Senior Mentor Reflective Essay

We had an assignment where we had to reflect on our feeling towards providing healthcare to the elderly.  Here's my essay:

Reading the three vague questions demanded of us in the senior mentor reflective essay, I can’t help but assume the administration just wants us to ramble on about our thoughts on providing healthcare for the elderly - so I plan on doing just that.  I apologize in advance if I don’t answer all three questions.

BMS
In 1978, Samuel Shem famously wrote a pseudo fictional memoir called House of God, in which he told one of the first tell-all books of the insanity of internship.  Shem covers a wide range of the insanity - the depressing isolation, the extreme coping methods, the reality of how little medicine can actually do - but one of his favorite targets is GOMERS, which stands for Get Out of My Emergency Room.  GOMERS are elderly patients that are suffering and actively dying, but medical technology is somehow keeping them alive.  The doctors and nurse taking care of GOMERS are frustrated that they take up so much of their valuable time and attention.  The question they ask is, “Shouldn’t they be allowed to die with dignity?”

My view on healthcare towards the elderly is, unfortunately, similar to Shem’s.  It is frustrating to me whenever I see off-hand statistics that mention the surprising concentration of healthcare dollars that are spent on the last six months of life.  If there is not enough money to go around to provide healthcare for everyone, don’t we need to ration our resources, and invest the money where it’s actually going to help our society?  On a simpler level - should we even be taking care of people that can no longer control their bowels, or worse - their breathing?  I imagine I am not the only young person that sees the world through this cynical lens.

Who deserves healthcare? ...a loaded question
These frustrations over serving an aging population that is no longer able to serve society like it used to, is one of the main reasons driving me towards something bordering on a fear of the elderly and an in interest in pediatrics.  I can't help but relate to the doctors portrayed in Shem's House of God and predicting that I too will fall into the same pessimistic bunch of docs.

I understand the situation in real life is much more difficult than crunching numbers - seeing one of your loved ones passing away, it must be difficult to let go.  There must be a point when it becomes more than just being about efficiency.  To that extent, I have never had close relationships with anyone over the age of say, 60, and being so unfamiliar, it is definitely difficult for me to relate to this age group.  

On a sidenote, I want to believe in the value of every life - young, old, black, white, rich, poor - whatever.  I definitely cannot say I live a life that embodies that ideal, but it is an ideal I wish to attain.  I sincerely hope the Senior Mentor activity will change my views on serving the elderly.  They have certainly done their part to serve out society, and they deserve to be taken care of in their dying days.  I also hope the senior mentor activity will help me understand the issue of dying.  Is it possible that it's not wrong to let GOMERS die?  Don't the elderly deserve the respect of dying with grace?  

It's hard to reach any substantial conclusions in a rambling reflective essay, but here's what I've come up with: I see a lot of personal conflict in serving elderly patients, and I hope that will change in the coming years.  

See you on the other side,

from ken

6 comments:

  1. Working as a paramedic in rural Ohio, I found that, if our patients weren't drunk college students, they were almost entirely geriatrics. It is a hard age group to work with. At a certain point, and especially for those using the 911 services, all of their faculties (mental, physical, whatever) hit the tubes. The best pieces of advice I can give is to treat everyone as if they're a blank slate. It's so easy to get sucked into thinking, "ah, old person. Better speak up." And then you'll meet the geriatric patient with perfect hearing who will give you one hell of a lecture for assume she's going deaf. Sure, with some, you'll have to treat them like children. And with some, you'll wish you could, because their physical ailments are so bad, that all you can do is hope they're not all there mentally. I treated a vet once who was so sharp and so on his game, but had gone completely incontinent and was having uncontrollable bloody diarrhea. It was awful to see how aware he was of everything that was going so embarrassingly and horribly wrong with his body. It is so important then that you put every effort into making them still feel like they have their dignity at that point. Any effort you give in that regard will go so far.

    Geriatrics are SO hard, but they can be the most rewarding of your patients. Whenever you can, take the time to spend an extra few minutes with them. Any one who's been alive for 60, 70, 80 years has something worthwhile to say and share. You can learn so much.

    Good luck. It's a miserably tough age group, but one that can be infinitely rewarding, every once in a while.

    And also - don't underestimate them. I got kicked in the teeth by what I thought was a sweet, little grandmother. Not so. Vicious lady. Very unhappy with me being in her house. Nasty right hook too.

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  2. Hey Kat,

    Thanks for your thoughts! I can see how it'd be super hard to work with geriatrics, which is why I'm so worried about it. Especially in the paramedic world - that's hardcore.

    from ken

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    1. You'll do great Ken. Communicating with people is something that (at least to me), you've always seemed really comfortable and adept with. I think you'll do a really great job with the soft-skills of patient care. I can't wait to hear more about your adventures!

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    2. Thanks! PS - didn't know you blogged! Really enjoy your thoughts, keep it up!

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  3. Hey, you are looking at your aging mother-in-law who is 60. You better be nice to me :)

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