Day 325 of 365 - Systemic Ills
There are a couple more topics that I want to address today, based on more reading in the Elderhood book by Louise Aronson.
The first is the impact of the electronic health care record, which is becoming the norm in hospital settings and probably clinics as well. The author, who is herself a doctor, describes that these records are designed and used primarily for billing efficiency. They have made patient records like standardized report cards, pretty much eliminating the possibility of including personal and pertinent data such as what might have been gleaned from attentive listening, shared decision making and individualized treatment. During and after appointments, physicians have to make the content of the appointment fit into arbitrary categories. She reports that this excessive and inappropriate form of record keeping contributes to physician burnout. If the doctor wants to keep track of the aspects of the visit which don't fit in the system categories, they have to do double record keeping.
You might think that everything is in your record, and that when you go to an appointment with someone else to further address an issue you have had a consult about before, they should 'know' everything. It's not likely. Firstly, the record may not contain what you would consider pertinent details, and secondly, the doctor likely has had very little time to even review what is there. It's just the current nature of our medical system.
The second area that caught my attention today was cultural and historical attempts to delineate categories of old age. I had not previously heard the terms Third Age and Fourth Age in relation to this.
Third Age people are the 'young old' and Fourth Age people are the 'old old'. Third Age people are essentially the seniors who still have the ability to live the way they want to live. They are active participants in our mass consumer society and are marketed to via all the strategies and products which are attempting to hold off effects of aging. I would currently fit into this category. Social and health care policies are trending towards this category having their essential needs met at the expense of what is available to the Fourth Age.
Fourth Age people are those who have less ability to care for themselves and often need more frequent hospital care as well as being less likely to live independently. Living and care options for people in this category are extremely variable depending on your social class and wealth. There are many very beautiful retirement homes now, but the majority of people can't afford them. It's a new marketing strategy to the Third Age people to make them believe they will continue to be attractive, useful and relevant living in a place like that. However, those places may not actually be able to provide the supportive kind of care individuals need when their health and abilities decline. It's sort of an offer of false hope which is more business driven than anything else. Also, unless you have the ability to advocate well for yourself, or have a family member or friend who can do so, you are at the mercy of the system.
I've written in another post in the past how I dread the idea of ending up in a publicly funded seniors or nursing home which is basically warehousing of those who are no longer relevant to the culture. So, the impression is pretty clear that we still have a place in society as long as our ills are relatively fixable and as long as we keep spending money to support the economy. Once we are not able to do that, it's anybody's guess where we might end up. Gee, that's pretty depressing isn't it?
On another more positive note, studies of individuals perception of happiness and well being show that people between the ages of 65 and 79 report the highest average levels of personal well being, followed by those over 80. Society and media would have us believe the the midlife age range of 35 to 59 are the happiest, 'have it all' people, but it turns out they are the most stressed out, anxious and miserable. Go figure! So, all of us older, supposedly less relevant members of society are in fact the happiest, or at least we are when our health is relatively intact.
If all this does not clearly illustrate how messed up our health care and social welfare policies are, we need to give our heads a scratch. We can't just blame the professionals and workers within the systems either. They are often doing their best within the limited scope of their positions to meet peoples needs.
The term successful aging is often used to mean an absence of disease, maintenance of physical and cognitive function and full engagement with life. It also refers to life satisfaction, social functioning and psychological resilience. For the average older person it generally means independence, comfort, meaningful relationships and feeling as if we contribute to society. Our success and happiness are not just a product of our spending ability to fend off aging. People of all ages deserve respect, care and supportive living situations.
The first is the impact of the electronic health care record, which is becoming the norm in hospital settings and probably clinics as well. The author, who is herself a doctor, describes that these records are designed and used primarily for billing efficiency. They have made patient records like standardized report cards, pretty much eliminating the possibility of including personal and pertinent data such as what might have been gleaned from attentive listening, shared decision making and individualized treatment. During and after appointments, physicians have to make the content of the appointment fit into arbitrary categories. She reports that this excessive and inappropriate form of record keeping contributes to physician burnout. If the doctor wants to keep track of the aspects of the visit which don't fit in the system categories, they have to do double record keeping.
You might think that everything is in your record, and that when you go to an appointment with someone else to further address an issue you have had a consult about before, they should 'know' everything. It's not likely. Firstly, the record may not contain what you would consider pertinent details, and secondly, the doctor likely has had very little time to even review what is there. It's just the current nature of our medical system.
The second area that caught my attention today was cultural and historical attempts to delineate categories of old age. I had not previously heard the terms Third Age and Fourth Age in relation to this.
Third Age people are the 'young old' and Fourth Age people are the 'old old'. Third Age people are essentially the seniors who still have the ability to live the way they want to live. They are active participants in our mass consumer society and are marketed to via all the strategies and products which are attempting to hold off effects of aging. I would currently fit into this category. Social and health care policies are trending towards this category having their essential needs met at the expense of what is available to the Fourth Age.
Fourth Age people are those who have less ability to care for themselves and often need more frequent hospital care as well as being less likely to live independently. Living and care options for people in this category are extremely variable depending on your social class and wealth. There are many very beautiful retirement homes now, but the majority of people can't afford them. It's a new marketing strategy to the Third Age people to make them believe they will continue to be attractive, useful and relevant living in a place like that. However, those places may not actually be able to provide the supportive kind of care individuals need when their health and abilities decline. It's sort of an offer of false hope which is more business driven than anything else. Also, unless you have the ability to advocate well for yourself, or have a family member or friend who can do so, you are at the mercy of the system.
I've written in another post in the past how I dread the idea of ending up in a publicly funded seniors or nursing home which is basically warehousing of those who are no longer relevant to the culture. So, the impression is pretty clear that we still have a place in society as long as our ills are relatively fixable and as long as we keep spending money to support the economy. Once we are not able to do that, it's anybody's guess where we might end up. Gee, that's pretty depressing isn't it?
On another more positive note, studies of individuals perception of happiness and well being show that people between the ages of 65 and 79 report the highest average levels of personal well being, followed by those over 80. Society and media would have us believe the the midlife age range of 35 to 59 are the happiest, 'have it all' people, but it turns out they are the most stressed out, anxious and miserable. Go figure! So, all of us older, supposedly less relevant members of society are in fact the happiest, or at least we are when our health is relatively intact.
If all this does not clearly illustrate how messed up our health care and social welfare policies are, we need to give our heads a scratch. We can't just blame the professionals and workers within the systems either. They are often doing their best within the limited scope of their positions to meet peoples needs.
The term successful aging is often used to mean an absence of disease, maintenance of physical and cognitive function and full engagement with life. It also refers to life satisfaction, social functioning and psychological resilience. For the average older person it generally means independence, comfort, meaningful relationships and feeling as if we contribute to society. Our success and happiness are not just a product of our spending ability to fend off aging. People of all ages deserve respect, care and supportive living situations.
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