Fading Out: Aging and Beyond RSS feed

Why U.S. medical costs are so high and where the system needs fixing

June 6, 2017

Tags: price transparency, drug costs, rate-setting, care fragmentation, who's in charge?, health care spending, medical errors, malpractice, medical economics, elder care, fee-for-service medicine

by Pat McNees (updated 5-26-17, orig. published 11-11-15)
Why are our medical bills so high? Why aren't drug prices regulated, as they are in other countries? Where is most of our health care budget spent? Where can we improve the system? Why do we overtreat the rich and undertreat the poor? Who is in charge, when a patient needs complex chronic care? Has our market-driven medical care system served us well or do we suffer from its perverse incentives? Ours is the most expensive health care system in the world but it is not delivering the most effective health care. What can we do? Here are links to key articles explaining the high cost of medical care in the United States -- and whether we're getting what we're paying for. (more…)

Conversations About Dying

January 8, 2017

Tags: Good death, bad death, dying well, Conversation Project, Five Wishes, Stanford Letter Project, Death Cafe, end-of-life care

(assembled by Pat McNees to facilitate conversations about death, dying, and final wishes)

We should all have the end-of-life conversation (Ellen Goodman on The Conversation Project). "Too many people are dying in the way they would not choose. Surveys tell us that 70 percent of Americans, for example, want to die at home but 70 percent end up dying in hospitals and institutions....Too many survivors, for that matter, are left not just mourning but feeling guilty, depressed, uncertain of whether they have done the right thing.... And we cannot wait for "the right time" (more…)

What's wrong with the 21st Century Cures Act

December 20, 2016

Tags: randomized controlled trials (RCTS)

Norman Bauman provided helpful links and comments about the 21st Century Cures Act in the Association of Health Care Journalists' discussion group. I share them (and quote from the sources) here:
• The 21st Century Cures Act is a deal that will give a lot of money to the NIH, FDA, Cancer Moonshot,etc., but will also weaken the FDA's standards of evidence used to approve drugs, particularly randomized, controlled trials (RCTs). (more…)

How storytelling can help dementia patients

December 18, 2016

Tags: Dementia, Alzheimer's

Updated 7-13-17. This former journalist helps caregivers get to know who their patients once were, before dementia took hold (Tara Bahrampour, The Age, 12-16-16) Jay Newton-Small, a District resident, started a business writing anecdote-filled profiles of dementia patients after her father got Alzheimer’s. 'Until seeing her profile, caregivers for (more…)

Lessons from "Obit," the documentary

November 15, 2016

Tags: obituary, New York Times

Vanessa Gould’s fascinating documentary Obit, shown at the summer Docs festival in Silver Spring, is a fascinating overview of how The New York Times obituary section is run. We learn how they decide which people to honor with an obit, at what length, with how many photos. The obit writers “document the lives (more…)

Doctors rebel against a re-certification test that costs $23,600 per doctor

June 27, 2016

Tags: MOC, maintenance of certification, medical specialty boards, revolt


written and posted by Pat McNees
"Over the last few months, we have seen a great increase in the number of doctors ... speaking up against the current MOC (maintenance of certification) that is now in place," wrote Dr. Linda Girgis in Are Medical Specialty Boards Extorting Physicians? Dr. Girgis explained why doctors do not want to comply with current MOC requirements:
1. The majority of doctors (more…)

Resources for finding service dogs, therapy dogs, and other types of assistance dogs

June 12, 2016

Tags: service dog, therapy animal, disability, medical assistance dogs, signal dog

by Pat McNees, updated 8-8-16, 5-17-17)
See also FAQs, stories, and articles about assistance dogs and Books about assistance dogs
Find the bomb! Good boy! Man’s best friend may be our best bet for staying safe. (Andrea Sachs, Washington Post Magazine, 8-4-16) Dogs are being trained and employed in such fields as search and rescue; narcotics, explosives and bedbug detection; and diabetes alert. Some are providing therapy support and detecting ovarian cancer. Nearly 1,000 six-legged teams safeguard more than 100 airports, mass transit stations and cargo-hold sites. In these anxious times, dogs could have a twofold impact on potential terrorist attacks: deterrence and detection. Sachs writes about where some of man's best friends are being trained, and how, to make the country safe.
A Complete Guide to Service, Therapy and Emotional Support Dogs (Karen Wang, Friendship Circle, 5-23-13) Suggests resources for finding mobility assistance dogs, medical response dogs (for humans with seizures, diabetes, severe allergies), signal dogs for the hearing impaired, guide dogs for the visually impaired, autism service dogs, psychiatric assistance dogs, therapy dogs, emotional support/companion animals.
Assistance Dogs International (a coalition of not for profit organizations that train and place assistance dogs (more…)

At least 100 tips on how to improve your life, home, and credit cards

May 29, 2016

Tags: cleaning tips

by Pat McNees
Preferring books to housecleaning, I live in a messy apartment. But now I'm ready to act on tips I've been gathering (posted below) on how to upgrade my home, make my clothes last longer, detox my life, find a better credit card, tidy up the spaces guests are most likely to judge me on, handle a tax audit, clean the bottom of my iron, sanitize a sponge in the microwave, and so on. For example, thanks to Buzzfeed, I've discovered how to
3. Hide my television wires in a shower curtain rod.
6. Add cheap framed mirrors to closet doors, painted to match.
19. Get the right-size rugs and learn how to (more…)

Estate planning and estate and inheritance taxes: What you need to know

May 23, 2016

Tags: estate tax, inheritance tax, estate planning, death tax, wealth transfer, fightss over inheritance

The Wills Party (Shmuly Yanklowitz, Modern Loss, 2-17-16) My wife and I thought finalizing our wills was a good reason to have a party. Here’s why. This excellent articles provides links to solid information about estate taxes (made more explicit here). Tell readers (more…)

My Mother, The Lion

May 8, 2016

Tags: Elders' Eden, eldercare, dementia

by Ruth Little
When my partners Holly Hanson, Judie Suit, and I started Elders’ Eden, our dream was to create for our mothers (and Judie’s aunt) a real home — a place where they were loved and valued as the remarkable people they are, each with special skills, achievements, and quirks. We wanted them to have close and continuing relationships with caregivers, children, and pets. And we wanted them to be able, if at all possible, to die at home. (more…)