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caregivingcover_rgbWe need a national strategy to address the needs of family caregivers. That’s the conclusion of last week’s 280 page reportFamilies Caring for an Aging America, from the National Academies of Sciences, Engineering and Medicine. Findings from a panel of experts call for forward-thinking policies and community efforts to help the estimated 18 million family members who care for an aging parent, or a spouse or child with a serious medical condition.

 

While each caregiving situation is different, one thing they have in common is that family caregiving affects their physical, emotional, and financial health, said Terry Fulmer, PhD, RN, FAAN, President of the John A. Hartford Foundation, one of the report’s co-sponsors. Fulmer was a co-chair of the committee prior to joining the Foundation. Many caregivers say they are stressed out, overwhelmed, and feel like the entire challenge rests on their shoulders.

 

There’s increasing urgency in finding solutions to caregiver concerns. People are living longer, but with more chronic conditions. Many hope to age in place and avoid institutional care for as long as possible. According to the report, the  need to address caregivers’ concerns is growing more urgent. Demand for caregivers is rising dramatically, especially among those age 80 and older, but the number of available caregivers is shrinking. Smaller families, more never-married or divorced older adults, geographic distance are some of the reasons.

 

More caregivers, still primarily women, work outside of the home. They find themselves caught between juggling job responsibilities and providing needed care to their loved one at home. Without community supports, more flexible employment options, and financial assistance, family caregiving in the U.S. is quickly reaching crisis levels.

 

I spoke with Fulmer about these challenges, and possible interventions. And, we discussed what policy changes are needed at all levels to overcome systemic barriers that family caregivers face every day.

 

Listen here

 

 

 

We need a national strategy to address

 

“That looks like a bad dude” was a police officer’s assumption in regard to Terence Crutcher, a black male whose car stalled out in the middle of a road in Tulsa, Oklahoma. What made this black male appear “bad” to an officer who was flying above in a helicopter? Was Mr. Crutcher wielding a gun at cops or shouting obscenities? Was it the way he was dressed? Or was it the color of his skin?
I recently posed this question to a relative who is an attorney. She expressed that the officer may have considered that Mr. Crutcher was “bad” because he was walking away, albeit with his hands up, and not following instructions. She added that individuals should not give police officers any excuse to shoot them. This could help remove the “excuse to shoot” and force police departments to address inherent biases. While her scenario sounds plausible, it misses the totality of how we cognitively determine whether someone is “bad”.

 

So what do you see first when you examine the different faces of Mr. Ross Smith? Do you see an award winning journalist, a visual artist, an intelligent son, a loving sibling or a multimedia artist? Mr Bayeté Ross Smith, through the use of his expertise in photojournalism, creatively illustrates how the single face can conjure up many beliefs about who he is. Some of the above images might have him falsely tagged as bad, mischievous or even dangerous. When you associate any of the above images of Mr. Ross Smith with the word “bad”, you are demonstrating the power of narratives that dwell in the subconscious and prompt you to form biased assumptions.

 

Should visual clues alone corroborate the assumption that one is “bad” or justify the killing of a 40 year old unarmed black male? Of course not. In fact, if you search for tangible evidence in isolation from the story you may find yourself duped. That’s because what makes us believe that someone is bad is not always or solely based on what we can visualize with the naked eye. It could include the silent narrative, or the culturally biased story that resides deep inside our mind.

 

Did the description of Mr. Crutcher originate from a subconscious space that is fortified by a false historical narrative of the black male? Big and Black male does not equate to harmful and dangerous. However, so many of us have unknowingly walked into and joined an unrelenting and perilous narrative about the Black male. A story that influences our behavior and could take over our actions. And so, although tired of and frustrated at what appears to be similar events stuck on rewind, we secretly know it’s not over. Another black male will, yet again, be unknowingly placed in the role of “bad” again and again… and again, unless we change the narrative.

 

Is the achievement of a socially just America truly possible? We all have prejudices for or against individuals or groups. So how do we create a safe space for a discourse about the reality of our prejudices and how it influences our behaviors? And then, how do we limit the influence that our prejudicial thoughts and actions have on employment rates, the academic achievement gap, patient outcomes, judicial hearings and so much more?

 

Silencing the narratives that harbor prejudices could weaken the fight for social justice. While the U.S. Justice Department begins to examine the tangible evidence to determine if Mr. Crutcher’s civil rights were violated, Mr. Bayeté Ross Smith will join me on HealthCetera to expose the silent narrative that kills and discuss ways to move forward. Join us on September 29, 2016, at 1:00 on WBAI, 99.5 FM in New York City or streaming at www.wbai.org; and be a part of the discourse that saves lives.

You can listen to the interview on iTunes here:

  [caption id="attachment_11720" align="aligncenter" width="348"] The Different Faces

PhotoCredit: Book Cover Rights Come to Mind Joseph Fins, MD

PhotoCredit: Book Cover
Rights Come to Mind
Joseph Fins, MD

A disturbing insight has motivated much of Dr. Joseph Fins work in understanding the minimally conscious state (MCS).  “Indeed, it keeps me up at night, worrying about a class of people, in the shadows of their own cognition, whom society  has forgotten, abandoned in nursing homes.”

The general public has been reading about severe brain injury cases from Quinlan to Schiavo for many years. HealthCetera host, Barbara Glickstein, talks with Dr. Joseph Fins, physician, researcher and bioethicist about the minimally conscious state (MCS), a diagnostic category that came into the medical literature in 2002. 

What are the neurobiological differences between the vegetative state and the minimally conscious state.

What is consciousness?

What do we know about the best treatment approaches to restore lost functioning in human brains?

What are the health care policy challenges related to the care of patients with severe brain injury, especially in light of health care reform and the Affordable Care Act?

This conversation could have gone on for hours for the host. She left it and wandered to a park bench to contemplate how much more there is to know about life.

Joseph J. Fins, MD, MACP is The E. William Davis, Jr. MD Professor of Medical Ethics and Chief of the Division of Medical Ethics at Weill Cornell Medical College where he is a Tenured Professor of Medicine, Professor of Medical Ethics in Neurology, Professor of Health Care Policy and Research, and Professor of Medicine in Psychiatry. He is the founding Chair of the Ethics Committee of New York-Presbyterian Weill Cornell Medicine where he is an Attending Physician and the Director of Medical Ethics.
He is a 2016-2017 Fellow Ambassador of The New York Academy of Medicine.

His most recent book is Rights Come to Mind: Brain Injury, Ethics & The Struggle for Consciousness, published by Cambridge University Press

Tune in Thursday, September 21 at 1 PM to wbai 99.5 FM and streamed live www.wbai.org. You can listen to the podcast now on iTunes

[caption id="attachment_11699" align="aligncenter" width="580"] PhotoCredit: Book CoverRights