Monthly Archives: August 2016

Asking Hard Questions Now Will Give Peace When Life Gets Tough

This year I read a book entitled, “Being Mortal” by Dr. Atul Gwande.  I don’t remember who recommended it to me, but it articulated many of my observations, experiences, and feelings based on my decision to pursue a career in nursing.  When I was a 20 year old student, I was assigned to care for individuals with incurable diseases, unexpected injuries, or sudden death.  It didn’t take long for me to discard the invincibility mindset that is typical of younger people.  It made me a believer that death and dying is real and doesn’t always give a warning notice or only happen to the elderly.

Our society promotes denial of these realities by removing everyone except health care professionals from the unpleasant sights and chores associated with taking care of a deteriorating or expiring body.  I worked in a nursing home the last three years of my career.  This experience made it impossible to deny the many scenarios that can be present at the end of life.  For those outside the health field, the initial brush with death usually results from a health crisis within the family.  We are rudely awakened from our denial by a tsunami of issues that we have never contemplated.

We are unprepared for all the questions that haven’t been addressed and decisions that must be made while in crisis mode.  Now, we have to deal with the problem and want information, even if we are frightened of the subject matter.

If we are uncomfortable with someone else’s death, the thought of examining or preparing for our own death is too startling to consider. Unfortunately, this ostrich approach robs us of having any control on the setting where we will be treated, the type of care we might receive, or determination of our preferences regarding how intensive we want our treatment to be.  The legal and financial chaos our irresponsibility causes may take years to untangle.

So, I increasingly wonder why we are so reluctant to find an expert in end of life that would be the equivalent of a CPA to help us with our taxes. As the saying goes, “Nothing is certain but death and taxes.”  Both are inevitable experiences.  To seek an expert to assist with our personal tax issues is considered intelligent.  Having an expert help guide us through the end of life paperwork and questions is avoided and almost viewed superstitiously as casting an unpleasant spell that will make our death more imminent.

Just try to have a conversation with someone about whether they have stated their preferences for their last days, or if their will or advance directives are completed.  This will quickly result in a change of topic.

So we remain a people uncomfortable talking about the subject of dying, even with those we love the most.  Being an informed patient, having all documentation in place and having it shared with relatives or our surrogate decision-makers prior to a crisis, can make our life and everyone else’s much less stressful.  It may be our greatest gift to our children.

We all know that in a matter of minutes the world as we know it can be shattered.  One phone call can confirm an incurable disease or notify that a loved one was killed in an automobile accident.  Yet we deny the fact that the mortality rate for EVERYONE is 100%.

If illness or death occurs in our circle of acquaintances, we frequently feel very uncomfortable about what to say or do. So, we frequently avoid them and say nothing.  This leaves our closest friends and relatives isolated and feeling lonely in a time of desperate need to talk about their deepest hurts and concerns.

I encourage everyone to “suck it up” and get the facts, paperwork, and skills to be a better decision-maker regarding their own critical life decisions and learn to be better communicators with all those individuals most dear to us. Come join The Women’s Information Network, Inc. on September 27, 2016 for our workshop entitled:  “Life:  The Final Chapter….Write Your Own Ending.” This seminar is designed to provide the documents that need completion, ways to communicate about this topic and resources in our community to provide assistance when needed.  For more information go to www.infoforwomen.org   Registration is $20.  Students  $10.

 

Sharon Baker is a member of the Georgia Commission on Women.  She is a retired nurse practitioner and is President and Founder of the Women’s Information Network, Inc.  She lives in Rome, Georgia.

Overalls and Pencil Skirts

Congressional Secretaries, 1920 Source: Wikimedia Commons, Public Domain

Congressional Secretaries, 1920
Source: Wikimedia Commons, Public Domain

I was born in overalls, or more accurately, I was raised in them. The moment I had the ability to think and move for myself, I ran full speed ahead to the most functional, albeit fashionable, OshKosh pair.  They fit unbelievably.

Like the quintessential poster child for the South, I climbed magnolia trees and caught lightning bugs in them, and despite my mother’s pleas, I snuck snails into the pockets for later examination underneath my covers with a flashlight. In junior high, I wore a white pair of overalls with pink stitching to the movies & was kissed slowly against the musty, butter-soaked wall. I felt invincible.

Recently someone told me that I romanticize most moments in my life, and I suppose my blue jean memories echo that sentiment, but in my mind, my overalls were perfect. Being in them didn’t camouflage my parent’s difficulties with their marriage or our less than affluent upbringing, but they made me feel able to accomplish anything, fearless even.

Fast-forward twenty-something years, through my parent’s divorce and into my current life, forging through congested city-traffic and wearing pencil skirts in planes amongst politicians. As the political liaison for the Commission on Women, I’m not only honored to help represent the women in Georgia, but also to address the inescapable truths that come with being a female in this decade.

