Healthcare

Senior Service Providers – a huge network of resources

Posted on by Michelle Fritsch, Pharm.D.
occupational_therapist
There are many types of senior service providers for you to research in your area.

Our population is aging! And there is a rapidly growing network of Senior Service Providers to help promote healthy, safe aging. I was first introduced to this ever expanding network about a year and a half ago.

So I want to introduce you to the many resources available to you, to your aging loved ones, and to anyone you know who is anxious to stay as healthy as possible.

I don’t think it would be possible to make a list like this complete. So know if you have a specific need not listed, search for what you need. I’m fairly certain someone has thought of that need and designed a solution. At the end of this blog I’ll point you toward a think-tank of even more innovative solutions being pursued.

Senior Service Providers to seek in your area

  • Aging-in-Place/Home Safety
  • Assisted Living Placement Services
  • Assistive Technology Devices
  • Certified Care Management
  • Computer & Technology Services
  • Daily Money Management
  • Estate Liquidation & Cleanout
  • Financial Services & Insurance
  • Fitness and Balance Classes
  • Home Modification and Repairs
  • In-Home Primary Care Provider
  • Legal Services
  • Licensed Massage Therapy
  • Medicaid Planning
  • Medical Alert Systems
  • Medication Management
  • Mortgage & Reverse Mortgage
  • Move Coordination from your home
  • Nutrition
  • Occupational Therapy
  • Personal Historian
  • Physical Therapy
  • Private Duty & Home Care
  • Real Estate
  • Senior Living Communities
  • Transportation

Ways to find senior service providers

Again, this is not an exhaustive list. If you want to modify a home to make it safer, there are specialists that can help you. Look for the ‘Aging in Place’ certification. If you want to know what resources are available in your particular community, find a local Lifecare Manager at www.aginglifecare.org. If you are faced with downsizing, moving from home to assisted living or in with children, or arranging for someone to move in with you, there are a host of specialists to help. There are realtors specialized in homes designed for safe aging; mortgage and reverse mortgage specialists to help find the best rates, companies that specialize in helping you sort through your belongings and sell those you don’t plan to keep to convert them to cash; and companies that specialize in sorting through horded materials. There are companies that will pack you, move your belongings, and unpack them so that they are right where you want them.

There are lawyers specializing in the sensitive needs of older adults making financial and legal decisions. You can find specialists that will manage your bills and finances for you in your home – http://aadmm.com.

Note, some of these services are covered by insurance while others are out-of-pocket. Be sure to ask about costs as you research your options.

And, as promised, I want to tell you about Aging 2.0. This organization is pulling together innovative people with any kind of solution that will enhance healthy aging. It gives those innovators a platform to share their innovation, perhaps find funding, and network with other providers so they can collaborate and offer a more robust service. You can learn more at https://www.aging2.com/about-us/.

I have been amazed at all of the available resources. I hope you find hope in the many kinds of senior service providers that can help you in your quest for healthy aging. For more information about options, please contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

As Christians, we have a lot of resources at our disposal, too. Within the body of believers we have every kind of gift and skill. In Acts the believers supported each other and shared everything. We don’t do that, but we can use our gifts to help each other in whatever God is calling us to do.

Acts 4:32-37 ESV

Now the full number of those who believed were of one heart and soul, and no one said that any of the things that belonged to him was his own, but they had everything in common.  And with great power the apostles were giving their testimony to the resurrection of the Lord Jesus, and great grace was upon them all.  There was not a needy person among them, for as many as were owners of lands or houses sold them and brought the proceeds of what was sold and laid it at the apostles’ feet, and it was distributed to each as any had need.  Thus Joseph, who was also called by the apostles Barnabas (which means son of encouragement), a Levite, a native of Cyprus, sold a field that belonged to him and brought the money and laid it at the apostles’ feet.

The messages about helping each other are found in the New Testament and the Hebrew Bible.

Hebrews 13:16 ESV

Do not neglect to do good and to share what you have, for such sacrifices are pleasing to God.

Philippians 2:4 ESV

Let each of you look not only to his own interests, but also to the interests of others.

It is through going to Church, being part of small groups, participating in Bible studies, and other times of fellowship that we can find out about the needs. Then, as we consider our own gifts, we can align ourselves with the needs where we can be of assistance. We can also help connect those with needs to those with matching gifts among our Christian community. It is so beautiful when those matches come together!

Blessings,

Michelle

Image source: National Eye Institute, National Institutes of Health, U.S. Department of Health and Human Services

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Gratitude and Satisfaction – Healthcare Perspective

Posted on by Michelle Fritsch, Pharm.D.
jamaica-group-wait
Have you expressed gratitude for your healthcare?

When was the last time you expressed gratitude for your healthcare? How often are you satisfied with the healthcare you receive? When do you suppose is the last time your doctor, nurse, pharmacist, medical assistant, intake/discharge specialist, or billing office received a ‘Thank you!’?

I encourage you to take a moment and list the last five benefits you received from your healthcare providers?

