Friday, 3 April 2015

As time goes by

Karen Hitchcock's Quarterly Essay (QE57) Dear Life: On Caring for the Elderly should be a must-read for government, policy makers, medical students and everyone working in the health care profession. It is a compelling and passionate plea to respect our elders, challenge agism, and invest more in quality care.

So often we hear about the tsunami of old age pensioners that will burden an already stretched health care system to breaking point. When the frail and demented find themselves in hospital, specialists race to see who can avoid treating them. They are shoved into corners, over medicated, and encouraged to move on. What is seen is failing kidneys, dodgy hearts, broken bones... Isolated body parts not connected to a real life person. Not a human being; someone's mother; someone's husband; someone who has contributed for their long life to the tax system and now seeks to make a withdrawal. Certainly not someone that you or I will become in twenty or thirty years.

Littered with touching tales of elderly patients, Hitchcock puts a human face to her essay - the man who thought he was a burden, the woman who only wanted time to say goodbye to her family. Woven throughout is the story of the author's Nan, who inspired her to become a GP.

Exposing the sad truth of many end-of-life decisions, the pressure placed on families, the over treatments and rush to deem treatments as futile merely because someone is old, Hitchcock makes a compelling case for reform. Starting with a medical system that shunts people into specialties which creates a false hierarchy within the profession, this allows geriatric care to be devalued reflected in the status and pay of those working in our nursing homes and hospices. If we want quality care in these spaces, we need to train, value and pay the staff that work there and ensure we put enough staff on so that they can spend time with the patients. 

She also argues that the biggest threat to the healthcare system is not the grey army, but rather those of us in younger generations - 'the population of increasingly poor, obese, diabetic, sedentary young and middle-aged who are the multi-morbid patients of the future'.  We need to invest more in attending to risk factors of smoking, alcohol, sodium, obesity, and high blood pressure. Instead, the government has defended the Australian National Preventative Health Agency and cut Medicare Locals. Let's hope the Minister for Health reads this before the exit federal budget and demands investment rather than the inevitable cuts.

Included in this volume is correspondence related to the previous QE on Clive Palmer. Of interest, Richard Denniss writes about the electoral system and the low percentage of eligible voters who actually elected the Abbott government to provide him his supposed mandate.  Dennis Atkins ponders whether the 2015 Queensland state election marks the beginning of the end for Palmer's party, especially with so few Senators remaining.

My reviews of past Quarterly Essays are also on this blog: