Sick to death and not going to take it anymore! : reforming health care for the last years of life

Bibliographic Information

Sick to death and not going to take it anymore! : reforming health care for the last years of life

Joanne Lynn

(California/Milbank series on health and the public, 10)

University of California Press , Milbank Memorial Fund, c2004

Available at  / 14 libraries

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Note

Includes bibliographical references (p. 167-189) and index

Description and Table of Contents

Description

Just a few generations ago, serious illness, like hazardous weather, arrived with little warning, and people either lived through it or died. In this important, convincing, and long-overdue call for health care reform, Joanne Lynn demonstrates that our current health system, like our concepts of health and disease, developed at a time when life was mostly short, serious illnesses and disabilities were common at every age, and dying was quick. Today, most Americans live a long life, with the disabilities and discomforts of progressive chronic illness appearing only during the final chapters of their life stories. Sick to Death and Not Going to Take It Anymore! maintains that health care and community services are not set up to meet the needs of the large number of people who face a prolonged period of progressive illness and disability before death. Lynn offers what she calls an "owner's manual for the health care system," which lays out facts, concepts, strategies, and action plans for genuine reform and gives the reader new ways to interpret information creatively, imagine innovative possibilities, and take steps to implement them.

Table of Contents

List of Illustrations and Tables Foreword Acknowledgments Introduction 1. JUST THE FACTS Serious Chronic Disease in the Last Phase of Life Living with Chronic Conditions . Shortcomings in Current Care . The Baby Boom Grows Old . Who Will Provide Care? . "Dying" and the Problem of Prognostication . Which Illness Will It Be? . Costs and Who Pays . The Shape of Things to Come PERSPECTIVE: THE LONELINESS OF THE LONG TERM CARE GIVER by Carol Levine 2. SEEING THE WORLD DIFFERENTLY Ideas to Shape Reform Life Span Perspective . Rethinking the Transition Model . Misleading Words and Ideas . The "No Surprise" Question . Trajectories of Illness across Time . Frequency of Trajectories . Anticipating Challenges . Creating and Naming a Category . More Patients, Fewer Caregivers .Working Out Patterns of Cost . Summary of Ideas to Shape Reform PERSPECTIVE : QUALITY COMES HOME by Donald M. Berwick 3. GOOD CARE FOR SOME PEOPLE SOMETIMES Hospice . Palliative Care at Home . Palliative Care in Hospitals . PACE: All-Inclusive Care . The Chronic-Care Model . Coordinating and Managing Care . Quality Improvement . Caregiver Programs . Practice Guidelines and Audit Tools . Gems and Strategies for Change PERSPECTIVE IN BRITAIN, PROGRESS IN CARE FOR THE LAST PART OF LIFE by Joanne Lynn 4. SURVERYING THE TERRAIN Opportunities and Challenges Key Features of Change . Caregivers as a Political Force . The Business Case for Change . Promoting Coordinated Care . Barriers to Reform . Avoiding Low-Impact Reforms PERSPECTIVE: THE CASE FOR REFORMING U.S. HEALTH CARE by the Committee on Quality of Health Care in America, Institute of Medicine 5. GOOD CARE FOR US ALL Building the Care System to Count On Reprise of the Current Situation . Trajectories Form a Basis for Achievable Excellence . MediCaring: From Promises to Practical Program . Methods to Achieve Reform . Reforms to Implement Right Away! . Forging the Will to Make Improvements Happen Appendix: An Agenda for Action References Index

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