Here is my current list:

  1. Emergency services in the middle of a blizzard for a head injury for a child.
  2. A surgeon and many, many supportive people for a rotator cuff repair.
  3. A patient, engaging ophthalmologist helping a frustrated teen with vision-related headaches.
  4. Access to an annual mammogram with follow up ultrasound whenever something looks suspicious.
  5. Preventative vaccines and personalized guidance from my physician in preparation for third-world healthcare provision.

Healthcare gratitude I experienced in Jamaica

I can’t stop thinking about my week in Jamaica and the many insights I took away. I was honored to serve with a team of about 20 people caring for people in St. Mary Parish, an underserved portion of Jamaica. We had physicians, nurses, pharmacists, medical records, check-in, child-care, and spiritual support specialists. (Remember that spiritual health is a key aspect to overall health).

Two situations have especially stood out to me. One was a woman who was diagnosed with breast cancer in 2014. She was treated with a mastectomy. She did not have access to radiation or chemotherapy. Now, in 2016, she had a lump under her arm. The physician prescribed an antibiotic. We are all hoping and praying it is an infected cyst and not cancer. Guess what? She was grateful for the care and for the antibiotics! She did not demand other therapy. She was not disgruntled. [Maybe she doesn’t know how it would be treated in a developed country with insurance. Then again, her gratitude and lack of stress over options can actually be to her benefit.]

The other situation was a young boy with low hemoglobin, so he was anemic. Hemoglobin carries oxygen throughout the body. There are several possible causes of anemia in a child. We were able to give him multivitamins and iron supplements. His mother was surprised to hear he was anemic. He was outside playing with the other children as we talked about the medicine. When he came in she showed me how strong and healthy he looks. She was very satisfied with the vitamins and iron. I couldn’t help but think how differently that exchange would likely be here in the US. Parents would want a series of tests to rule out any obscure implication of the anemia. [Note, anemia in children is not uncommon in Jamaica. Children are breastfed for an extended period by mothers who do not have prenatal vitamins. Then, because meat is expensive, the diet has less iron in it.]

Health benefits of gratitude

It is so easy to find fault in other people and in systems. Add the element of fear that comes with medical diagnoses, and people often have very negative reactions in the healthcare setting. That increases stress for the patient, any caregivers with the patient, the physician, and all members of the healthcare team.

Consider the benefits of gratitude instead. Gratitude can:

  • Boost your spirits and sense of well-being
  • Boost your immune system making you less likely to get sick
  • Decrease your chances of heart disease
  • Improve your performance (job, concentration)
  • Bust your stress

By all means, when mistakes are made they need to be addressed. But mistakes are not the norm. People go to school for many, many years to be able to provide the best healthcare they can provide.

We saw hundreds of patients in very hot August in Jamaica in churches with no air conditioning and few fans. And I only heard one person complain over five very full days. That woman didn’t understand why the man next to her got more diabetes medication than she got. Once she understood it took more medicine to manage his sugar she was satisfied.

If you would like to hear more about my trip to Jamaica or about the health benefit of gratitude, contact me at www.medsmash.com/newsblog/.

BIBLICAL APPLICATION

Life feels so different when we live in gratitude rather than dissatisfaction. Negativity stresses us out and ultimately kills us.

1 Thessalonians 5:18 ESV

Give thanks in all circumstances; for this is the will of God in Christ Jesus for you.

I have a new source of gratitude this week.

Do you ever have a God moment when something becomes so clear? I received the best analogy this week. And I can’t wait to tell you about it!

It likens faith with a child going on vacation.

When a family is going on vacation, the child knows the mom or other adult will pack the clothes, the snacks, the sunscreen, the towels, and anything needed for that vacation. The child knows someone will take care of the directions, putting gas in the tank, making hotel reservations, and other travel details. The child knows there will be a safe place to sleep, some fun adventures along the way, food to eat, and all basic needs will be met. The child gets in the car when told it’s time and follows the lead of the adults who have planned the trip. The child is along for the fun with no stress and no second-guessing the plans.

Wow, isn’t that like faith? God’s got this! He has plans for your life. He has plans for each year, month, day, minute, … Faith is being the child with full faith in the adults who are in charge of the details.

Proverbs 3:5-6 ESV

Trust in the Lord with all your heart, and do not lean on your own understanding. In all your ways acknowledge him, and he will make straight your paths.

Isaiah 42:16 NIV

I will lead the blind by ways they have not known,

    along unfamiliar paths I will guide them;

I will turn the darkness into light before them

    and make the rough places smooth.

These are the things I will do;

    I will not forsake them.

I encourage you to spend less time on daily travel details and more time letting God take the lead this week.

Blessings,

Michelle

 

When the Rules Don’t Quite Make Sense

Posted on by Michelle Fritsch, Pharm.D.
Airplane ors.od.nih.gov
Interpretation of rules has created an airplane that has launched with no plans to build the runway in healthcare.

To finish a thought from last week’s blog, sometimes the rules create their own problems. The Centers for Medicare and Medicaid (CMS) created a new risk-sharing payment strategy with hospitals. If someone has health insurance through Medicare, and if they are readmitted to the hospital for the same condition within 30 days, then the hospital will not be paid for the second admission. (Of course it’s a bit more complex than that, but this is the gist).

