New York, New York

Just recently, I returned to New York City for 10 days. This was partly holiday, but also involved some interesting healthcare business.

First, I met with Paula Span (see other post), who was encouraging and helpful about home care of the elderly and publicizing the campaign to spread the word about its value.

Also, I spent a day with the doctors and nurses in the New York City home care program.   This goes by various names (please see my other post on the subject, where you can view a video describing the program).  One of the most fascinating things about this experience was the similarities between their program and ours in Vancouver, in spite of the fact that the Canadian and American healthcare systems are really quite different.  Those similarities include problems with caregiving and the importance of function in frail people at home, the struggle of covering crisis 24 hours a day, major and persisting difficulty with getting elderly people in and out of the hospital safely, and the clash of two philosophies regarding medication in frail old people.

Everyone familiar with this blog and my book understands that I’m squarely on the side of restricting frail elderly people’s medication to drugs that  promote comfort and function, assuming the elderly person or their decision-makers agree with that philosophy.  The wonderful professionals who kindly took me out on the road with them in New York, and met with me to discuss program planning, agree entirely.   The clash is between all of us and the things that seem to go on in hospitals these days.

But there’s hope, and some changes that have long been needed are beginning to happen.  Many thanks to Meng Zhang, Theresa Soriano, Cameron Hernandez, Laura Donnelly, and Mary O’Connor.

I also, by the way, had a fabulous time doing normal things in that wonderful city: Broadway musical, jazz, museums, the Empire State Building, US Open tennis, and restaurants.  OMG the food!  Still recovering …

About John Sloan

John Sloan is a senior academic physician in the Department of Family Practice at the University of British Columbia, and has spent most of his 40 years' practice caring for the frail elderly in Vancouver. He is the author of "A Bitter Pill: How the Medical System is Failing the Elderly", published in 2009 by Greystone Books. His innovative primary care practice for the frail elderly has been adopted by Vancouver Coastal Health and is expanding. Dr. Sloan lectures throughout North America on care of the elderly.
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