Tuesday, April 1, 2008

Disability & Inevitablility: A Touch of Philosophy

From the March 6, 2008 New England Journal of Medicine:

"In the United States, 125 million people are living with chronic illness, disability, or functional limitation. The nature of modern medicine requires that these patients receive assistance from a number of different care providers. Between 2000 and 2002, the typical Medicare beneficiary saw a median of two primary care physicians and five specialists each year, in addition to accessing diagnostic, pharmacy, and other services. Patients with several chronic conditions may visit up to 16 physicians in a year. Care among multiple providers must be coordinated to avoid wasteful duplication of diagnostic testing, perilous polypharmacy, and confusion about conflicting care plans."

These 125 million people are not the unfortunate "other." They are not only our partners, children, sisters, brothers, parents, and friends. They are us.

A friend who has worked in the rehabilitation field for decades likes to shock people by saying that there are no dis-abled people, only temporarily abled people. And none of us has the algorithm for figuring out how long we will be abled.

So what's a person to do when the outcome is so fearsome and so certain:

"Keep walking, though there's no place to get to. Don't try to see through the distances. That's not for human beings. Move within, but don't move the way fear makes you move."
Rumi (13th century Persian poet)

...and it wouldn't hurt to consult with a long term health care/financial planner; build a strong relationship with a primary care provider; find a health care facility that has a geriatric service that provides case management (like John Muir Health Senior Services in California); talk to your family before a crisis hits about your wishes and the kinds of help family members can offer.


therapydoc said...

Good advice, especially the part about having a GOOD relationship with your pri-care.

Diane J Standiford said...

Great advice, but try getting some people (my great aunt, in(out) laws, mother,) to take it. I tried, failed, and things got ugly at the end when they didn't need to be.

Barbara Kivowitz said...

Very true Diane. You can only push a boulder uphill so far.

AmyT said...

Hi There,

I did a post today on Diabetes & Disability at

We're kind of in this no-man's land of semi-disability. Emotions run high.