The Best Of Care

A palliative care doctor on the front lines of hospital care illuminates one of the most important and controversial ethical issues of our time on his quest to transform care through the end of life. It is harder to die in this country than ever before. Statistics show that the vast majority of Americans would prefer to die at home, yet many of us spend our last days fearful and in pain in a healthcare system ruled by high-tech procedures and a philosophy to "fight disease and illness at all cost." Dr. Ira Byock, one of the foremost palliative-care physicians in the country, argues that end-of-life care is among the biggest national crises facing us today. In addressing the crisis, politics has trumped reason. Dr. Byock explains that to ensure the best possible care for those we love-and eventually ourselves- we must not only remake our healthcare system, we must also move past our cultural aversion to talking about death and acknowledge the fact of mortality once and for all. Dr. Byock describes what palliative care really is, and-with a doctor's compassion and insight-puts a human face on the issues by telling richly moving, heart-wrenching, and uplifting stories of real people during the most difficult moments in their lives. Byock takes us inside his busy, cutting-edge academic medical center to show what the best care at the end of life can look like and how doctors and nurses can profoundly shape the way families experience loss. Like books by Atul Gawande and Jerome Groopman, The Best Care Possible is a compelling meditation on medicine and ethics told through page-turning, life or death medical drama. It is passionate and timely, and it has the power to lead a new kind of national conversation.

The preeminent doctor and bioethicist Ezekiel Emanuel is repeatedly asked one question: Which country has the best healthcare? He set off to find an answer. The US spends more than any other nation, nearly $4 trillion, on healthcare. Yet, for all that expense, the US is not ranked #1 -- not even close. In Which Country Has the World's Best Healthcare? Ezekiel Emanuel profiles eleven of the world's healthcare systems in pursuit of the best or at least where excellence can be found. Using a unique comparative structure, the book allows healthcare professionals, patients, and policymakers alike to know which systems perform well, and why, and which face endemic problems. From Taiwan to Germany, Australia to Switzerland, the most inventive healthcare providers tackle a global set of challenges -- in pursuit of the best healthcare in the world.

“An outstanding book . . . documents how the VA’s system of integrative care outperforms the models used by private insurers.” —USW Blog (United Steelworkers) NEW EDITION, REVISED AND UPDATED Phillip Longman tells the amazing story of the turnaround of the Department of Veterans Affairs health-care system from a dysfunctional, scandal-prone bureaucracy into the benchmark for high-quality medicine in the United States. Best Care Anywhere shows that vast swaths of what we think we know about health, health care, and medical economics are just plain wrong. And the book demonstrates how this extraordinarily cost-effective model, which has proven to be highly popular with veterans, can be made available to everyone. New to this edition is an analysis of how the shortcomings of both so-called Obamacare and Republican plans to privatize Medicare reinforce the need for applying the lessons of the VA. Also included are completely updated statistics and research, as well as examples of how the private sector is already beginning to learn from the VA’s example. “Among the most important social policy books published in the last decade.” —Ezra Klein, The Washington Post “Read Best Care Anywhere not just to learn about one of our public health agencies that is a global star in terms of cost effective, evidence-based results, but also to learn how your own health care process can be improved by adopting the Veterans Health Administration’s methodology for transparency and patient-centered care.” —New York Journal of Books

America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.

A USA Today BESTSELLER! "Informative. Complete. And practical. This book will guide family caregivers through the surprisingly complex world of senior care." —MEHMET OZ, M.D., New York Times bestselling coauthor of YOU: The Owner's Manual: The Complete All-in-One Care Guide Choosing the best care for your aging parents and other seniors in your life is not only complex, with multiple options available, it's also highly personal and often emotional. This essential resource—written by the founders of Home Instead Senior Care, the world's largest provider of nonmedical care for seniors—guides you through a comprehensive range of things to consider, step by step, so you can make better informed decisions and be confident that the senior in your life is receiving the best care possible. Checklists and diagnostics will help you: Decide if at-home care is the right choice for you and your loved ones Evaluate the pros and cons of retirement communities, adult care centers, nonmedical caregivers, assisted living facilities, nursing homes, and hospice Determine the costs of senior care options and find helpful support networks "This is not just another book about caring for aging parents. It's a great reference you'll use again and again. Stages doesn't shy away from the hard questions. Rather, it shows you how to confront them."—SUZANNE MINTZ, President/CEO, National Family Caregivers Association "Recognizing that there is no one-size-fits-all solution, this salient volume compassionately addresses a full range of hard-to-discuss subjects."--PUBLISHERS WEEKLY All of the authors' profits from the sale of this book will be donated to the Home Instead Senior Care Foundation. Paul and Lori Hogan founded Home Instead Senior Care in 1994. Now with 850 offices in 15 countries, Home Instead is recognized as a global leader and authority on senior care. Visit them at www.stagesofseniorcare.com.

The number of elderly and disabled adults who require assistance with day-to-day activities is expected to double over the next twenty-five years. As a result, direct care workers such as home care aides and certified nursing assistants (CNAs) will become essential to many more families. Yet these workers tend to be low-paid, poorly trained, and receive little respect. Is such a workforce capable of addressing the needs of our aging population? In Who Will Care for Us? economist Paul Osterman assesses the challenges facing the long-term care industry. He presents an innovative policy agenda that reconceives direct care workers’ work roles and would improve both the quality of their jobs and the quality of elder care. Using national surveys, administrative data, and nearly 120 original interviews with workers, employers, advocates, and policymakers, Osterman finds that direct care workers are marginalized and often invisible in the health care system. While doctors and families alike agree that good home care aides and CNAs are crucial to the well-being of their patients, the workers report poverty-level wages, erratic schedules, exclusion from care teams, and frequent incidences of physical injury on the job. Direct care workers are also highly constrained by policies that specify what they are allowed to do on the job, and in some states are even prevented from simple tasks such as administering eye drops. Osterman concludes that broadening the scope of care workers’ duties will simultaneously boost the quality of care for patients and lead to better jobs and higher wages. He proposes integrating home care aides and CNAs into larger medical teams and training them as “health coaches” who educate patients on concerns such as managing chronic conditions and transitioning out of hospitals. Osterman shows that restructuring direct care workers’ jobs, and providing the appropriate training, could lower health spending in the long term by reducing unnecessary emergency room and hospital visits, limiting the use of nursing homes, and lowering the rate of turnover among care workers. As the Baby Boom generation ages, Who Will Care for Us? demonstrates the importance of restructuring the long-term care industry and establishing a new relationship between direct care workers, patients, and the medical system.

The Best Kept Secret in Health Care is about a relatively unheard of specialty in chiropractic called Upper Cervical Care. Upper Cervical care has been helping thousands of people around the world improve their health and get their lives back. Upper Cervical doctors have been helping people with common conditions like headaches, back and neck pain, sleeping problems, weakened immune function, as well as chronic illnesses or conditions they were told they would have to live (or die) with such as Multiple Sclerosis, Fibromyalgia, Diabetes, high blood pressure, Trigeminal Neuralgia, Meneire's Disease, and many other debilitating illnesses that traditional medical treatment has been unable to cure or relieve. Therefore, the audience for this book is everyone who is concerned about their health, especially those who are looking for an alternative to prescription drugs or surgery. This book written to let the secret out and tell the world about Upper Cervical.