Sunday, January 30, 2011

Extra Credit

Contact: Lucille E. Bruto Tel: 212-875-8958 Coordinator of DOROT

I live in a building that is classified as a Naturally Occurring Retirement Community or a NORC by the New York City Department of Aging. This title allows the building to receive money from the city to finance programs and other events for the elderly. A NORC is a community or neighborhood where residents remain for years and age as neighbors. In my building they have banded together and developed services to aid those needing assistance; thereby, retaining the highest quality of life for all residents as they age. The community offers services and amenities to serve their residents such as social and recreational programs, continuing education programs, information and counseling, outside maintenance and referral services, emergency and preventive health care programs, meal programs, transportation on a schedule, and many more. These programs are run by an organization called DOROT. DOROT sends volunteers and social workers to work and plan events for the elderly. It was an outreach program in my building that contacted DOROT to help our building in 1996.

A wonderful woman named Florence, whom I have known for most of my life, is elderly and suffers from terrible hip problems and arthritis in multiple places. She can barely walk now and is bound to a wheel chair. I have been raised to always lend a helping hand and my family has reached out to Florence ever since I can remember. I have fixed her computer more times than I can count, gotten her groceries and talked to her often. Over the past six days, I visited Florence frequently to keep her company and help her in her home. I was able to assist her a great deal. My first task was to organize and clean her kitchen. Florence has always loved to cook so she has numerous pots, pans, bowls and every kitchen appliance you can imagine but over the past three years she has not been able to bend and reach or put back any of them neatly. I cleaned her entire kitchen out and organized he shelves so they look as beautiful as she remembered. I also helped her go grocery shopping and got her the newspaper every morning. I took walks with her in the snow to make sure she stayed safe and moved furniture around her house. Sometimes we just sat and talked. On very damp days her legs are always in extreme pain and it is difficult for her to move around much. The best medicine for her is laughter and that’s what I was able to provide.

The twelve hours of community service was nothing compared to seeing how happy it made her feel to have me regularly visit her. When I think of a dominant social practice that an old person faces, the first thought in my mind is someone locked in their house not talking to anyone. Florence defies that social practice; even in her pain she packs a lunch and brings it to the community room to eat with a group of her neighbors on days when the weather is better and she can manage they go outside. She does not want to live isolated in her apartment; she wants to be free like she was when she was younger. I see no social practices that would ever undermine her chance of living a well life.

Tuesday, January 25, 2011

Hw 33

\Max-
I agree 100% with you that dying alone is the most nightmarish practices around illness and dying. To accept death is hard enough but to do it alone is something i wish upon no man. I liked that you asked your reader to imagine what you would feel like if this happened to you. "Just imagine literally being the most scared you have been ever and not having anyone around you to assure you that things will be okay and that they are there for you." It gave me a real connection to what your were talking about.
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Javon-
It is hard to think about one day ending up in a hospital very ill but to prevent ending up there sooner we have to think about what we do to our bodies now. You made an excellent point at the beginning of your post, "Aren't hospitals there for us(patients) to be aided? I understand that not everyone can be saved and that every doctor is not a good doctor but shouldn't the hospital be somewhere we feel safe?" I agree with you but i was not surprised about the fact that"More people die in hospitals today then anywhere else." When ever a person gets sick they go to the hospital and before most people die the are sick so they go to the hospital. The hospital can save people but when people rush to the hospital before their death doctors can't do anything to save their life.
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Younger Person-
He made a mistake and commented on my comment of Javons post.

I agree with the point that Javon made when he essentially said that some people are beyond help but that doesn't mean that we can't help them emotionally.
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Older Person-
The quote I appreciated was "Even when you have health insurance it doesn't cover everything." The reason I liked it was because most teens and young adults are not aware of this fact.

This unit was extremely insightful for Evan. He was aware that problems existed with health care in the US but he did not exactly know the issues. He was totally impressed with the issues of cost and how doctors treat their patients when it comes to end of life decisions.

Friday, January 21, 2011

Hw 32

During this unit I learned incredible nightmarish aspects about the social practices of illness & dying. Before this unit I didn’t know much about health care coverage and how fortunate I was to have it. The health care system in this country does not exist to help the people; it exists to make money off the one thing that happens to all people, getting sick. Even when you have health insurance it doesn’t cover everything. After talking and watching movies on health care I’m scared about my future in the health care world. I ask such questions as will it get harder to get health care, will I be able to afford it for my family? I don’t want to be left in the dust like so many other Americas who don’t have health care coverage in the United States.

