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Archive for the ‘Articles of Interest’ Category

Good – But Not Good Enough

Posted on: June 19th, 2015 by Mike

Building Better Nursing Homes

After plenty of isolated successes, the question isn’t what good nursing homes look like, but how to transform existing facilities into places that look like them.


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By ALANA SEMUELS for The Atlantic


The woman Barry Berman saw sitting in the dining room of the nursing home was not his mother.


Or, at least, she was his mother, but didn’t look anything like her. His mother was vivacious, or she had been until she was felled by a massive stroke and then pneumonia, so he’d moved her into a nursing home so she could recuperate. He knew he could trust the nursing home, since he ran it, and knew it was lauded for the efficiency with which it served residents. But when he went to look for his mother a day or two after he moved her in, he barely recognized her.


“I’ll never forget the feeling as long as I live,” he told me. “I said, ‘Oh my God, there’s my mother, this old woman, in a wheelchair, lifeless. Look what my own nursing home did to my own mother in a matter of days.”


Berman had run assisted living and nursing complexes for 23 years before this moment, but it completely changed the way he thought about how to care for the elderly. He moved his mother home immediately, arranged for home-care aides to come to her, and then set about to completely upending the way his organization, Chelsea Jewish Foundation, cared for its aging patients. Read more here… .

Speaking about the unspeakable

Posted on: June 12th, 2015 by Mike

Death Cafés Breathe Life Into Conversations About Dying


By DEENA PRICHEP for National Public Radio

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We live knowing that everything dies. Like the sun, it’s a fact of life. And like the sun, we tend not to look right at it. Unless you’ve experienced a recent death, it’s probably not something you discuss. But a new movement is trying to change that, with a serving of tea and cake …. [I]t ends up being about not so much how we die but how we live. Read more here.


Posted on: June 5th, 2015 by Mike



An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?



BY ATUL GAWANDE for The New Yorker


It was lunchtime before my afternoon surgery clinic, which meant that I was at my desk, eating a ham-and-cheese sandwich and clicking through medical articles. Among those which caught my eye: a British case report on the first 3-D-printed hip implanted in a human being, a Canadian analysis of the rising volume of emergency-room visits by children who have ingested magnets, and a Colorado study finding that the percentage of fatal motor-vehicle accidents involving marijuana had doubled since its commercial distribution became legal. The one that got me thinking, however, was a study of more than a million Medicare patients. It suggested that a huge proportion had received care that was simply a waste. Read more…


Love, Death and Spaghetti

Posted on: May 13th, 2015 by Mike

Love, Death and Spaghetti

By THERESA BROWN / Artwork by Bianca Bagnarelli


“Theresa, you gonna sit, you gonna eat.” My orientation for hospice nursing didn’t cover this — an Italian grandmother who was clearly not going to talk to me about her dying husband unless I sat at the dinner table with her family and ate. Well, when in Rome, I decided, and obediently pulled up a chair.


The emotional connection between food, love and survival runs deep, and it comes up again and again at the end of people’s lives. “I can’t just let her starve,” family members will say about a loved one near death with little ability to talk, much less eat, and certainly no desire for food.


It was the same for this struggling wife. She wanted to feed her husband, in part because food was how she connected with people. Her husband was beyond any hope of cure. Giving him food was the last concrete gift she had to offer, and the one most associated in her mind with a lifetime of caring.


Her children, all grown, thought their mother was in denial, that she couldn’t accept her husband’s imminent death. They wanted her to stop trying to feed him, because he could no longer chew and swallow. They were concerned that he could choke, that any food he managed to get down was likely to make him feel worse, not better, because that’s how it goes when the body starts to permanently shut down. And they were right.


So, I talked to her about it while we both ate, twirling spaghetti around the tines of a fork, smoothing butter over a piece of bread. I reviewed the history of her husband’s illness and the signs that he was in a terminal decline: worsening respiratory status, an escalation in pain and a quickly diminishing ability to recognize or respond to anyone, including her. I gently told her that not only could her husband not eat anymore, he didn’t need to — that when people get very close to death they lose interest in food. She nodded while looking down at her lap, tears pooling at the edges of her eyes. Read more from the original article in The New York Times…

Theresa Brown is a hospice nurse and the author of “Critical Care: A New Nurse Faces Death, Life, and Everything in Between.

Dying Shouldn’t Be So Brutal by Ira Byock

Posted on: March 2nd, 2015 by Mike


“Our health care system is well honed to fight disease, but poorly designed
to meet the basic safety needs of seriously ill patients and their families.
We can do both. We must.” Read more here…

Being Mortal

Posted on: March 2nd, 2015 by Mike


Having the Conversation – JHCN staff recently  the PBS Frontline documentary by Dr. Atul Gawande, followed by a 30-minute discussion. Touch points included how to start conversations with patients and families facing terminal illness, the importance of listening, the value of silence, and the perspectives medical professionals, social workers and clergy bring to an end of life conversation. Click here to view the video online.


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