aplaceI came across a frightening blog post by A Place for Mom, praising the easy access their senior living sites grant to Compassion and Choices, the nation's most vocal assisted suicide advocacy group.  The article boasted about the "choices" available to seniors who live in their facilities, and the author was especially proud that A Place For Mom would ensure that the families of these seniors were informed of Mom and Dad's right to kill themselves. (The article was written in Washington State, where assisted suicide is legal).  We were first made aware of the post by Wesley J. Smith whose outstanding blog Human Exceptionalism at National Review offers consistently coherent arguments for life and dignity.  He brought our attention to the blog post here and here.

I made the following comment at the post today:

"I am a geriatrician and I think end-of-life planning is very important. I am appalled that A Place for Mom promotes an assisted suicide advocacy group in this article, without presenting the other side of the issue. You are certainly not "neutral" as you claim, and I will never refer my family or any of my patients to A Place for Mom after reading this."

2 hours later, the blog entry was gone.  I'd like to take credit, or give credit to Wesley, or dozens of irate callers, or National Right to Life who also exposed the agenda.  However, it's more likely that the blog entry made its own "choice" to request "aid in dying" from its author at A Place for Mom.  After all, every blog entry has a right to know about this option.  It's cruel to force these blogs to go on living, when their anemic existence is only taking up space on the internet.  Whatever this blog's reason for choosing death, it must have been a good one.  Perhaps it felt that it had become a burden to its fellow blog posts, as it was creating negative press for A Place for Mom.  Maybe it had no sense of purpose, depressed about its pathetic number of visits.  Or maybe it knew that its existence was costing too much bandwidth, and it recognized that the most compassionate choice it could make would be to just go away.  Yes, compassion won in the end.  How wonderful that the blog entry was presented with all of its end-of-life options.  I'm certain that, in its already frail and threatened state, when authoritative end-of-life experts gave the option to commit suicide, it never would have interpreted that as a subtle suggestion.  Never.

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Monday on Special Report with Bret Baier, correspondent Jim Angle did a story about home health care and possible job losses due to the new health care law.  The segment featured one of my home care patients and her daughter who cares for her.  I also appeared in the segment.  Watch it here.

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ramis

I was sad to learn of the death of Harold Ramis, whose classic comedy films like "Vacation" and "Caddyshack" produced so many quotable moments.  My personal favorite was "Groundhog Day."  Unfortunately, Harold Ramis died today of, his agent informed us, "Autoimmune Inflammatory Vasculitis."

You won't find this exact term in a medical dictionary.  Vasculitis is an autoimmune disease, meaning that the body attacks itself, causing inflammation ('-itis') in the blood vessels ('Vascu-').  Saying "autoimmune inflammatory vasculitis" is like saying "respiratory infective pneumonia."   It's a bit redundant, but talent agents are not medically trained, so Mr Ramis' agent gets a pass.  The important point is that vasculitis affects the blood vessels throughout the body, and it is difficult to treat.  There are many types and many causes, but usually the disease is related to a "confused" immune system that attacks the lining of the arteries and veins.  This can cause pain, and it always leads to inflammation and narrowing of the vessels.  As the vessels narrow and blood flow to critical organs is interrupted, consequences such as lung disease, kidney disease, and stroke can occur.

Treatment is often limited to medications that blunt the body's immune system, in an attempt to reduce the attacks on the blood vessels.  These medicines can be toxic and cause serious side effects.  Harold Ramis probably suffered from this disease, and its treatment, for a long time.  Thankfully, he still found a way to make us laugh through his pain.

For more detailed information on vasculitis, and how to recognize its signs, visit rheumatology.org

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In 2009 I wrote an article about President Obama's intention to slash payments to Medicare Advantage plans.  Turns out I was right, as reported last week.  It is a controversial move, as reported by Jim Angle at Fox News on Friday.  For seniors enrolled in these plans, the move will make it much less likely they will be able to "keep their plan."

Now, it appears that more cuts are on the horizon that will affect seniors.  Home health services are slated for a 14% cut over the next four years under the new law, and as a doctor who makes house calls, I'm concerned that the essential members of my team, the home health workers I depend upon, will be less available to my patients.  When I initiate a plan of care for a homebound patient, I rely on nurses, physical therapists, and others to carry out that plan in the home.  At Doctors Making Housecalls, we strive to help our patients remain out of the ERs and hospitals, unless absolutely necessary.  This is better for patients, and it saves money (imagine that!).  We can't do it alone, and cuts to home health services will make it even harder for us to provide quality home medical care as home care physicians.

Tonight on Fox News Special Report with Bret Baier we will hear more about these looming cuts, and their impact on frail, homebound seniors and their caregivers.  Tune in at 6pm ET and check back here for video.

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