This ruling has created a whole new ‘market’. A group of very smart technology experts and entrepreneurs have identified this as a place to create new ways to keep people healthy at home. Tools and solutions are created that help people be successful at home after being in the hospital.

  • Patients benefits by having new resources to help them maneuver their care at home and stay at home.
  • The hospital benefits by losing less money on readmissions within 30 days.
  • The new companies, technology gurus, and entrepreneurs make money by being paid through the hospital’s cost savings.

Rules (and solutions) – make sense?

These are the parts that are missing, in my opinion.

  1. Once we determine how to keep people home safely for 30 days, I anticipate CMS will expand the time window to 60, 90, or more days. So short–sighted solutions will not survive.
  2. What happens after 30 days? Many of these new solutions involve technology. Who pays for the technology and the monitoring after the 30 days? Will it just be removed from the person’s home? Then what happens? Is that cost effective? Does it even make sense?
  3. What about people who are fearful of technology? Again, most of the solutions I’m hearing and reading about are based on technology. What if the person doesn’t have internet access or land-line phone access? What if the person has no interest in learning how to use the technology? What if the person just can’t get the hang of the technology?
  4. As I mentioned last week, I am finding very little data on what users/people with chronic medication conditions want. Solutions are being developed with little to no input about whether people will actually want or use the solutions.

For some of these issues the answers I’ve received are that there will always be exceptions. Those will be dealt with one by one. The goal is to find solutions for the majority.

It was funny, in one of these conversations we likened the current technology solutions boom to the airplane that’s in the air but no one has thought yet about the runway. That seems like a fitting analogy to me right now.

Hope

There is hope. I talked yesterday to a company taking a MUCH broader view of helping people stay healthy in their homes. They are not even thinking about the 30 day readmission rules. They are looking at long-term solutions that are created and maintained around the person that is using them. I know that company is not alone. I’ll put my hope in these types of companies!

For more information about new technologies in healthcare, please contact us at www.medsmash/contact.

BIBLICAL APPLICATION

Do you ever feel like the ‘rules’ of Christianity don’t make sense? Are you left wondering why the Christians around you are doing things a particular way? Have you been instructed to do something that doesn’t make sense?

In these instances, I encourage your FIRST question to be, ‘Is it Biblical’?

1 John 4:1 ESV

Beloved, do not believe every spirit, but test the spirits to see whether they are from God, for many false prophets have gone out into the world.

2 Peter 2:1 ESV

But false prophets also arose among the people, just as there will be false teachers among you, who will secretly bring in destructive heresies, even denying the Master who bought them, bringing upon themselves swift destruction.

I’m not saying every pastor or spiritual leader who says something that is not Biblical is a false prophet. People, even pastors, do make mistakes. But we have A LOT of examples of people adding rules to what is in the Bible. These ‘human’ rules are just that. Each denomination has their ‘way of doing things’. Even these are often the result of people trying their best to understand and interpret the scriptures. So see if the item that you question is from people or from God.

Your SECOND question should be, ‘Did I understand correctly’? Never hesitate to ask clarifying questions. We are all guilty of making assumptions about the other person’s knowledge when we answer a question. This often leads to complete misunderstanding.

Proverbs 18:13 MSG

Answering before listening

    is both stupid and rude. 

1 Timothy 6:20-21 MSG

And oh, my dear Timothy, guard the treasure you were given! Guard it with your life. Avoid the talk-show religion and the practiced confusion of the so-called experts. People caught up in a lot of talk can miss the whole point of faith.

I encourage your THIRD question to be, ‘Does it glorify God?’ By this I mean, does it promote the type of life and interaction we are called to live?

James 3:17-18 MSG

Real wisdom, God’s wisdom, begins with a holy life and is characterized by getting along with others. It is gentle and reasonable, overflowing with mercy and blessings, not hot one day and cold the next, not two-faced. You can develop a healthy, robust community that lives right with God and enjoy its results only if you do the hard work of getting along with each other, treating each other with dignity and honor.

The real ‘rules’ and instructions are in the Bible. The rest are interpretations, good/spot on and sometimes misguided. So discernment helps us sort them out. I know I have trouble sorting through it all on my own. Bible reading, study, trusted people to talk with, and prayer help me through.

Blessings,

Michelle

Image source: Office of Research Support; National Institutes of Health; U.S. Department of Health and Human Services.

30 Days – CMS and Hospitals Share Risk – Input Desired

Posted on by Michelle Fritsch, Pharm.D.
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Technology is being developed to help you stay healthy and out of the hospital 30 days.

The Centers for Medicare and Medicaid Services (CMS) are striving to keep healthcare affordable. Healthcare is expensive. Healthcare is necessary. We all need it at some time or another. It is best if medical conditions that require hospitalization are fully treated while in the hospital. CMS wants to pay for these conditions just once. So, to help make sure they are fully treated and that patients are sent home with all they need to stay healthy, there is now a shared risk payment model. If someone returns to the hospital within 30 days of discharge, then CMS will not pay for that second visit. (Of course it is all more complex than this paragraph describes).

So, there are a number of very smart people working hard to increase the success of people going home from the hospital to help them not return. At least making sure people don’t return for the same problem within 30 days.

There are people working on tools to help keep medication regimens straight. Others are working on ways to monitor health so if it starts to get worse an adjustment can be made at home. This could prevent a need to go back to the hospital. These tools can monitor blood pressure, blood sugar, weight, oxygenation, and more. There are also tools to monitor in-home activity, measure falls risk, and respond when someone has fallen. Much of the follow up after a hospitalization can occur more frequently and simply with telehealth. This means talking with your doctor, nurse, pharmacist, or other provider over the computer.

There is an explosion of new technology. The issue now is to determine which types of technology are most effective. It is also to determine which types really help people get better. And ideally, the best technology will help people stay better for a long time.

Then there is the issue of how people, the patients, feel about the technology. Some are very excited to have new ways to monitor their own health. Look at the growth and acceptance of wearable devices. Some popular examples are Fitbit, Apple watch, and Garmin Forerunner, and TomTom. Spark.

  • I can find a lot of information about how the technology is proposed to help people safely go home and stay healthy enough to stay out of the hospital.
  • I can find some information demonstrating that these really do cut down on the number of people that bounce back to the hospital.
  • I can find very little data about how people feel about the use of such technology, especially for at least 30 days.

Hospitals are preparing to spend millions of dollars on these solutions. For the money saved by reducing readmission, the hospital and the solutions companies will share those dollars.

  • So what do you think?
  • Are you excited about the use of technology to help you stay healthy?
  • Do you see more advantages or disadvantages?
  • Have you experienced some of these technologies when you or a loved one has been discharged from the hospital?

I would love to hear your thoughts. Please send your questions, your ideas, and your opinions to us at www.medsmash.com/contact.

BIBLICAL APPLICATION

Another thing that I’ve been pondering about 30-day readmission rates is the usefulness of short term solutions. I might have to write about that next week.

I find that topic to be really relevant in my Christian life as well. I love the ‘mountaintop’ experiences. These are the times when you are absolutely on fire for God. They are the times when you are closest to God. They are the times when you most directly feel God’s presence.

At those moments, what do you plan to do? Do you agree with me that it feels like you’ll be able to stay in that intimate place for a long time? How long do those intentions really last?

Have you ever made plans during those times when you felt most intimate with God? Did you make some promises? Did you decide your were going to make big changes in your life? I know I have.

Even now, just two weeks back from a life-changing experience in Jamaica, I’ve fallen back into old habits. I’m putting my needs and desires before other people. I’m way less focused on all that I could be doing for others. I’m more focused on my own aches and pains again. This is not what I intended. It is not what I told myself or God I would do when I got back.

Romans 8:5 ESV

For those who live according to the flesh set their minds on the things of the flesh, but those who live according to the Spirit set their minds on the things of the Spirit.

I really, truly want to live according to the Spirit. Yet my progress often feels like two steps forward, one step back.

Do you have the same experiences?

So each day, I strive to stay focused. I try to keep my eyes on God.

Colossians 3:2 ESV

Set your minds on things that are above, not on things that are on earth.

Every day I fail at some point, or a lot of points. But, I also have more of those moments of intimacy. I feel better in every way when I make that time for God. (And knowing that, I still charge right past that time to get on with the to-do list of the day).

Proverbs 16:3 ESV

Commit your work to the Lord, and your plans will be established.

So today, I will strive again to stay focused on God’s plans. I will strive to keep my ‘spiritual eyes’ on and see the needs of those around me. I will keep working toward the long-term goal rather than a short-term solution.

Blessings,

Michelle

To feel better – do for someone else – altruism

Posted on by Michelle Fritsch, Pharm.D.
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Altruism helps others and improves your health

I am just back from Jamaica, and I need to write about altruism. I was working with a mission group called TEAMS. You can learn more about them at www.t4mm.org. This medical mission group included 3 physicians, 1 nurse practitioner, 2 nurses, 3 pharmacists, 3 for registration, 2 to be with the children while their parents received care, and 2 to provide prayer and emotional support to those coming for care.

We were serving in St. Mary Parish, one of the poorest of the country. Clinic was held in churches in four different areas of the Parish. A Parish is similar to a state in the United States. Sheets draped over ropes often separated exam rooms for physicians. I counseled people about their medications as they sat among many other people. So this was not a private setting. But, excellent practitioners provided individualized care with great compassion.

Each clinic served a particular community. Within that community you could look out at all who were waiting and see the way they cared for each other. Babies would be passed around, older members would be assisted with steps, others in nearby seats would assist with understanding when I was struggling with the Patois (English with a thick dialect spoken very quickly).

It was very hot. Fans helped to stir the air. There was no running water. (I am so thankful for hand sanitizer). Some children had lice or scabies yet they waited patiently with their family. You know they had to be miserable between the heat and the intense itching. Some people had to wait from early morning until mid afternoon to be seen.

Yet, I didn’t hear one person complain. No one was demanding to know why their wait was so long. No one was complaining about the conditions. No one was asserting their needs or rights before someone else’s.