After watching Near-Death, I was nervous about going to hospitals because of its portrayal of doctors. In Near-Death we saw doctors provide false hope for patients, not ask patients how they want to die and talk to family members behind patients’ backs. I don’t want to be left out of discussions about my own sickness. In order to try to disprove the nightmarish dominant social practices I saw in Near-Death I chose to interview a doctor I knew. She spoke about all the good hospitals do for their patients and contradicted the social practices seen in the film. She also shared how our government is trying to make hospitals better.

This unit has opened my eyes and taught me valuable lessons about the health care industry.  I will be better prepared as an adult knowing the choices I will have to make.

Wednesday, January 19, 2011

Hw 31

Max-
I enjoyed hearing that your cousin will be alive for 10 more years. I thought it was great that you were able to tell him that he would have more time on earth then he thought. I expected AIDs to be a much shorter death. But a disease that gives 25 years to live is one of the best to get because thats a quarter of a life time, you can do a lot in that time. You need to proof read your work and fix spell mistakes but over all it was a good project.
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Alex-
Your project feel right in to your lap but not in the way you wanted. I know how hard it is to see some one commit suicide and how it makes you think about life and the world but i have never thought about the aspect of the mind dying and the body wanting to live. "How can the mental part of you want to die but the physical part of you want to keep going? I know that the girls body wanted to live because she was still breathing after she was hit by the train." I thought this was a very interesting insight. It shows me that you took time to think about this girls death and the time you spent looking at her.
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Susan Gordon-
The best part of the blog was Dr. Burn's interview. The points that were interesting were that she does not give false hope to patients but rather emphasizes being positive. I also found it fascinating that many end of life patients are not mentally alert and that when she finds a patient depressed she makes the appropriate referral. Additionally, I appreciated Evan's comment about the patient having full control over their end of life decision.

I think this blog is well-developed and clearly points out and summarizes the differences between the movie and and what actually takes place in a hospital setting.
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Matt B-
Facing death is my greatest fear so i know where your coming from. It is that impossible journey to understand death. You fell you should understand it hearing about it and seeing it but you never do until you experience it at least thats what I've herd. Your speech in class made me want to read your blog post because it was powerful and mysterious. I liked the line,"It happens whether your ready or not. A long life is not promised." because its as true as can be and your promised nothing in this word.
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Nick-
I think that Dr. Burn answered every question in an extremely honest manner. I know that to me taking about death is much more awkward and weird. I can only assume that this is easy for her because she has seen death so many times. But that raised a question for me, When does death stop being important?
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Christain-
After hearing your speech in class i was very interested in your point of view on illness and dying. When you stated, "So what would a person with a terminal illness fulfill their neediness with? The care from others? Love and support from family and friends? How much more different is that from a person who doesn't suffer from an illness?" I really liked that you made this point because I to think about how a persons desires change when there faced with terminal illness. I would like to know how my desires would changed faced with death. But I dont want to die any time soon. Everyone I have talked to says life does not feel as strong till your dying.

Sunday, January 16, 2011

Hw 30

To find out if what we learned about the dominant social practices around illness & dying in a hospital were true I interviewed a doctor about how they feel and handle illness & death in their hospital. In class, we saw Near-Death a documentary about how doctors handle death with their patients. From the movie we found that doctors provide false hope for patients, don’t ask them how they want to die, talk to family members behind their backs and have important meetings about patients in the open. I decided to see if doctors really do these things so I interviewed a close friend of mine, Patricia Burns, an Assistant Attending Assistant Professor at Weill Cornell Hospital, about how she handles illness & death in her hospital.


Patricia Burns
Assistant Attending Assistant Professor at Weill Cornell Hospital


Q: Do you see illness and death at your job?

A: I see illness everyday but not much death in my field of work.

Q: If a patient of yours dies in the hospital how do you handle it?

A: First, I help the person’s family handle the immediate issue of death. Then I try to find out their religious beliefs so I know how to act next. I then give them space so they are able to let their emotions out but if they can’t accept what just happened. I try to introduce them to the idea that death is one stage in life everyone goes through.

