What It Is:
A book looking at the healthcare we providing the aging in the United States. The book specifically explores care given in hospitals, nursing homes, and by hospice.
What Struck me:
I thought it was a breath of fresh air to hear a physician discuss the challenges of navigating the medical system. As he and his mother (both medical doctors) try to help with his father's illness (also a medical doctor), I started to get a sense of the disconnect between the hopes and actualities of medicine. Discussing potential benefits while clearly outlining the likely outcomes, sacrifices, and quality of life are a weak point for the U.S. healthcare along the entire continuum.
What I learned:
I loved hearing about alternative types of nursing homes and people organizing to manage their own home health needs with their community. He also eloquently discussed three types of doctors (and his failure to be the one he wanted on occasion). After Chapter 7, I felt like I fully understood the paternalistic, informative, and interpretive doctor.
Nursing Relevant - This shed a lot of light on why I have disliked some of my past doctors. These ideas are also very relevant to me as a nurse, because I can anticipate my patient's needs better if I recognize the type of doctor I am working with.
When I came to Thailand, I thought that the extending families living together and hospital care provided by family members was a cultural choice - and it very well may be. However, it was interesting how the author discussed how the typical trajectory of healthcare as nations gain wealth is: people die at home, people die in the hospital, and then people die at home again.
Why Read it?
The likelihood that most of us will die suddenly or quickly becomes more remote with every new medical advance. This book will help any reader start to understand what type of life we are willing to have and what disabilities we can live with in our twilight years.
The book also helps us understand how to talk to our loved ones about the same issues before it is too late. We do not all have dies with a tube down our throat and nurse like me pushing on the chest hard enough to break ribs.
"One has to decide whether one’s fears or one’s hopes are what should matter most" (p232, loc3290).
"But whatever we can offer, our interventions, and the risks and sacrifices they entail, are justified only if they serve the larger aims of a person’s life. When we forget that, the suffering we inflict can be barbaric. When we remember it the good we do can be breathtaking" (p260, loc3689).