On the medical team, several people were struggling with their own health issues. One was on crutches due to a broken leg; one was recovering from bronchitis; one had a cold; several had various aches and pains. The age range of the care team was 22 to 82. Personally, my leg is still recovering from a ripped calf muscle, and my back has been hurting from all of the time that I was on crutches and a boot.

What struck me was how none of that mattered! Rather than thinking about our issues, we were completely focused on all of the people who had arrived to receive care. My leg did fine the entire week, even carrying heavy tables and boxes and fans to set up and take down clinic every day up steep hills and steps. I didn’t do my back stretches or sit around rubbing my back the way I do at home. That is because I wasn’t even thinking about my back.

Altruism

Altruism is, ‘feelings and behavior that show a desire to help other people and a lack of selfishness’ as defined by Merriam-Webster. I have read several articles linking altruism as a factor in happiness, health, and how long you live. In general, studies have shown that people who focus on others are happier and even live longer, in general. In 2005, Stephen Post published an article in the International Journal of Behavioral Medicine entitled, ‘Altruism, Happiness, and Health: It’s Good to be Good’. A quote from the article is, ‘The article concludes, with some caveats, that a strong correlation exists between the well-being, happiness, health, and longevity of people who are emotionally and behaviorally compassionate, so long as they are not overwhelmed by helping tasks.’

I have seen truth in this in many instances. While I was doing post-graduate training in Wisconsin a study demonstrated that home-bound elders who were in a calling circle.  Those who called to check on each other and remind each other to take medications felt less isolated and more valued. A project called the Eden Alternative long ago demonstrated the value in having daily purpose for everyone in a nursing home setting. Depending on ability level residents would care for a cat or dog, garden, water plants, feed birds, feed fish, or other activities. It was a huge success and continues today! Everyone needs to be needed. That sense of purpose and belonging plays a big role in overall health, including anxiety levels, pain, and depression.

When was the last time you focused on the needs of someone else? I encourage you to find a way each day this week to meet someone else’s needs. Some examples are to check on an older neighbor; take a meal to someone who recently had surgery; call a mom with small children to see if you can grab some things for her when you go to the grocery store and save her a trip.

For more information about how altruism is connected to health, contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

It is no surprise that altruism is linked to enhanced health. Jesus told us many times about the importance of selflessness.

John 15:12-14 ESV

“This is my commandment, that you love one another as I have loved you. Greater love has no one than this, that someone lay down his life for his friends. You are my friends if you do what I command you.”

Daily devotions, a lot of singing, and prayer with each community were cherished parts of this mission.  The care was among providers, among recipients, among those at the church helping with coordination, and among those providing protection.  My visual each day was being filled up with the Spirit to be completely poured out by the end of the day.

Some say Christian selflessness is not true altruism because we will be rewarded for such care and compassion. Ultimately, eternally a reward is waiting. But while here in this life, you might not see a reward. In fact, your giving isn’t meant to be for show.

Matthew 6:2-4 MSG

“When you do something for someone else, don’t call attention to yourself. You’ve seen them in action, I’m sure—‘playactors’ I call them—treating prayer meeting and street corner alike as a stage, acting compassionate as long as someone is watching, playing to the crowds. They get applause, true, but that’s all they get. When you help someone out, don’t think about how it looks. Just do it—quietly and unobtrusively. That is the way your God, who conceived you in love, working behind the scenes, helps you out.

Paul, Peter, Luke, John, and many other writers in the New Testament extol the virtues of giving to others.

Philippians 2:4 ESV

Let each of you look not only to his own interests, but also to the interests of others.

Luke 6:35 ESV

But love your enemies, and do good, and lend, expecting nothing in return, and your reward will be great, and you will be sons of the Most High, for he is kind to the ungrateful and the evil.

1 Peter 3:8 ESV

Finally, all of you, have unity of mind, sympathy, brotherly love, a tender heart, and a humble mind.

What can you do today to help someone else?

Proverbs 19:17 ESV

Whoever is generous to the poor lends to the Lord, and he will repay him for his deed.

Blessings,

Michelle

Your Medical Insurance – perfect?

Posted on by Michelle Fritsch, Pharm.D.
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Does you medical insurance meet your needs? Is it a right?

You likely have medical insurance if you live in the United States. As of 2014, 90% of Americans did. When the 2015 data is released, that number is likely to go up a bit. It increased 2.9% from 2013 to 2014.

Does your insurance policy cover all that you want it to cover? Are all of the types of care you desire covered? Is your care ever delayed longer than anticipated due to insurance company authorization steps?

Our family just experienced this for the second time this year. It is very easy to get frustrated with insurance-related delays. Your doctor orders a test or procedure, and your insurance company takes time to authorize it.

There is a series of checks and balances between the healthcare system (doctors, clinics, hospitals, etc.), insurance companies, and lawyers. Sometimes it seems to tip, leaning more in one of these three directions, but each aspect is needed. Insurance provides you with coverage to maintain your health without losing all of your money due to an illness. It also provides checks and balances to assure cost-effective use of resources, such as procedures, surgeries, and devices. Lawyers help assure you have recourse if healthcare harms you rather than help you.

