples’ lives.”
As a communications vehicle, stories are powerful, able to convey a great deal of complex information in a compact, engaging form. We need good stories to engage others in why they should care about our common work in geriatrics, and invite them to join us. We need stories to provide an emotional complement to the incisive logical arguments on behalf of the field and our programs. And our own stories can also teach us about ourselves, can reveal how we and others perceive this work.
A number of articles and posts this week have called out the dangers that medications can pose for older adults. This is a topic near and dear to our hearts, and one we have frequently covered on Health AGEnda.
Unfortunately, far too many potentially dangerous drugs are still being prescribed to older people. Even more unfortunately, not giving drugs that are known to cause harm is the easy problem. What’s much more difficult is understanding and dealing with the complexity involved in medication management for elders.
This complexity can arise from a particularly difficult single condition such as Parkinson’s disease or from the often tangled knot of social, financial, and functional barriers that can make a medication regimen totally unmanageable for an older patient. Often, the complexity comes from the numerous medications taken for different, overlapping chronic conditions that create tough treatment trade-off decisions.
This past weekend I sat with some of the top leaders in geriatrics and heard them rail against usual care for older adults by specialists and non-geriatrically trained generalists. They complained bitterly about oncologists who wildly overtreat the frail and yet undertreat the vigorous, cardiac procedures done without patient benefit, and silo mentalities that predictably put complexly ill people on trajectories of misadventure, hospital readmission, and decline.
However, in public, I know that most professionals will not break the white-coat wall of silence and denounce their colleagues for inappropriate care. And so, the fact that non-geriatrically informed care doesn’t have to be our usual care escapes most people. Unless you’ve been very lucky and seen someone receive geriatrically skilled, compassionate, and patient-centered care, you don’t know what you’re missing. And it is very hard to create demand for things that no one knows.
As I thought about this problem, I realized that I had also heard many of those same railing voices talk about how to deliver good care to older adults—not in a conference room or a big meeting, but all by myself while running on the treadmill at my local Y. Not an hypoxia-induced hallucination, but really real.
Chris Langston, right, with his younger sister Anne, mother Adair, and grandmother Nancy Imber, circa late 1970s. Did someone with geriatric expertise make a difference in your family’s life?
There are just four more weeks left in the John A. Hartford Foundation’s new Heroes of Geriatric Care story contest (due April 15—like taxes). We’ve received a few submissions (and a lot of questions), but we want more.
Part of the reason for having the contest is that we want to discover the variety of ideas and experiences out in the world without unduly influencing anyone’s thinking. Nevertheless at this point, I thought it might be helpful to give a few examples of geriatrics hero stories.
March 2nd marked what would have been Dr. Seuss’ 109th birthday (Theodor Seuss Geisel, Born: 1904, Died: 1991). I have always been a big Seuss fan, but even more so after my 7-year-old son recently checked out Dr. Seuss’ You’re Only Old Once! A Book for Obsolete Children from his school library. (“Because you like old people, Mom.”)
It is a fantastic patient-centered read and a hilariously sad reflection of our health care system.
“This small white pill is what I munch At breakfast and right after lunch. I take the pill that’s Kelly green Before each meal and in between.