The patient ease studies collected in this book provide first-hand accounts of health care delivery in multiple settings in a variety of national and local systems. These accounts, focusing on real experiences and real patients, transcend the rhetoric of political debate about health care delivery. The cases offer lessons for how we might draw on the virtues of other health care systems, understand strengths and shortcomings in our current system, and work toward potential improvements. --

I have given an inside view of my perception of the heath care dilemma. I was motivated by my daily experience with my wife who has suffered from the sudden onset of a stroke. This experience has brought me face-to-face with occurrences and situations which were alien to me as a physician and consultant in physical medicine and rehabilitation. Many events included here were previously disclosed by the press or published by government or private agencies. Some of this information may have escaped the attention of readers. Interpretation and presentation of events, however, are based on experience gained by years of practice in the field of medicine; this is in contrast to the experience of a layman whose spouse has suffered a major medical event. I found myself in a very unique position of being "two persons in one," the experienced physician on one side of the coin and the spouse of the victim of a major medical event--a stroke--on the other side. My task as an author is to present perspectives which I could not envisage as a physician. I have concluded that it was easier as a physician. Many of the events encountered were unthinkable and unknown to the author. I have now brought into focus two sides of the same coin. the view from inside has revealed that there are many players in the field of health care delivery, all of whom exert some influence in its delivery. What is disconcerting is the fact that none of the players has taken any responsibility for its unbridled and escalating cost; they all believe that it is the responsibility of the other player. Therefore, nothing is done to reduce the cost of health care and the unconscionable burden on Middle America. I have mentioned important players in the field who may be contributors to this dilemma and have cited some of their contributions. the intent here is to be more informative. Ideas presented are not intended as gospel but merely another point of view. Readers may expand their thoughts by reading original manuscripts and reports available for public scrutiny. Senior care, skilled nursing facilities, independent living facilities, and the role of physical medicine and rehabilitation are all discussed at some length. Issues and concerns obliquely related to health care were also discussed; these include long-term insurance coverage, the immigrants' contributions to health care, and the most precious years of our lives, "the golden years." Finally, an overview of the dilemma in health care was given in the context of a physician.

Disease Management

Prepare your students for successful careers in caring for geriatric populations with Williams’ Basic Geriatric Nursing, 6th Edition. This easy-to-read bestseller includes the latest information on health care policy and insurance practices, and presents the theories and concepts of aging and appropriate nursing interventions with an emphasis on health promotion. Part of the popular LPN/LVN Threads series, it provides opportunities for enhanced learning with additional figures, an interactive new Study Guide on Evolve, and real-world clinical scenarios that help students apply concepts to practice. Complete coverage of key topics includes baby boomers and the impact of their aging on the health care system, therapeutic communication, cultural considerations, spiritual influences, evidence-based practice in geriatric nursing, and elder abuse, restraints, and ethical and legal issues in end-of-life care. Updated discussion of issues and trends includes demographic factors and economic, social, cultural, and family influences. Get Ready for the NCLEX® Examination! section at the end of each chapter includes key points along with new Review Questions for the NCLEX examination and critical thinking which may be used for individual, small group, or classroom review. UNIQUE! Streamlined coverage of nutrition and fluid balance integrates these essential topics. Delegation, leadership, and management content integrated throughout. Nursing Process sections provide a framework for the discussion of the nursing care of the elderly patient as related to specific disorders. Nursing Care Plans with critical thinking questions help in understanding how a care plan is developed, how to evaluate care of a patient, and how to apply knowledge to clinical scenarios. LPN/LVN Threads make learning easier, featuring an appropriate reading level, key terms with phonetic pronunciations and text page references, chapter objectives, special features boxes, and full-color art, photographs, and design. UNIQUE! Complementary and Alternative Therapies boxes address specific therapies commonly used by the geriatric population for health promotion and pain relief. Health Promotion boxes highlight health promotion, disease prevention, and age-specific interventions. Home Health Considerations boxes provide information on home health care for the older adult. Coordinated Care boxes address such topics as restraints, elder abuse, and end-of-life care as related to responsibilities of nursing assistants and other health care workers who are supervised by LPN/LVNs. Clinical Situation boxes present patient scenarios with lessons for appropriate nursing care and patient sensitivity. Critical Thinking boxes help you to assimilate and synthesize information. 10th grade reading level makes learning easier.

Vol. 6 includes reports of cases dealing with national insurance and general insurance (other than marine).