Speaking of birth, illness and death, such a topic is too heavy, but it is a problem we have to face.
After reading the book The Best Farewell by Indian doctor Gervind, I have a deeper understanding of these three issues.
This book shows us how Americans think about these three issues through a large number of examples, which is very enlightening and informative.
I see from this book that two aspects are worth learning, namely, the development of nursing homes in the United States and three types of doctors.
According to the description in the book, I smoothed the timeline of the development of nursing homes in the United States.
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19 13 years
Research shows that the workhouse was a hellish place at that time, where the poor and the old were sent.
1935
The Social Insurance Law was passed, and the United States established a national pension system.
1954
Legislators allocated funds to hospitals to build separate nursing wards for patients who need long-term "recovery". This is the prototype of a modern sanatorium.
1983
Karen Wilson founded a new "assisted living center" called Park Plaza, which opened in Portland.
1990
Oregon took the lead in encouraging the construction of more similar nursing homes.
199 1 year
Bill Thomas took over Chase Memorial Sanatorium, bringing animals, plants and children into the originally lifeless sanatorium.
1992
Alice, a case figure, lives in Longwood Senior Apartment, a high-rise building complex serving the elderly. This apartment provides a nearly perfect nursing plan, but ignores the spiritual needs of the elderly as an independent person.
In 2000,
The company of assisted living center has expanded from less than 100 employees to more than 3000 employees, and operates 184 nursing homes in18 states.
At the same time, Thomas began to build the "Green House", the Leonard Florence Life Center, which is more like a "home" than a nursing home.
20 10 year
Users of assisted living facilities are close to nursing homes.
It can be seen from this timeline that the development of nursing homes in the United States has gone through a process from control to opening. They have been groping along this road and finally come to the conclusion that nursing homes should adhere to the concept of helping people in an independent state maintain their existence value.
Not long ago, I saw an article about nursing homes written by my comrades in the writing community. She wrote:
If you look at your comrades-in-arms, combined with the situation around you, this is really the status quo of nursing homes in China.
Nursing staff, living environment, food standards, these, as long as you have money, are easy to solve. However, if you tell the elderly at home that you want to send TA to a nursing home, then TA must be full of resistance. Once upon a time, sending the elderly to nursing homes became synonymous with "unfilial".
Comrades finally came to the conclusion that they chose to ask hourly workers to take care of their parents with their families. But is this really the best choice?
An example is mentioned in The Best Farewell:
An old man named Lu Sanders once lived in a nursing home with good conditions, but he was not happy there. His daughter Shelley had to put her father in a place he didn't like for safety reasons. As a daughter who loves her father very much, she knows his spiritual needs, and she also tries to take him to her home to take care of him. However, when her father's health is getting worse and worse, she needs more and more care, plus the pressure of her own life, she has to make such a choice.
My grandparents are also very old. Like many old people in the book, they are gradually losing their ability to take care of themselves. Like his comrades in the writing world, his father and his brothers and sisters hired a nanny to take care of the elderly at home. However, one nanny after another, it is difficult to meet people who are satisfied with each other. Moreover, in case of any emergency, the nanny who lacks professional knowledge is at a loss or even confused. Several times, my grandparents suddenly felt uncomfortable, so the nanny contacted my father in a hurry, and then my father called the emergency number to take the old man to the hospital. This kind of situation happens again and again, which is deeply frightening.
It can be seen that it is much more difficult to take care of yourself or ask someone to take care of you.
I learned from The Best Farewell that since the development of sanatoriums in the United States, the "semi-nursing system" has been adopted for the elderly who have the ability to take care of themselves, which is a community-based way of providing for the elderly at home. For the elderly who have lost the ability to take care of themselves, there are institutions such as "Assisted Living Center" and "Green House". They not only take care of the safety and health of the elderly, but also pay attention to the spiritual needs of the elderly, because they know that although people are old, TA is still an independent person mentally.
In fact, the spiritual needs of the elderly are not so complicated. What I said in the book is exactly the same as what I actually felt. Old people often just need the feeling of home. There is no nursing home around us that feels like home.
In dealing with the relationship between home and nursing home, the nursing home in China is not a little worse than that in the United States. Although this seems contradictory, nursing homes can never be equated with home, but the continuous exploration of the United States on this road is very worthy of our reference. Minimizing the gap between the two is what nursing homes should think about.
In this book, the author summarizes three types of doctors:
Parental, informative and explanatory.
Paternalistic: This is the oldest and most traditional type of doctor. This kind of doctor, like his parents, thinks he is an authority, and patients just have to listen to themselves.
As a sick person, I am actually very helpless. If the doctor doesn't say anything, but just puts on a "parent" posture, then the patient's psychological pressure will only be greater.
Information-oriented: This kind of doctor is just the opposite of the parent-oriented doctor. He will tell the patient the facts and data, and then let the patient decide. In the author's words, this is a "retail" relationship.
Doctors are technical experts and patients are consumers. Doctors provide the latest knowledge and technology, and patients' task is to make decisions. Generally speaking, this kind of doctor is still popular.
Explanatory type: this kind of doctor will ask the patient what is most important, what is most concerned about, what is most worried about, and so on. Knowing the patient's answers, he will introduce the drugs to the patients and tell them which one can best help TA achieve the priority goals.
This kind of doctor helps patients determine what they want.
The author criticizes paternalistic doctors because patients are completely passive; He opposes information doctors, because patients are often at a loss and it is difficult to make correct decisions; He advocates that doctors who interpret meaning, doctors and patients make treatment decisions together. To this end, doctors should fully understand patients' treatment goals and life wishes, and then try to help patients achieve them.
This should also have great enlightenment for domestic doctors.
At present, the tension between doctors and patients is largely due to poor communication between doctors and patients. Many of our doctors are parents, so it would be nice to be able to use information technology. As for the illustrative type, I haven't seen it myself.
The author Artu Gwende is an excellent doctor. From his books, we can see that he is a compassionate and humanistic writer.
I have carefully read every case of this book, and I am deeply impressed by the author's perspective and sincere language.
These issues he pondered not only caused extensive discussions in the United States, but also had profound reference significance for people in the pension and medical industries in China.
For those of us who are not employees, many cases written in the book can also let us know that Americans have a deeper understanding of life and death, family and friends, and doctor-patient relationship. I see that when everything returns to the relationship between people, Americans, like us, are full of human feelings, not as indifferent as in the legend.
The level of old-age care in our country is still far behind that in the United States. But I believe that with the development of economic level, the way of providing for the aged around the world will become more and more similar-that is, socialized providing for the aged. The medical level will also develop in a more humane direction.
Finally, I hope all the friends here can finish reading this book, and you will benefit a lot.