Q: Now, personally, how do you handle the death of a patient?

A: I have different relationships with different patients. I feel closer to some patients than others; it also matters how long I have had the patient under my care. I feel it’s alright for doctors to feel sad about a patients death but I also feel it’s important that a doctor’s sadness doesn’t get in the way of their job. I can share my feelings and talk with my family. In the moment, it’s an opportunity that belongs to the patient's family. I may shed a tear but I don’t want to impose on people’s feelings.

Q: How is how you handle death different from your co-workers?

A: It affects each person differently. Ssome people choose to feel nothing and other people make it part of their life. I work in the woman’s imaging field at the hospital and I do procedures on women who might have or have had breast cancer. Nurses that have had breast cancer before sometimes have a hard time not telling their story to every patient that walks in. I think it’s bad for nurses to tell stories about when they were sick because it’s not their time to be heard it’s the patient’s time to act and let their feeling out. I also think this affects nurses abilities to do their job well because they want to talk about what happen to them instead of listening to the patient. 

Q: Do you lie to your patients?

A: No, I don’t ever lie to my patients. Sometimes I have them focus on positive things before a biopsy comes back because I might have a good idea of what the outcome will be and if I feel they may not be mentally ready for the truth. I tell them we are taking one step at a time and if there is an issue you and your doctor will talk about it. A lot of times its better to give a person a week to think of what could happen and maybe be a little more open that the test results could come back positive.

Q: When a patient is on their deathbed do you ever refrain from telling them the whole truth and give them false hope?

A: I never gave false hope to a patient that I know would not live. If I am in the situation I say it in a polite way. If they ask me if its time to call their family I say if it were me I think at this point I would. Also, often around the time of death a patient is no longer mentally present.

Q: Do you talk to your patients about how they want to die?

A: I saw people in the hospital on their deathbeds when I was interning and doing my residency at hospitals. The doctors and I would talk through different options with the patients so they were well informed. When talking to the patients we would explain the medical terms so they fully understood what we are talking about. Then we would have a family meeting where we go through what the patient want to do. But some times the patient and their family don’t see eye to eye. No matter, what I have to do what the patient wants.

Q: What do you do if you think a patient is making the wrong choice by giving up?

A: Patients choose what they want to do first but if I feel they are making a bad choice I explain everything the best way I can. I also look if the patient is depressed because; if so, it might be impairing their judgment and they can get help for that first. That’s what I think happened to my sister.

Q: Is talking about a patient around the halls common?

A: Most times if we our talking about a certain patient we go to inner dispensary conferences where we talk privately with the patient’s doctor and other professionals in the field helping on the case about what direction to take next.

After my interview with Dr. Burns I saw major differences from how the movie portrayed doctors and how Dr. Burns portrayed herself and her colleagues. Dr. Burns stated that she does not practice giving false hope to her patients but helps them handle the pain they are feeling. I also found that Dr. Burns asks her patients how they want to die unlike in Near-Death but this can now happen in all hospitals because President Obama is trying to make this option open to all patients in America. He proposed giving doctors a bonus for talking to their patients about death. “2011 would let the government pay doctors who discussed end-of-life care options with their patients during annual visits.” (TOWEY 1

I also learned that family members are just informed about their loved ones and not given any power over their well being and when a patient is talked about with other doctors its behind a closed door so the patient's  privacy is respected. This makes me feel better about hospitals. One of the most interesting things I learned is that a patient can be depressed before death, which can alter an end of life decision.

This interview shows me, that in the last decade, that the dominant social practices of illness & dying have changed a great deal in our hospitals. This change is for the better because it means we are caring for our patients in a more humanistic way. I enjoyed studying this subject because it made me feel better about going to hospitals.

Bibliography

TOWEY, JIM. "Obama's end-of-life bungling." New York Post (2011): 1. Web. 18 Jan 2011. <http://www.nypost.com/p/news/opinion/opedcolumnists/obama_end_of_life_bungling_M3v6alI9iFO7cZETf5ZqJO>.