As a healthcare provider, I have seen numerous examples of excellent healthcare that has prevented or effectively treated a medical issue. I have seen unnecessary use of resources such as antibiotics or procedures. I have seen mistakes and the ramifications. I have seen heroic efforts by all involved to pull together, analyze mistakes, and create safety procedures to prevent such a mistake from happening again.

Is healthcare a right?

A question I annually ask students is whether healthcare is a right. It always leads to great discussion. If it is a right, then how should the system look that provides healthcare to the uninsured? Right now the emergency department (most cannot turn people away for lack of payment) is often the only source for uninsured people. That is a grotesquely expensive misuse of the specialized skills of emergency department personnel. But if you had no insurance, and your child was sick, what would you do? I know I would take my child to the emergency department if that were my only choice.

If it is not a right, then what should happen to uninsured people who are unable to access the healthcare system? Should we stand by and watch suffering and disease that could be treated? Could you walk down the street and just pass by someone suffering? (Do we already do that every day? If you live in Baltimore or another city of significant size, I know that you do.) It’s so easy to focus on ourselves and lose sight of those around us. I challenge you to get to know at least one uninsured person and hear his/her story. What should happen next time that person is injured in an accident or has trouble breathing due to asthma?

Is your medical insurance perfect?

I imaging your answer is ‘no.’ I know mine is far from perfect. But, I am so grateful to have insurance! I am grateful for the coverage I do have. Next week my daughter will get a sports physical to be sure she is healthy enough for her sport; my other daughter will be assessed for a nagging cough; my husband will see a surgeon to create a plan to treat his shoulder. All of these things are possible due to insurance. If all of that was out-of-pocket, my youngest would not play a sport, my middle child would continue to cough, and my husband would try to continue to function with one arm.

Perspective

Next weekend I leave on my first international medical mission trip. In the excellent materials I have been given to prepare, there is a statement that I will see more worms, scabies, and lice than I have seen in my entire career. Caring for the homeless of Baltimore, I have seen some of these things, but apparently not in the quantity I will see next week. How many times have you been treated for scabies, lice, or worms? Probably not many, if ever. We will also be caring for people with diabetes, hypertension, asthma, and the chronic conditions we treat in the affluent in the US. I am especially looking forward to analyzing the needs of a growing population over age 65.

I don’t claim to have the answers. But I do know there are several issues to be pondered. If you have ideas and opinions, please share them with me at www.medsmash.com/contact/.

BIBLICAL APPLICATION

There is no shortage of social issues that need to be addressed. Quality of insurance for the insured and what to do about the uninsured are certainly on that list.

Our pastoral team has been delivering a series based on Deuteronomy this summer. Here is a verse that very directly addresses these questions:

Deuteronomy 15:11 ESV

For there will never cease to be poor in the land. Therefore I command you, ‘You shall open wide your hand to your brother, to the needy and to the poor, in your land.’

This is from the Old Testament/Hebrew Bible, but wow, is it not as relevant today as it has ever been?

We are challenged in at least 60 verses to address these issues.

Proverbs 19:17 ESV

Whoever is generous to the poor lends to the Lord, and he will repay him for his deed.

1 John 3:17 ESV

But if anyone has the world’s goods and sees his brother in need, yet closes his heart against him, how does God’s love abide in him?

Luke 12:33 ESV

Sell your possessions, and give to the needy. Provide yourselves with moneybags that do not grow old, with a treasure in the heavens that does not fail, where no thief approaches and no moth destroys.

Proverbs 14:31 ESV

Whoever oppresses a poor man insults his Maker, but he who is generous to the needy honors him.

Proverbs 29:7 ESV

A righteous man knows the rights of the poor; a wicked man does not understand such knowledge.

I am not suggesting you go out and give everything you have right now. I am not suggesting you feel guilty about what you have.

I am suggesting you join me in contemplating these issues. They will certainly be in my face next week. So, I will be back to talk more about this as my own understanding and experience continue to grow.

Blessings,

Michelle

No U-turn available

When a U-turn is not available – end-of-life care

Posted on by Michelle Fritsch, Pharm.D.
No U-turn available
Supportive options when it’s time for end-of-life care.

Now we turn to end-of-life care.  Last blog we talked about the U-turns available in your life and health. These can help you feel better and live healthier. We learned you can still make changes that have a positive impact on your overall health.

What about when a U-turn is not available?

What about when you get that diagnosis of:

The U-turn is not available.

We can’t stop it. We won’t be able to turn it around. There are a number of conditions that at this moment have no cure or way to get rid of them.

When we run out of options, then the end of life becomes our focus. This is peaceful for some. It is frightening and a huge struggle for others. It impacts not only the person diagnosed but also all of their friends and family. Each person involved deals with a number of feelings during this time. There can be guilt, fear, conflict, regret, and grief, among others.

The support of others, education about what is happening, and sources of comfort are critical.

Resources for end-of-life

Following are some resources for everyone involved in end-of-life care.

