LGBT Seniors Fear Discrimination From Caregivers

LGBT Seniors Fear Discrimination From Caregivers

Posted on Monday, July 1st, 2013 at 12:00 pm by Life Matters Media

Dozens of seniors and medical providers crowded into the Unitarian Church of Evanston, Illinois Saturday to watch “Gen Silent,” a critically acclaimed 2011 documentary highlighting the fears many seniors in the LGBT community have about end of life care.

Directed by Stu Madduxthe film chronicles the lives of six seniors living near Boston. They go back-and-forth recounting their experiences growing up during the onset of the gay rights movement and sharing their present struggles– ranging from fears of abuse from long-term care providers to judgmental caregivers and family members.

“When someone’s facing the end of life and feeling alone and isolated it’s incredibly sad,” said palliative care physician Catherine Deamant, a member of Chicago’s End of Life Care Coalition. Many in the LGBT community are afraid to show their “true selves” to caregivers for fear of bullying, she said, and long-term care facilities tend to overlook the individual.

“Many who won the first civil rights victories for generations to come are now dying prematurely because they are reluctant to ask for help and have too few friends or family to care for them,” according to the film’s website. Oppression from the years before the Stonewall riots continues to linger with those in the film.

The audience was clearly moved by the hour-long film, with many wiping their eyes or shaking their head with disapproval at some of the film’s more emotional moments. “I find it very frightening what lies ahead of me,” one man shouted out during the discussion. “Is this another reflection of how we handle the elderly? Why should it be different for any other group?” a woman asked.

The film, similar to the 2012 Oscar-winning drama, “Amour,” did not shrink away from showing the hard truths of aging, including scenes of hospitalization and loss of strength. “I think they saw the full humanness of the people in the film– they weren’t one-dimensional,” Deamant said.


What Is A Life Worth?

Posted on Thursday, May 30th, 2013 at 2:38 pm by Life Matters Media

Geriatrician argues against bias against the aged and ill

Spirituality

Physicians caring for the elderly and for those nearing the end of life cannot be effective patient advocates until they confront their own deep and widespread prejudices, said geriatrician James Wright at the University of Chicago’s Conference on Medicine and Religion Wednesday.

Wright’s presentation, “The Courage to be a Geriatrician,” examined the bias held by many towards those lacking in independence, particularly those residents of nursing homes.  “Most of us share the same prejudice, that life is of less value when lived in dependency,” Wright explained. “We are in a tradition that cultivates freedom, independence and productivity, and that is what we give value.”

“We live in an era of meaningless- now that we no longer fear the sword, plague, even hell, we fear meaningless,” Wright said.

This prejudice thus serves as a blockade to administering comprehensive care to some of society’s most vulnerable- the oldest and most infirm. Medical professionals, those in geriatrics especially, must experience a shift in mindset from valuing life based on independence and instead towards seeing innate human value. The oldest and sickest are long divorced by age and ability from past functions, Wright said, but their lives remain valuable. That value does not stem from any thing they once did.

Prejudices manifest

Prejudices manifest, Wright said, when doctors make quality of life assessments. His research demonstrates that when simultaneous assessments of life quality are made by both physician and patient, the patient almost always scores his or her quality far higher than the physician.  “These devaluations matter,” he said.

The discrepancy, Wright argued, arises out of the drive of younger, working people towards self-affirmation. We often think, he said ‘‘I am not only alive, but my existence has meaning.’’ This quest for meaning is why the able-bodied join larger movements- political, civic or social. These movements give us worth.

“We live in an era of meaningless- now that we no longer fear the sword, plague, even hell, we fear meaningless,” he said, and this fear inhibits proper care of those we judge to have none.

Wright pointed towards the leaders of the Protestant Reformation as ones who can teach medical providers intrinsic human value. “All beings have equal value not because they earned it, but they were made that way by God, the source of all value,” Wright said. Both Martin Luther and John Calvin agreed that all of us, as humans, are not good enough, and fall short of our own expectations. However, God who loves without condition.

“We are enough as is,” Wright said, “and that gives us courage to be not as something greater.” The most successful providers see all life as equally acceptable and valuable, simply because that life is human.

“All people are created equal and remain equal throughout the course of their lives,” Wright concluded. “Only with this conviction, can we truly be trusted to value and care for the elderly in a way we all deserve.”