Friday, January 7, 2011

Hw 29

Facing Terminal Illness

Facing Terminal Illness is a time in a person’s life that can either be a time of reflection and understanding or a time of remorse, regret and disappointment. In Tuesdays With Morrie, Morrie takes a positive out look on his situation reflecting on his past. ““There is no point in keeping vengeance or stubbornness. These things”-he sighed– “These things I do regret in my life. Pride. Vanity. Why do we do the things we do?”” Page. 164 Our guest speaker Beth reflected on her husband’s death telling us about all his great accomplishments and how he was still happy making the best of the life before he died.

Family

Family is one of the most important things in life. Our guest speaker Beth had a very close family when her husband was passing away. Her oldest son was very close with his father and she thought he could not handle seeing him die so Beth sent him away. Their younger son Evan was stronger and could handle it so he was able to take care of his dad up until his death. In Near-Death the doctors would consult the families of patients with the truth of what was happing with their family member and give them the power to make life decisions to them if they want. At the same time they where telling the patient lies giving them hope.


Being sick 

Being sick is very common in modern society and when it happens we try to get better threw drugs that have been pre-approved for our use by doctors. After we find that all the drugs we are allowed to use don’t work we go to the hospital where doctors can look at us and give us more drugs. In my own life I find this to be true. In my family when a person gets sick it is a ritual to take aspirin every two hours for a day. In most cases it works and makes your sickness go away but if it doesn’t work we make the first doctors appointment we can to get check out to see what the doctor could do for us to get better.

Tuesday, January 4, 2011

Hw 28

Max-
I agree with a lot of the insights you found in your cousins life. "while in these situation you have to make the best out of it or else your waisting valuable time in your life. It is amazing to me that he could have such a good attitude to such a horrible situation." This is what Morrie was talking about in Tuesdays With Morrie, when your face with certain death you tend to see the world in a brighter light. You don't think about the problem you have you just think about the the best things in life. You had a few weird sentences but beside that you had good grammar.
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Younger Person-
I think that you neighbor handled the situation in a very calm manner. T also think that you helping her out does more than you believe. I might give her comfort to know that there are people out there who care. And she's right there is no point stressing because the situation will just get worse, so don't let her see that this hurts or bothers you.
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Older Person-
The best part was when Evan said her condition was likely to worsen from lack of using her brain and lack of social interaction.

It shows that Evan is aware of the needs of elderly people to maintain an active mind. Studies show that the best ways to prevent Alzheimer is to have daily social interaction and participate in mind games such as crossword puzzles or card games.
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Harry-
I feel bad that the American health care system didn't do a good job in taking care of your family friend but im glade he got help. Does your family friend have good incerence? What cant he do now did it affect him in any way for life? These are follow up questions I would have asked him to go more in-depth. I really liked that you reflected on your work at the end and showed where you could improve.

Saturday, January 1, 2011

Hw 27

I have a neighbor who my family has been very close to for many years. She had been having trouble remembering things the last few months and went to the doctor and found out she had clogged arteries in her neck leading to the brain. I knew all about this problem because my grandmother suffers from the same thing. When talking to her the first time she came back from the hospital I saw no hope in her eyes but this time talking to her she looked happy not worried about it. She said she can’t worry about it or it will ruin the life she has left so ignores it. She does get very annoyed when she forgets things so she writes most things down now. Sometimes it is hard to talk to her because she repents her self but it’s not her fault so I ignore it. 

I think this is terrible and hard to go threw knowing your losing you brain to a blocked space in your neck. If this problem didn’t occur she would be fine and able to live out her life with no problems. My father and I get her grocery every week because she is scared she will forget where she is going and have no one to help her get home. She is somewhat almost not able to go out side unless a family member of hers comes and walks with her. This makes her condition worse because it’s harder for her to use her brain and work on making it stronger with out more social interactions. This problem she faces to day came from a lack of human knowledge on food during her life and resulted in her eating fatty food that clogged her arteries and is causing her to die. 

My neighbor never had the problems with health care like we saw in Sicko. She has always had good health care but her doctors just didn’t find her blocked arteries early enough. She watched her husband die in the hospital four years ago and she wished he could have been at home with her just like Beth took care of her husband at home. Just like Morrie in Tuesdays With Morrie my neighbor is living out her life happy even when she is faced with certain death. She doesn’t know if she accepts death but she doesn’t think about it but she knows it will happen to her one day.