Wednesday, June 30, 2010
Geriatric Management Consulting #5
Another sentence from the article on the E-Myth website (www.e-myth.com), The Challenges of a Family Business, that grabbed my attention:
“When we stepped back and looked at the business holistically…”
Gradually the medical field is starting to look at the individual holistically---not just a bag of parts. Still the conscious and unconscious contract between doctor and patient is one-on-one as if the person existed as an encapsulated monad. Relationships are ignored or endured as major or minor nuisances.
In my experience, often in order to meet professional standards (HIPAA), geriatric care managers, social workers, hospice nurses, etc. engage with the individual in the same way. Sometimes I also see these professionals hiding behind HIPAA perhaps to avoid those pesky outsiders.
If individuals in a family/friend system are to get quality personal and medical care going forward, holistic has to expand to include the relationship network. The person is going to be drawing on financial resources; require some amount of unpaid labor.
Who else is drawing on these resources of time, money and energy? Spouse? Children? Grandchildren?
Who else will soon be drawing on these resources?
Is there enough to go around?
So often I hear from medical staff instructions issued in the passive voice with the agent unexpressed: Your bandage will have to be changed every day.
Or the instruction completely ignores the individual’s ability to comply without assistance, be it meal preparation or transportation or personal care.
I realize that medical staff have no time for this kind of discussion but that doesn’t mean it isn’t essential. Too often I see families burn themselves out on one crisis. This can breed resentment and actual (realistic) fear in the survivors---what about me when my time comes?
When we stepped back and looked at the family holistically…