Monday, June 7, 2010

Dr. Robert W. Handy Memorial "Check out your doctor day"

I am starting a new tradition in honor of my dad, Robert Wesley Handy, PhD. We will continue this educational segment on the first Monday of each month.

Do you really know your physician or surgeon. You or a loved one may be in a hospital and the care may be provided by a "hospitalist" or "stranger doctor."

1. How much do you know about this doctor?
2. Is he or she licensed to practice medicine?
3. Does he or she have board certification?
4. Did he or she graduate from a medical school in a foreign country? Ask whether the foreign medical school is rated. That is important.
5. Was the physician raised in a foreign country?

Do not be shy about asking the physician questions about his or her background. It may mean the difference between life or death.

Check the license through your state's medical board.

Check the board certifications through the American Board of Medical Specialties


My dad was treated in August 2008 at Duke University Hospital by a physician who was a foreign medical graduate (FMG). She went to a medical school in South Africa. As a caregiver, you should understand the basic human values of the country where your physician grew up or studied medicine.

What basic values could exist in South Africa that would affect the physician's judgment and care for my elderly dad? Those from South Africa can no more put aside the values of their society than a United States resident could.

The elderly are not valued in South Africa. If your physician is a FMG from South Africa and/or raised in South Africa, you should be aware of that unfortunate fact.

Article titled "Times Have Changed for Elderly People in South Africa and so have the rules."

WE WERE shocked to read in the press of the fire that broke out at the Rusthof old-age home in Paarl on May 1, and of the three frail residents who lost their lives. In November 2007, 16 elderly residents of Kwabadala Home in Nkandla, Kwa-Zulu-Natal, were burned to death.
The Paarl fire is being investigated and no report on the Nkandla fire is available but both tragedies point to the importance of proper safeguards for the elderly.
Coincidentaily, the Regulations of the Older Persons Act of 2006 were published in the Government Gazette on April 1. Once implemented, this act wiil dramatically improve the care of older people.
However, the lack of media interest in the bill, the act and the finalisation of the regulations is of great concern, as public awareness is crucial. Few in our mostly youthful society give a thought to how old peopie are faring, except in their immediate families, whom they try to provide for
Perhaps this is not surprising, since so many old people are hidden from view in rural areas, backyards, retirement villages or homes for the aged not necessarily from choice. This lack of interest reflects the fact that the old are still seen as unproductive and a burden, even though many are care-givers of grandchildren, and volunteers.
The gestation period of some eight years between the first Older Persons Biil and the promulgation of the act must account for some of the inattention of the media. But the delay reflects the considerable consultation to ensure the fmal act met the needs of the old. This included public hearings in all provinces by the SA Human Rights Commission and a national convention in 2005 at which an interim committee was set up to form the SA Older Persons Forum, a voice for older persons to interact with the government and monitor the implementation of the act. The forum is a registered NPO and Section 21 company and provincial forums are in most provinces, including the Western Cape.
Priority must be given to preventing the sorts of disaster that occurred at Kwabadala and Rusthof Residential facilities must be required to have emergency exits and disaster plans, fire protection certificates in terms of the Occupation, Health and Safety Act 85 of 1993 and smoke detectors. And these requirements must be regularly monitored.
For many years the care of older people was regulated by the Aged Persons Act of 1967, mainly concerned with old-age homes. The 2006 Older Persons Act reflected international thinking, which has moved from institutional care towards community care. This is due to the realisation that the world's elderly population is increasing at an unprecedented rate and institutional care will soon become unaffordable even to the wealthiest nations. In South Africa, with its high Aids-related death rate, the estimated population of over-60s was 5.3 mfflion in 2009, nearly 11 percent of the total population.
The approach of the Older Persons Act goes beyond providing alternatives for the care of older people. Recognising that societies can no longer afford to see older people as a growing burden requiring more and more help, the act emphasises their participation and involvement.
This wifi require that their rights are respected, that they have better health, education, adequate income and suitable housing, so the ageing population can become a valuable and important component of society's resources. (Vienna International Plan of Action on Ageing).
While compulsory retirement is not yet seriously questioned in South Africa, the act goes a long way towards making the constitution a reality in the lives of older people.
Instead of looking upon them as recipients of grants or objects for welfare, it aims to ensure their rights are respected and protected. It also aims to facilitate accessible, equitable and affordable services.
Older persons rights are now laid down in law and all government departments and organisations will be obliged to respect such rights.
Many challenges face us in ensuring the implementation of the Older Persons Act. Despite severe budgetary constraints, service providets and operators of old-age homes, assisted living accommodation and retirement vifiages must be alerted to the norms and standards which will soon apply.
Government departments such as hea1th and the police must ensure they no longer discriminate unfairly against older people. The community too, has a responsibility: any person who suspects an older person has been abused or suffers an abuserelated injury must immediately notify the police. Failure to do so wifi be an offence. Furthermore, compudsory admission to a home against the wishes of an older person wifi now require a medical practitioner to certify that any delay in admission might result in their death or irreversible damage to their health.
Provincial budgets for services for older people and their care and protection are modest and, in the poorest provinces, paltry. The bulk of this money is stifi spent on subsidies to homes, even though these subsidies have long been frozen and are no longer are enough to cover the cost of even the most basic care.
Finally, the engagement of the press and media is crucial if the rights and welfare of older people are to be kept in the public eye.
This extract from the Vienna International Plan of Action on Ageing (August 1982), is highly pertinent to South Africa: The human race is charactensed by a long childhood and by a long old age. Throughout history this has enabled older persons to educate the younger and pass on values to them... The presence of the elderly in the family home, the neighbourhood and in all forms of social life stifi teaches an irreplaceable lesson to humanity.
Not only by his life but indeed by his death, the older person teaches us all a lesson. Turok is chairwoman of the Western Cape Older Persons Forum.

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