  • Support groups – There are support groups for most common diagnoses, for people with the diagnosis and for caregivers and family members, and for various stages of the condition.
  • Caregiver stress and burden – Caring for a loved one near the end of life can be emotionally and physically exhausting. There are many resources that provide assistance (such as in-home care agencies) or respite (short term stays while the caregiver takes a break).
  • Caregiver care – A caregiver can’t fully care for their loved one if they don’t also take care of themselves. Emotional, physical, and spiritual health need attention during this demanding time.
  • Resources – Your community will have various agencies available to provide numerous sources of help. These include direct healthcare, legal guidance, financial aid, spiritual support, placement options, and more. If the person nearing end-of-life is over age 65, your local Agency on Aging could be a valuable source of lists of the resources available in your area.
  • Palliative care – This is care that is focused on comfort and support to accomplish goals toward the end of life.
    • Hospice is one form of palliative care. Your hospice organization can support you, provide education about current and future changes, and help you with preparation for all involved.

When the end-of-life can be anticipated (vs suddenly taken), there is an opportunity to prepare and fully live those final months or days.

For more information about end-of-life options, contact us at www.medsmash.com.

BIBLICAL APPLICATION

What’s different about the people that find peace in the end of life?

Romans 6:23 ESV

For the wages of sin is death, but the free gift of God is eternal life in Christ Jesus our Lord.

This tells us that death of this life is not he end. It is only the beginning of eternity. What does that mean to you? Is it really true?

John 3:16 ESV

“For God so loved the world, that he gave his only Son, that whoever believes in him should not perish but have eternal life.”

The hope we can take through those seasons of palliative care and hospice is the result of anticipating the end of this life and moving on to eternal life.

John 5:24 ESV

Truly, truly, I say to you, whoever hears my word and believes him who sent me has eternal life. He does not come into judgment, but has passed from death to life.

Ephesians 2:8-9 ESV

For by grace you have been saved through faith. And this is not your own doing; it is the gift of God, not a result of works, so that no one may boast.

If this life is just the preamble to a life of eternity with Christ, then death loses its sting.

1 Corinthians 15:55-57 NIV

“Where, O death, is your victory?

    Where, O death, is your sting?”

The sting of death is sin, and the power of sin is the law.  But thanks be to God! He gives us the victory through our Lord Jesus Christ.

I pray you find hope and peace as you ponder this perspective of death.

Blessings,

Michelle

Four Components of True Health – Mental Health

Posted on by Michelle Fritsch, Pharm.D.
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Mental health is one of four components of total health

Mental health is the second of the four components of health. True health requires health in all four components. Last week we covered physical health. Over the next two weeks we will talk about each of the others separately.

Mental health is getting more attention as an essential component of health.  It requires a health system of diagnosis, treatment, and management similar to physical health. Insurance has historically not provided as much coverage for mental health compared with physical. But, finally, that is changing in a very positive way!

A new set of diagnostic standards was published in 2013. This update came after over 10 years of work to refine and identify diagnoses since the previous set of guidelines. The standards cover everything from neurodevelopment disorders (such as autism), schizophrenia, bipolar disorder, and depression to anxiety.  They also cover obsessive-compulsive disorder, trauma and stress-related disorders, eating disorders, substance abuse, phobias, and personality disorders.

There are several classes of medications that are prescribed to manage mental health conditions. Some examples include neuroleptics (also called antipsychotics), antidepressants, antianxiety medications, and some medications that are also used to treat seizures.

So what can you do to improve your mental health?

Consistency is very important with mental health. Accurate diagnosis is obviously also key.

These conditions are complex. They are true biologic medical conditions. Sometimes people think these conditions are something someone can control by him/herself. That can lead to shame, denial, or avoidance of these complex conditions. They DO require medical care.

From mentalhealth.gov:

Myth: Personality weakness or character flaws cause mental health problems. People with mental health problems can snap out of it if they try hard enough.

Fact: Mental health problems have nothing to do with being lazy or weak and many people need help to get better. Many factors contribute to mental health problems, including:

  • Biological factors, such as genes, physical illness, injury, or brain chemistry
  • Life experiences, such as trauma or a history of abuse
  • Family history of mental health problems

People with mental health problems can get better and many recover completely.

Counseling is often an essential component of care for these conditions. Qualified counselors listen, coach, and strategize. They can also help diagnose and participate in therapy decisions. They can educate and work with the person with the  condition and with all family and caregivers, as approved by the patient.

So mental health conditions are medical conditions just like cancer and diabetes are medical conditions. They are treated with counseling, procedures, and medications. Many require lifetime management (versus one time treatment). So, relationships with the healthcare team are important. You want providers with whom you are comfortable and can be open.

Note, for many mental health conditions, especially depression, medication needs to be taken every day for up to two months to see the full benefit. The medication very gradually changes transmitters in the brain back to healthy amounts. So, please be patient and take the medicine faithfully.

For more information about mental health, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

Mental illness impacts people of faith just as it impacts people who have never heard about Christ. So, can God use mental illness for His glory? Can anything good come from struggling with mental illness?

I believe God can use any of our weaknesses, any of our conditions, to His glory. Nothing is beyond His ability.

John 16:33 ESV

I have said these things to you, that in me you may have peace. In the world you will have tribulation. But take heart; I have overcome the world.

2 Corinthians 12:9 ESV

But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me.

Luke 1:37 ESV

For nothing will be impossible with God.

