Culling the Herd
A few years back, there was a program to protect the deer population on Fire Island, NY, from starvation during the winter (similar to one employed on Hilton Head Island in South Carolina). The program consisted of hunting the deer in specific quantities to thin the herd and ensure the herd's survival. There was understandable protest and outrage from many groups on this technique.
While reading the New York Times online, I came across this article about how social services are being cut across the United States: http://www.nytimes.com/2010/07/21/us/21aging.html?_r=2&scp=1&sq=oregan%20home%20care%20cuts&st=cse.
Oregon, which had been a leader in supportive care, is making very significant cuts. The cost of home care support is only $1,500 a month compared to $5,900 for nursing home care. Many of these people will need to be admitted to a facility if they can't get care at home. It seems ludicrous to support such "cost savings" when there don't appear to be any.
Except many of these people could live at home for many years with this support. In a number of articles I've read, the average lifespan for 50-60 percent of those who enter a facility permanently is around two years. Here is one of those supporting articles: http://www.homecaregroup.eu/content/view/117/42/. Are we, in fact, culling the herd by sending disabled and older adults to nursing homes rather than providing for them at home?
A few months back as tea partiers were decrying the "death panels," there was a lot of outrage. Where is that outrage now? One of the things I've learned is that health is not solely about medical advances. It has much to do with social care as well. That is why the USA ranks only 37th in terms of overall health in the world. Here in the UK, and from my public health course of study at Nova Southeastern University, I have learned that health only improves with combined medical and social support. As health professionals whose primary focus is function, we cannot let these vulnerable people have their lives shortened as a cost measure.
Speaking of cost measures, the UK has announced some dramatic changes here in the NHS. I'll have more on that for you next week.