Author Archives: John Sloan

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.

The REAL Reason Agitation is a Problem in Dementia

Further to the fuss in my last post over Global TV, here’s my loonie’s worth of opinion on what we in healthcare call “Agitation in Dementia” AKA PBSD (psychological and behavioural symptoms of dementia). What would having severe dementia feel … Continue reading

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Globaloney

It has a new meaning! Global TV’s “15 x 9” revealed to me last week a spectacular level of journalism nonsense and dishonesty. Here’s what happened. A producer called and asked if I would appear on TV giving my opinions … Continue reading

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House Calls 1

Under this heading, I’m going to post a few anecdotes of my home-care practice experience. I hope these will be taken in the spirit in which they are intended. That is a window on a peculiar kind of practice which … Continue reading

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Further Adventures of the Geriatric Doctor-in-Law

My hordes of readers will recall “The Other Side“, about five posts ago. With both my parents long passed away, I am finding out for the first time about caregiving of frailty semi-first-hand through my wife’s folks. With my background, … Continue reading

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The Developing Evidence Base

Since my last post on this subject (click here), there have been some developments in the ongoing effort to show the benefits of multidisciplinary primary care of frailty at home. First, our friend and colleague Dr. Ted Rosenberg in Victoria … Continue reading

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Young at Heart

I was in Prince Edward Island in October giving a presentation at a conference that ended with a musical performance by a group called  Young at Heart Musical Theater for Seniors (click the name to go to their website). WOW!  The … Continue reading

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Video of Me Speaking

At long last, I was able to get someone to videotape me doing a presentation. Now anyone interested can have a look at me strutting and fretting my brief hour on the stage here, as I have also posted it … Continue reading

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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 … Continue reading

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HomeVIVE update

About three years ago, I reduced my home care of the elderly practice radically, and most of the patients were taken over by a program called “HomeVIVE”, operated by Vancouver Coastal Health, comprising three family physicians and a nurse case … Continue reading

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The Other Side

I was doing “full service” when I started out in general practice, including delivering babies. Obstetrics was a not-too-challenging routine part of my work (except having to get up in the middle of the night), but I never dreamt what … Continue reading

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Paula Span NY Times blog on Sloan

I’ve mentioned “New Old Age” before, the New York Times blog mostly authored by journalist Paula Span. I was fortunate to have Paula attend my talk in Manhattan in June, and even luckier to be featured in this recent post. … Continue reading

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Another voice for frail elderly care reform

A colleague directed me to this lovely article by Dr. Dennis McCullough, a family physician and geriatrician working at Dartmouth University in the US. You can follow links in the article to his website, where you will discover he has written … Continue reading

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How Important is Diet for Old People?

On April 1, I presented a talk at a drug therapy conference in Vancouver in which I critiqued the evidence for benefit from healthy eating. Long story short, there is shockingly little evidence. And this is for all ages. Fat, … Continue reading

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Dr. Mark Nowaczynski’s wonderful film “House Calls”

I finally figured out how to post this. click here Mark is a pioneer of home care of the elderly, and a good friend. Several years ago, Ian McLeod (husband of Margaret Wente) produced this fabulous hour-long National Film Board … Continue reading

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Walrus Magazine discusses frailty

Thanks, Katherine Ashenburg, for your well-researched and well-written article on the elderly in the March 2011 issue of Walrus.  Katherine interviewed me several months ago as part of her research, and I was honored to see a few of my … Continue reading

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Homegrown evidence for home care effectiveness

I met with Dr. Reva Adler, medical director of the Home VIVE program in Vancouver, a couple of weeks ago.  Home VIVE is a very effective primary home care of the elderly program that took over most of my home care … Continue reading

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How do I prevent disaster for a frail person?