In the Bible, mental illness is sometimes referred to as having an ‘afflicting demon’. Understanding of mental health continues to grow. The medical/biological understanding of these conditions is much better understood than they were in Biblical days, but there are still questions to be answered.

Matthew 4:24-25 The Message (MSG)

He also healed people of their diseases and of the bad effects of their bad lives. Word got around the entire Roman province of Syria. People brought anybody with an ailment, whether mental, emotional, or physical. Jesus healed them, one and all. More and more people came, the momentum gathering. Besides those from Galilee, crowds came from the “Ten Towns” across the lake, others up from Jerusalem and Judea, still others from across the Jordan.(emphasis mine)

The multiple components of total health – physical, mental, emotional, spiritual – are recognized throughout the Bible. Mental health conditions require treatment and must be addressed to reach a state of true health.

There is no shame. Again, these conditions have biological sources. We are called to love and support each other.   Education, understanding, and unconditional love can help us help each other find God’s purposes in each of our afflictions.

Blessings,

Michelle

Image Source:  National Institute on Aging; National Institutes of Health; U.S. Department of Health and Human Services

Approach Your Doctor Visit Differently in 2016 – Win-Win

Posted on by Michelle Fritsch, Pharm.D.
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Prepare for your doctor visit

 

How do you prepare for a doctor visit? Have you ever experienced, or can you picture, the following scenario?

You have a health-related issue and want to see your doctor. You call to make the appointment. You wait and monitor the issue until the day of the appointment. You think about the appointment as you get ready and drive to the office. You think about the visit while in the waiting room. You briefly tell the assistant about the issue while you are being checked in with your weight, blood pressure, etc. You think more about the issue while waiting for your provider to enter the room. Then, your provider comes in and your mind goes blank.

Has this ever happened to you? Even if you remembered most of what you wanted to discuss, did you leave and realize you forgot to mention something important?

Doctor Visit Preparation

This happens all too often! Sometimes people feel rushed. Sometimes they get caught up in conversation with their doctor and don’t realize the time available for the appointment has slipped way. I have had patients bring up important information at the very end of appointments many times. It is so late that we can’t fully address the issue with the time remaining.

So, what can you do to avoid this situation?

Important steps

Here are some important steps to help you get the most from your healthcare visits.

  1. From the time the issue arises until your appointment, write down important details your doctor will want to know.
    1. When did it start?
    2. How did it start?
    3. What makes it worse?
    4. What makes it better?
    5. Use good descriptive words to describe your symptoms.
    6. How often does it occur?
    7. Have you had something like this happen before?
    8. What has changed that might be related to this issue?
    9. Keep a journal of how the issue impacts you daily.
    10. What outcome are you hoping to have from your visit?
  2. Prioritize the issues you want to discuss at the appointment.
  3. Limit your list to the top 3. You can bring others to mention if there is time, but most visits have time for only 1 major or up to 3 more minor issues.
  4. Bring two copies of your list to your appointment.
  5. Give the list to the assistant who checks you in. He/she can then give it to your provider to review before coming in to the room with you. This will save a lot of time in the first part of your appointment.
  6. When your provider comes in the room, you will each have a copy. This will take the pressure off of you to remember the details. It will also help guide your provider to quickly understand the issue(s) you want to talk about.
  7. You can now have a more relaxed conversation with your provider in the time that is available for your visit.

Your provider will truly appreciate this approach. Keep in mind, for some symptoms your provider only knows what you tell him/her. So, the more thorough you can be, the better your provider can make the correct diagnosis.

Consider your healthcare to be a partnership rather than a one-way interaction. You and your providers will feel better about your relationship.

For more information about preparing for doctor visits, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Just as there are more successful ways to approach medical visits, there are some best practices for communicating with God.

Jeremiah 29:12-13 ESV

Then you will call upon me and come and pray to me, and I will hear you. You will seek me and find me, when you seek me with all your heart.

In all parts of the Bible there are tips, insights, and instructions for maintaining our awareness and dependence on our Lord and Savior to walk with us through any circumstance.

Mark 11:24 ESV

Therefore I tell you, whatever you ask in prayer, believe that you have received it, and it will be yours.

Philippians 4:6-7 ESV

Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.

James 5:16 ESV

Therefore, confess your sins to one another and pray for one another, that you may be healed. The prayer of a righteous person has great power as it is working.

John 15:7 ESV

If you abide in me, and my words abide in you, ask whatever you wish, and it will be done for you.

1 John 5:14-15 ESV

And this is the confidence that we have toward him, that if we ask anything according to his will he hears us. And if we know that he hears us in whatever we ask, we know that we have the requests that we have asked of him.

God is there with you, loving you, holding you at all times. He never leaves to take a break. He never gets distracted.

If you are feeling alone and not aware of His presence, you have your ‘shields’ up. Take them down. Go to Him in prayer and take down those defenses that are making you feel separated. God will love being able to communicate with you again. You will love that flood of security, grace, and unconditional love.

Blessings,

Michelle

P.S. Have you noticed that all of our instruction in prayer puts praise first? Then, bring your requests, hurts, and desires to God.