Susannah Fox

I help people navigate health and technology.

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Comments

  1. Yep, these are the two demographic shifts that other countries have been including in their strategies for a while. USA, like many societies, is aging and becoming non-white. This is where we need to start learning from countries paying attention to the obvious epidemiological trend that emerges, chronic illness and multiple chronic illness as well as the burden on caregivers. A lot can be done to start preparing for this including a real attention to support networks, basic primary care infrastructure, community health workers, integrated physical and mental healthcare, family approaches, etc., etc.

    Somehow, we are still stuck in the piecemeal solutions and the gadget technology silver bullet solution, the demographic trends are clearly happening. We should look around ourselves and observe who is presenting, who is leading, and who is attending the numerable healthcare conferences. If it looks a bit white and a bit too male, we may want to raise our voice and ask sponsors and organizers how that can be.

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    • Thank you, Gonzalo — I’d love to learn more about what other countries are doing. I have seen stories about how Japan is taking their aging population quite seriously — where else can we look for inspiration?

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    • Always the nerd — and I love you for it, Matthew!!

      Sometimes I don’t want to post infographics because they smudge and allide and even bastardize the data. This one meets my standard because I have confidence in my former colleagues at the Pew Research Center (a more serious bunch you will not find) but yes, it is still artwork and therefore imperfect.

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  3. Love the graphic – prepared we are not!

    For many years before joining PatientsLikeMe I worked in community-based hospice and palliative care. These one-on-one relationships with patients and families in their homes were often punctuated by conversations about preparation for what was ahead.

    For too many patients and their loved ones time for preparation was woefully short since the reality of their situation was not previously broached by their care providers or if discussed not fully absorbed by the patient and family. We must do better and frankly can do better.

    There is no lack of exemplary resources and tools to support what I call “anticipatory guidance” – which is not just about the end of life – its about what it takes for someone to live as well as possible across their whole life during times of wellness, illness, caregiving and aging. When done well and over time anticipatory guidance can help identify where there might be uncertainty about what’s ahead and where there are gaps in care or resources that need consideration and planning. Yet, for me the most gratifying outcome of modeling anticipatory guidance with my patients and their families was the opportunity to illuminate with them their existing strengths, assets and resiliency.

    Anticipating what may be ahead instead of stumbling headlong into uncertainty day after day can be reassuring and quite empowering. To live as well as possible across our lives it takes creative collaboration across all of the communities in our lives – where we live, work, play, socialize, connect, get care and otherwise spend our time – this is especially true during times of illness, caregiving and complicated aging.

    As always your posts provoke interesting contemplation – thanks!

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    • Anticipatory guidance. I’m going to need to sit with that phrase for a few days.

      What if we received anticipatory guidance about immunizations when we first find out that we are pregnant, instead of waiting until the nurse is coming at our sweet newborn with a needle?

      What if we received anticipatory guidance about the possibility of chemicals settling in our children’s fat cells before we shopped for a mattress or a couch? (I just read the eye-opening book Breasts, by Florence Williams, who tested her own breast milk and found very high chemical levels, some of which came from her fireproof-treated couch.)

      But I digress.

      What if, indeed, we all received anticipatory guidance about living out our years to the best of our abilities and in line with our values?

      Thank you, Sally!

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  4. Wow, all three of you, excellent comments. Later today I’ll be posting one of my own, but for right now I’ll add this, by Kay Lazar (a writer I love), from the front page of today’s Boston Globe:

    Elder advocates raise concerns on assisted living

    (Remember, this is assisted living, not a so-called Skilled Nursing Facility.)

    In Stoughton, an elderly woman walked out of a locked dementia unit at an assisted living residence in May, wandered into another room and fell from a second-story window.

    That same month, at a Framingham assisted living facility, two staffers were arrested for allegedly slapping and pinching two elderly residents who have Alzheimer’s, and filming a third who was partly undressed.

    In July, an 88-year-old man with a history of falling, and who had a tube in his chest for dialysis treatment, apparently tripped in the bathroom of his Revere assisted living residence and bled to death before staffers reached him.

    Residents in Massachusetts assisted living facilities are in harm’s way too often, and the Executive Office of Elder Affairs, the state agency charged with overseeing the 224 residences, is ill-equipped to protect these increasingly frail residents, elder advocates say.

    And this pull quote by a facility staffer, touching on an effect I’ve observed myself among families I’ve seen:

    “We don’t want anyone to reside in our community if they are not safe, but often it is the families that want them to stay.”

    The families I’ve seen are in the pinch of “S/he seems to be doing pretty well so far” (a mix of hope and wishful thinking) and the cost difference between assisted living ($4588/month!) and nursing homes ($345/day, >$10,000/mo).

    Prepare, indeed.

    What if we took this GIF itself as anticipatory guidance at a community level?

    What if some big-money innovator who specializes in customer delight decided to solve this problem with an approach that works and that families love?

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  5. The desire to slice & magnify these numbers differently (per Matthew) made me remember that Pew publishes its raw data, precisely so others can do that. But all my search skills have failed to find the original report – any suggestions on how I can get it?

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    • The raw data in this case is Census projections, I believe. If you click on the graphic above it will take you to the Pew Research Center mini-site for Paul Taylor’s book:

      http://www.pewresearch.org/next-america/

      So… not sure it will help you since it’s custom art for a book based on government data. Different from most reports.

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  6. Susannah,

    I blogged about this a few days after you did, and I just got punched in the gut by this comment from a Kaiser doc. It put me instantly into tears of hopelessness. Be careful before you start reading it – a true story … from twenty years ago.

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  7. Hi all,

    I started a new thread on the topic of the coming age boom if you want to check it out:

    What if?

    Gonzalo already dove in with a comment (thank you!)

    Reply

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