Geriatrician Shortage Unlikely To Be Remedied

Posted on Saturday, March 16th, 2013 at 7:15 am by Life Matters Media

Image: DeviantArt via Creative Commons

DeviantArt via Creative Commons

“Aging Americans are the elephant inside the demographic pyramid.”

There are too many old people in America and not enough geriatricians to care for them all, said leading elder care professionals at the Association of Health Care Journalists Conference in Boston, MA.

The rift between the growing elder population and the declining number of physicians trained in geriatrics will only grow larger in the coming years, said Sharon Levine, M.D., a professor in the Department of Medicine Geriatrics at Boston University School of Medicine.

“Aging Americans are the elephant inside the demographic pyramid,” said Levine.

With the population of those 85 and older increasing at four times the rate of other Americans, an estimated 30,000 geriatricians will be needed by the year 2030. Levine explained that this target can be hit only if 1,200 medical students enter geriatric medicine fellowship programs each year for the next two decades.

However, such entrance levels are far from likely. Only 75 medical school graduates entered geriatric fellowships in 2010, according the The American Geriatrics Society. That number was down from 120 in 2005.

Levine insists that dwindling interest in geriatrics is due, in large part, to increasing medical school debt and significantly less earning potential. In 2010, a geriatrician’s median salary was $183,523. That was almost six thousand dollars less than the average salary of a family physician, and close to $22,000 less than the average salary of a general internist. Geriatricians must train at least one year longer than their colleagues in primary care.

Currently, there are currently 3.8 geriatricians for every 10,000 older Americans. Elderly living in the Sun Belt and New England have the more geriatricians per capita in their regions than elderly patients in other parts of the country.


An OP-ED for PBS: Inequalities In Health Care System

Posted on Thursday, February 21st, 2013 at 10:30 am by Life Matters Media

Life Matters Media co-founder Mary F. Mulcahy, M.D., published her research about the racial and economic inequalities in the U.S. health care system for PBS. She continues to spread the message of advance care planning.

Mary F. Mulcahy

Mary F. Mulcahy

She writes:

“Racial disparities and inequities in American healthcare are evident in daily life, but regrettably they are also prominent in death. In these final days of Black History Month, it is imperative to reflect on the final days of all African-Americans and the choices they have within our health care system. These are the choices they aren’t taking, and the phenomenon serves as a means of further disenfranchisement from the medical community at large.

The National Center for Health Statistics reports that African-Americans in home health care and nursing homes are half as likely as whites to have an advance directive, such as a living will or a do-not-resuscitate (DNR) order. This disparity leaves African-Americans at risk for unwanted medical procedures, unnecessary pain and family strife.”

Read the rest at PBS


The Lack Of Advance Care Planning Persists

Posted on Monday, February 4th, 2013 at 10:41 am by Life Matters Media

Image: CDC

Centers For Disease Control

Although more affordable senior care services are emerging as the U.S. population continues to age, most still do not plan for end of life care, as The Associated Press’ Matthew Perrone reports.

“Nobody wants to go to a nursing home, it’s the last resort,” James Firman, president of the National Council on Aging, told the AP. “People want to stay in their own home, and if they can’t, they want to go to a place where they can get assistance but that still feels homelike.”

Nursing homes continue to be the most intensive and expensive form of long-term care, which often includes 24-hour medical supervision, the AP reports. The average cost of a semi-private room in 2011 was $81,000, according to a survey by MetLife. A private room can cost more than $90,000, as the average daily rate for a private room in a nursing home rose more than 4 percent in 2011.

Most seniors will not require extended nursing home care. However, Medicare does not cover less intensive care options, such as in-home help with meals and chores.

“The issue is that these are long-term costs and almost all of it comes out of pocket,” said John Migliaccio, director of research for Metlife’s Mature Market Institute. “It’s important to have some idea about what it will cost dad, mom or your husband to get the care they need.” Only some 5 percent of adults have long-term care insurance to help pay for these services. Some policies can cost $8,000 a year.

The National Association for Professional Geriatric Care Managers recommends families discuss long-term care options early on, before a medical emergency.

“Advance care planning is a dynamic process that evolves over time as a person’s health goes from well, to ill, to ultimately terminal,” LMM co-founder Mary F. Mulcahy, M.D., wrote for The Huffington Post. “Medical advances have led to few cures of illness, have prolonged the experience of living with chronic illness and have prolonged the process of dying.”

In 2000 there were more than 35 million Americans 65 and older. By 2030, there will be 72 million. According to the Georgetown University Public Policy Institute, almost 10 million seniors currently rely on others for daily care.