Nearly a century ago today, on August 26, 1920, the 19th amendment was made an official addition to the United States Constitution. Women’s inability to vote, a concept difficult for most millennials to grasp, was changed by a small, boisterous, group of rebel gal pals that came together in an effort to make America great.

As of late, being a woman tends to tastes bitter, not sweet like honeysuckles, and the slimiest thing I have been stuffing into my pockets for later examination is self-doubt, along with an inexcusable amount of receipts for half priced Pinot Noir from Trader Joe’s. In 2016, the pressure that women feel to be enough is at times, all consuming. Hollywood’s unrealistic perception of what is beautiful and social media facades are only a portion of the influencing factors that bind women to the notion that they have to be something other than authentic in order to be desirable.

I write this, not as a skeptic or a judgmental surveyor of the major flaw women have with comparison, but instead as someone who can feel diminished with insecurities daily due to something as fleeting as vanity. Elizabeth Cady Stanton, Lucretia Mott, Susan B. Anthony, and Alice Paul, the foremothers of women’s voice, were not consumed with what would be lauded as beautiful, but instead what would be accepted as just.

Today, on Women’s Equality Day, I can’t help but wonder what incredible things could be accomplished if women refused to let unrealistic standards and comparison be the thief of joy, and instead let differences bind them together to accomplish goals yet achieved. What if the women who fought tirelessly for women’s rights were reduced to how many ‘likes’ they obtained, or what filter camouflaged their tireless efforts? What if instead of teaching our daughters to fit into a glass slipper, we encouraged them to shatter a glass ceiling? What if we found freedom in the confidence within ourselves to be wholly our own, possessing power in the belief that by just being us, we have the power to speak up when someone judges based only on appearances?

When I was a little girl, clumsily running around in Georgia red clay-stained overalls, I didn’t wonder who would be looking, I was too focused on the genuine freedom and confidence I found in being completely myself. Happy Women’s Equality Day, ladies. I hope you can find the strength to put on your own pair of overalls today and feel capable, strong, beautiful, and able (because you absolutely are.)

 

Emily Bowers was appointed by the Commissioner of Labor, Mark Butler, in 2015 & serves as the liaison to the Georgia Commission on Women.  Begrudgingly a Millennial, Emily is passionate about travel, loved ones, and all things policy.  She lives in Atlanta.

Georgia’s Rural Hospitals Need Life Support

Phoebe Putney Memorial Hospital in Albany, GA Source: Wikimedia Commons, Public Domain

Phoebe Putney Memorial Hospital in Albany, GA
Source: Wikimedia Commons, Public Domain

Many of Georgia’s hospitals are in critical condition.  That is the message delivered by speaker after speaker at the Senate Health and Human Services Committee hearing at the Georgia Capitol on August 22, 2016.

Our rural hospitals are struggling.  Forty-one percent of them are working with a negative operating budget, and that number is expected to climb past 50 percent in the next few years.  In the past couple of years, five rural hospitals have closed in Georgia and others have scaled back services, leaving patients in the communities they serve to have to travel farther for medical care.  Cash-strapped community hospitals are unable to purchase the newest technology or update their aging buildings, so many people in those communities choose to drive to hospitals in bigger markets under the impression that newer stuff means better care.  A few hospitals have so little cash on hand that they have struggled to meet payroll at times.

Georgia ranks 4th in the nation in the number of uninsured patients, aggravating hospitals’ already precarious financial situations.  Medicaid recipients make up a large share of rural patients, and with Medicaid paying 20 cents on the dollar for services, you see a sizable chunk cut from local hospital revenues.  Add in the underinsured, which often show up in the bad debt column, and you have a toxic fiscal environment for our rural hospitals.

Solutions are hard to come by.  Georgia’s Hub and Spoke model for community care with regional hospitals and community service providers is showing promise.  Resistance to change is a big challenge, however, and more needs to be done to coordinate between service providers and communicate the value of receiving care in the local market to those in the community.  Many patients are managing multiple chronic conditions, and some require help beyond their medical issues.  This type of intensive case management is best handled at the local level.

The Rural Hospital Stabilization Committee is one organization that is studying the challenges facing our rural hospitals and will be reporting back to the Health and Human Services Committee throughout their pilot process.  Their goals are to help local hospitals increase market share while reducing Medicare readmissions, which come with a penalty, as well has improving access to primary care and reducing non-emergency care in the  communities they serve.  They have many tools in their toolbox and expect to make some inroads in the pilot communities.

The Georgia Chamber of Commerce has convened a health care access task force who will be reporting their findings as well.

In the meantime, rural hospitals will continue to do their best to meet the needs of their communities with the limited resources they have, and we will all continue to hope that they can hang on until state leaders can shape policies to fix what ails them.

 

Karla Jacobs is a member of the Georgia Commission on Women.  She lives in Marietta with her husband, two kids, a dog, and some fish.

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