Rosemary Rawlins, right, and her mother in “The Bistro.”
For much of the past 13 years, Rosemary Rawlins has found herself thrust into the role of family caregiver in a series of very different scenarios.
First, her husband, Hugh, suffered a severe traumatic brain injury (TBI) after being hit by a car while riding a bike in 2002 and underwent two years of arduous rehabilitation. Then, a year after her husband made a recovery bordering on the miraculous, Rawlins became a caregiver to her parents, as described in her prize-winning story below. And most recently, she helped her husband take care of his father through Parkinson’s disease until he passed away last September, and is preparing to have her mother-in-law move in this spring.
At the age of 4, Halima Amjad was already telling people she wanted to be a doctor. And not just any doctor.
“I used to say that I want to be Mommy and Daddy’s doctor,” says Amjad, MD, MPH, a clinical and research fellow in geriatric medicine at Johns Hopkins University School of Medicine and winner of the 2014-15 John A. Hartford Foundation Story Contest. “I don’t think I actually meant anything by that, but it ultimately ended up coming true that I chose geriatrics as my parents were getting older.”
One of this blog post’s authors, Teresita Hogan, MD, speaks on care transitions during the Geriatric EM Boot Camp in Milwaukee.
Editor’s Note: In our Feb. 19 Health AGEnda post, the team we’re informally calling the Hartford Geri EM Champions shared information about the first two Geriatric Emergency Medicine Boot Camps and a meeting hosted by the John A. Hartford Foundation in late January to discuss new opportunities to improve acute care of older adults. Today, in the second of two parts, our EM experts discuss why our current system is failing older Americans, and share their vision for better emergency department care that can both serve the needs of older adults and contribute to a more efficient and value-based health care system.
The acute care provided to older adults in emergency departments (ED) across the country, and world, is often inadequate and sometimes dangerous.
One of this blog’s authors, Dr. Kevin Biese, right, and Dr. Jan Busby-Whitehead lead a collaborative project at UNC-Chapel Hill to develop a unique model of a geriatric emergency department (ED) focused on improving care transitions.
Editor’s Note: This is the first of two parts.
“Geriatric Emergency Medicine”—As health professionals in Emergency Medicine (EM) who have chosen to focus on the geriatric population, we wish we could claim the topic brings a sense of excitement and opportunity to EM physicians worldwide.
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.
Throughout my career in aging, I have worked for and with community-based agencies. I know how essential these agencies are in helping older people remain well and in their homes by providing and coordinating needed supportive services.
These critical services for older people who have difficulty with daily tasks or younger people with disabilities include home delivered meals, shopping, cooking, bathing, bill paying and/or emotional support, as well as support for their caregivers. In-home assessments determine exactly what is needed for each individual and their family.
The agencies providing these services have always operated on slim budgets funded by federal block grants and philanthropy. Due to funding limits, there are months-long waiting lists for older people who are desperately trying to remain as independent as possible for as long as possible in their own homes.
As Orson Welles might have said: “We will evaluate no program before its time.”
One of the first things you learn in “foundation school” is how easy it is to kill even great programs by evaluating them before they are ready.
Nothing innovative starts working on day one as well as it will with practice, adjustment, and refinement. Even more deadly is an evaluation with low-cost methods that doesn’t really provide the information you want and need. One of the painful lessons I’ve learned is to always buy the highest quality and therefore most expensive evaluation you can afford, because it’s cheaper in the long run.