5 minute read Imagine an older Latina woman we’ll call Maria who is accompanied to her primary care visit for a diabetes check-up by her two adult daughters. Because Maria speaks little English and her provider speaks little Spanish, the daughters immediately start translating for their mother. The daughters also directly answer the provider’s questions […]
Original post available here. One day, while working as a clinical psychologist in a primary care practice, I was asked by the family doctor scheduled to meet that morning with Lisa, a 72-year-old woman with moderate dementia, to stop by and see her 75-year-old husband, Dennis, for counseling for possible depression. Within the hour, I […]
Original post available here. One day, while working as a clinical psychologist in a primary care practice, I was asked by the family doctor scheduled to meet that morning with Lisa, a 72-year-old woman with moderate dementia, to stop by and see her 75-year-old husband, Dennis, for counseling for possible depression. Within the hour, I […]
5 minutes How are helping professionals coping in the waning days of the pandemic? Signs of burnout are everywhere. One in three nurses reportedly plan to leave their jobs. Physicians, especially hospitalists, are wracked by moral injury. Behavioral health workers are being crushed by the press of people seeking help for depression, anxiety, and substance […]
5 minute read First published January 20, 2021. Original post here. “The key to working with behavioral health clients,” a clinical supervisor told me over 30 years ago, “is asking about the past losses they’ve suffered and exploring whether they mishandled them.” He was a loss zealot, a mourning maven. He walked clients through guided […]
5 minute read In the pre-Covid years, when I was the family caregiver for my mother with mild dementia and chronic pain, I became the point person for her home-based care team. I was forever on the phone managing the shifting schedules of her home health aides and receiving instructions from her home-based physical therapists […]
5 minute read “The key to working with behavioral health clients,” a clinical supervisor told me over 30 years ago, “is asking about the past losses they’ve suffered and exploring whether they mishandled them.” He was a loss zealot, a mourning maven. He walked clients through guided imagery exercises of standing beside their loved one’s […]
4 minute read I can hear her soft voice, with its slight Long Island intonations, murmuring in the next room as she comforts her many struggling psychotherapy clients about the pandemic during their telehealth appointments with her. My office—once our adult son’s childhood bedroom with YA titles and high school notebooks still on the bookshelves—is […]
4 minute read To us nervous old guys, this pandemic is about risk and fear. I take early morning walks in my leafy hometown of Swarthmore, PA when the sun is still well below the treetops to avoid social contact and possibly contracting infection. But twice in recent weeks, I’ve turned a corner and run […]
5 minute read The initial panic about the coronavirus has long passed. Sadness and grief from Covid losses is settling in on clinical settings, including behavioral health. In my small psychotherapy practice, I’ve heard about one client tragedy after another: The adult daughter who feels stricken because hospital policy wouldn’t allow her to be at […]
5 minute read During the years I was my mother’s family caregiver, I had widely different interactions with her physicians. Some embraced me as a partner in her care, talking directly to me during my mother’s medical visits about her symptoms and medications—and largely ignoring her. Afterwards, during the car ride home, my mother would […]
3 Minute Read This piece originally appeared on the Huffington Post. Posted here with permission. “You are treating her like she’s a piece of meat,” Tony was shouting angrily at me. I hadn’t the power to change the care his 62-year-old wife was receiving in my hospital’s intensive care unit—for the past two years, I had […]
Healthcare is awash in quality metrics. Registries of PHQ-9 scores. Frequency of visits. Decreased utilization rates. Reduced response times to emergencies. We believe they create better clinical outcomes through greater accountability of interventions and systems. Of course, there’s a great deal of truth here. But the touchy-feely therapist in me tells me there’s something […]
Dear RAISE Family Caregiving Advisory Council You are the Dream Team of family caregiving innovators, the all-stars of our fiercest advocates. Since President Trump signed the RAISE Family Caregivers Act in January 2018, mandating the creation of an Advisory Council to devise a national strategy for supporting family caregivers, we’ve been awaiting your anointment […]
Physician greets older male patient. Physician greets patient’s adult daughter. Physician asks about patient’s conditions. Physician asks for daughter’s input. Physician does physical examination. Physician makes recommendations and writes scripts. Physician asks patient and daughter if they have questions. A very normal-sounding outpatient medical visit, right? What could possibly be wrong with this picture? For […]
As befits his majestic name, Brian Duke threw down the gauntlet. “If you really want to help health systems do a better job of supporting family caregivers,” said the former Secretary of the Pennsylvania Department of Aging and the current System Director of Senior Services for Main Line Health in suburban Philadelphia, “then you better […]
Around the long mahogany board room table, the 40 middle-age nurse and social work care managers of this large Medicare ACO regarded me with a mixture of inquisitive and impassive looks. I was supposed to deliver the good news on how strategies for supporting family caregivers are becoming more sophisticated. I started off by asking […]
During the 24 years I worked as a psychologist in family medicine, I heard many complaints about patients’ family members gumming up the healthcare system in various ways. For instance: “My patient’s wife keeps asking me to do things I can’t do—like arrange for her husband to live elsewhere—and taking up my time with frequent […]