Somebody recently told me they’re not worried about dying, they’re worried about the run up to it. It’s that run that we’re talking when we say “frail”, “fragile”, “Sunshiners”. The huge challenge is that what’s going to happen is pretty … Continue reading

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Wonderful New York home care program

Last year, a colleague in Toronto told me about a very effective program in New York City.  A group of doctors do home care of housebound elderly, out of the largest organized home care facility in the United States, run … Continue reading

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New York Times elders blog

I’ve run into a very interesting blog site associated with the New York Times. “The New Old Age: Caring and Coping” (click here).  Frankly, it looks like the kind of conversation I’m hoping people will eventually have on sunshiners.ca!  Meanwhile, … Continue reading

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Margaret Wente supports Sunshiners

Another powerful article from the Globe and Mail in support of reasonable care for frail elderly people. Thank you, Margaret! click here

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Globe and Mail article on home care

Read Rod Mickelburgh’s short but brilliant article on home care of the elderly. click here

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Questioning the Common Scientific Wisdom

Here’s an article from the Atlantic about research skeptic John Ioannidis. Should be required reading. click here

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What can I expect from aging?

This title has been the most popular for people coming to Sunshiners.ca, and I think the list of resources I posted might have disappointed some. So here are a couple of answers to this provocative question. Expect the unexpected. People … Continue reading

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Cure vs. comfort focused care: new article from New Yorker.

“Letting Go”, a New Yorker article by Dr Atul Gawande. This is a very insightful look at the difference between care that focuses on cure and care that focuses on comfort, and the importance of understanding your priorities.

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‘Advocate for a more dignified, less expensive way to help frail seniors’ reports Tyee.

A very well supported article written by Tyee after we met recently over coffee. Click here to read it.

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Confused by medication? Looking to minimize drug intake?

Have a look at this short list of resources. Let us know how they helped! Minimally Disruptive Medicine. A well-designed site featuring arguments for individualizing drug treatment. http://minimallydisruptivemedicine.org/ Healthy Skepticism. This Australian site, operated by Dr. Peter Mansfield, takes a … Continue reading

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Resources on aging issues

Browse these sites. They’re a great starting point for learning. Public Health Agency of Canada Seniors’. This site provides a large amount of conventional healthcare information for elderly people on behalf of this Canadian government agency.  http://www.phac-aspc.gc.ca/sh-sa-eng.php?rd=senior_agee_eng Canadian National Study … Continue reading

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I’m a caregiver. Where do I go for resources?

Look no further. Below is a short list of websites that are either well known to us or have very comprehensive resources. We don’t necessarily agree with everything on these sites, but present them as a starting-point for exploring certain … Continue reading

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How should we decide who gets priority healthcare?

A 91-year-old woman needs a hip replacement. How quickly should she get the surgery? Paul Wilcocks discusses this controversial issue in his blog. Scroll to the bottom – a reader brings my book ‘A Bitter Pill’ into the conversation and … Continue reading

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‘The Writer’s Cafe’ talks with me about ‘A Bitter Pill’.

Click here to hear the full interview.

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The Toronto Star on ‘old folks’ and healthcare.

Click here to read the article.

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The Vancouver Province discusses medical treatment for the elderly.

Here’s an excerpt from Elizabeth Payne’s article in the Vancouver Province about my book, A Bitter Pill. There is real anger in his newly released book. “The way modern medical care is practiced is all wrong for people near the … Continue reading

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My interview with CBC The Current’s Anna Marie Tremonti

Click here to hear my interview.

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Know what you want: HAVE the tough conversations early.

Is it okay not to investigate and treat somebody when they get sick at home? This is a big scary question for a lot of people. Part of the answer for a Sunshiner is to know what the person wants … Continue reading

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How do I keep a Sunshiner at home?

Sometimes people tell me I’m not being realistic and expecting them to keep their frail relatives at home. How can we deal with a sudden change in independence if we can’t get supporting help quickly? How do we know what’s … Continue reading

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I’m a Sunshiner and I’m in ‘crisis’. What do I do?

One of the big differences between medical care that works for Sunshiners and ordinary care is how “crisis” is handled. Crisis for younger people is some sort of a big disaster, the kind for which hospitals were designed. Crisis for … Continue reading

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