My Mother And The Medical Care Ad-Hoc-Racy
The former head of Kaiser Permanente finds that the health care system doesn’t work as well as it could, for his mother or anyone else.
It was a phone call children dread. “Mom’s fallen,” said my sister. “She’s in the emergency room at the hospital with a badly broken left leg. Her left shoulder and wrist are broken, too.” My mother is an eighty-eight-year-old mentally alert widow who is fiercely independent and lives alone in an eldercare complex. She had tripped and fallen hard while leaving a “Friends of the Columbia River Gorge” evening meeting at a colleague’s home in Portland, Oregon. She waited thirty minutes for the ambulance and several hours in the emergency room before she was admitted for surgical repair of her leg. After a two-hour operation to knit together the three fragments of her femur just below the hip joint, she remained in the hospital three and a half days. She was then transferred to a private skilled nursing facility (SNF) to receive the intensive physical therapy that would enable her to resume her busy life.
A Complex Web Of Care
In the first month of her combined hospital and nursing home stay, Mom was cared for by ten physicians: three primary care physicians, an emergency room doctor, two radiologists, an orthopedic surgeon, an anesthesiologist, a geriatrician at the SNF, and a wound care specialist. She was attended by at least fifty different nurses, ten physical and occupational therapists, and a host of nurse aides. Four nurses and two social workers arranged her transfer from the hospital to the SNF; two more arranged her stay in the assisted living section of her eldercare complex. At the SNF the nurse aides who bathed her, helped her with her toilet, and answered her questions were from Ethiopia, Eritrea, El Salvador, Brazil, Cambodia, and …
