Desde Bitacoramédica

1.- El Medico del futuro Margot Phaneuf, R.N., Ph.D. “The Roles and Qualities Required of a Case Manager”, 2005.

La medicina moderna ha intercambiado la mortalidad precoz por  morbilidad crónica. Hoy en día, las principales causas de muerte en edades tempranas se han erradicado gracias a las medidas preventivas y terapéuticas. La esperanza de vida de la población ha aumentado considerablemente y las enfermedades crónicas, la mayoría de ellas multifactoriales e incurable, se han convertido en los principales problemas médicos. Esta situación plantea nuevos retos a los médicos, que normalmente estaban  entrenados para tratar las  condiciones agudas y curables pero insusuficientemente preparados para hacer frente a las múltiples condiciones crónicas que un paciente de la tercera edad. Con estas limitaciones de formación, los médicos no están preparados para proporcionar atención adecuada

New roles: case manager and caretaker

According to Tudor Hart, modern medicine has exchanged early mortality for chronic morbidity. Nowadays, the major causes of death at early ages have been eradicated thanks to preventive and therapeutic measures. Life expectancy of the population has increased considerably and chronic diseases, most of them multi-factorial and incurable, have become the major medical problems. Is situation poses new challenges to physicians, who are specially trained to deal e ciently with acute and curable conditions but insu ciently prepared to confront the multiple chronic conditions that a ect aged patients and for which the doctor lacks e ective curative measures. With these training limitations, doctors o en provide inconsistent and fragmented care in situations that require quite the contrary.

2.- Interesting quote from «Being Mortal: Medicine and What Matters in the End»»Ser Mortal:  Lo que importa al final» por Atul Gawande

«Los profesionales de la salud tienen un sistema formal de como debe ser la  función vitalde  una persona, es decir funcionar sin ayuda: Usar el baño, comer, vestirse, bañarse,  salir de la cama, levantarse de una silla, y caminar, son  «Actividades de la Vida diaria» –Es decir la  capacidad de independencia física básica. Hoy en dia en las personas de tercera se requiere mas;  comprar sus cosas más sencilla, preparar su propia comida, mantener su limpieza, lavar la ropa, administrar sus medicamentos, hacer llamadas telefónicas, manejar sus finanzas, es decir tiene una falta de la  capacidad para desenvolverse. En algunas sociedades estas medidas  básicas de independencia, se hace muy complicado y puede generar crisis de la familia”.

«Being Mortal: Medicine and What Matters in the End» by Atul Gawande and wanted to share this quote with you.

«Health professionals have a formal classification system for the level of function a person has. If you cannot, without assistance, use the toilet, eat, dress, bathe, groom, get out of bed, get out of a chair, and walk—the eight “Activities of Daily Living”—then you lack the capacity for basic physical independence. If you cannot shop for yourself, prepare your own food, maintain your housekeeping, do your laundry, manage your medications, make phone calls, travel on your own, and handle your finances—the eight “Independent Activities of Daily Living”—then you lack the capacity to live safely on your own. My grandfather could perform only some of the basic measures of independence, and few of the more complex ones. But in India, this was not of any dire consequence. His situation prompted no family crisis meeting, no anguished debates over what to do with him. It was clear that the family would ensure my grandfather could continue to live as he desired. One of my uncles and his family lived with him, and with a small herd of children, grandchildren, nieces, and nephews nearby, he never lacked for help.»

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