Comfort Settings for the Terminally Ill (Extra Analytical Posting)

In the article “Abraham House: ‘Next best thing to home’“, author Amy Neff Roth investigates an Upstate NY model comfort home for the terminal ill, and interviews some patients in the home along with family members with experiences. I was initially struck by the caption under the article photo: ““When I heard about Abraham House, I wished I had learned about it before my mom passed away,” said Bowen, who would have rather had her mother stay at the facility in her final days.” In my mind, this mirrors the statistic we learned about in class regarding how many people die in hospital settings against their wishes. Thus, Roth provides us with a view of an alternative: a home-like pallative care hospice setting.

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Emotional Toll on Hospice Staff for the Terminally Ill

I personally have had a family member pass of Leukemia in a hospice like setting, The Abraham House. Even with the entire family in agreement, it was still difficult to see my relative there and accept that there were no available treatment options left at his stage. He was in the home for three to four months, during which time he developed strong relationships with the daily staff. This nonprofit hospice model proved to be one of the best experiences with the healthcare system that he ever had, and truly brought him comfort during his last few months. The home was modeled after a real home, with a real kitchen, living room, and patient rooms. Caregivers cooked home-esque meals, and offered to eat with patients if possible. My uncle’s health actually briefly improved once he was transferred into the home from highly medicalized hospital settings. If anything, the Abraham House is the gold standard of pallative care.

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Death & Directives

“Tip-Toeing Toward Conversations About Death”by Bebinger provides a comprehensive look into the issue of health proxies and healthcare decision responsibility. Most interestingly, the article mentions that increased awareness surrounding the issue may be a significant advance in patient-centered care, a topic discussed prior in our class.

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Healthcare Horizons

The lessons, evidence, arguments, and viewpoints presented in Sociology of Healthcare have collectively become one of the biggest influences in my life pushing me to pursue a healthcare related field. I’ve always thought of attending medical school, have considered myself a student activist for human rights since high school. This class helped me come to the full realization that the two go hand-in-hand, and that choosing to not only pursue but change the field of medicine is a choice to fight for human rights.

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Lack of Welfare in Elder Care

The article “Fighting to Honor a Father’s Last Wish: To Die at Home” by Nina Bernstein clearly highlights the shortcomings in institutionalized and home-care forms for the majority of individuals within the United States of America. Collectively as a society, there exists no proper or cost-effective solution for healthy, nurturing, burden-less elder-care. These failures in care are likely speeding up the decline of individuals in the face of the discrepancies. Such raises a huge, frightening, and charged question: is committing an elder to an institution akin to committing them to an earlier death?

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Recision Revision

The passage of Obamacare was designed to fight “negative” aspects of the insurance market, one of which was the famous “rescission” where individuals found themselves without insurance plans in critical times. Unfortunately, even with the passage of healthcare legislation, it appears that a new – albeit less critical – version of rescission has reappeared.

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F.D.A Targeting Testing

“Life-threatening diseases go undetected in some cases. In others, patients are treated for conditions they do not have.” The continued debate on overtesting within the U.S. healthcare system was recently exposed by a new F.D.A investigation conducted by federal investigators, discussed in the article “F.D.A. Targets Inaccurate Medical Tests, Citing Dangers and Costs” by Robert Pear. In the article, Pear discusses the various findings of the newly released federal study, which concluded that “Patients have been demonstrably harmed or may have been harmed by tests that did not meet F.D.A. requirements.”

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Elder Care Disparities and Rarities

In “Does Investor Ownership of Nursing Homes Compromise the Quality of Care?” study authors investigated the effects of for-profit nursing home systems on quality of care, and concluded that, compared to other systems, a variety of deficiencies plaque the investor-owned systems. This thus raises the question, how can we develop cost-effective and care-effective solutions to the deficient investor owned homes? One potential option that seems to embody both qualities is the Green House Project.

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Hospital Code = Zip Code?

More often than not, the ZIP code health paradigm seems to be defining healthcare outcomes – and hospital codes – in cities across the United States. I found one of the most striking aspects of this unit to be this extreme correlation between zip code and health. It appears as if zip codes act as very simple, very prominent way of measuring social determinants of health in a specific geographical area via highly readily accessible data. The question is, in what way can this paradigm be effectively tackled in order to reduce this zip code inequality?

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Medicalization of the Medical Setting

In The Rise of the Modern Hospital, Rosenbergon discusses the medicalization of the hospital setting and the hospitalization of physicians and private practice. As mentioned in lecture, he discusses how hospitals transformed into a fully integrated medical setting from a previously personalized, potentially less effective social model. This joining of healthcare directly coincides with other articles discussing over-medicalization, which brings up the question: was the hospitalization of physicians potentially one of the first steps in over-medicalization of society? Though critical to our idea and perceptions of modern day hospitals, did this transformation push hospitals to be too medical for proper health and healing?

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